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The effect of n-3 polyunsaturated fatty acid supplementation on cognitive function outcomes in the elderly depends on the baseline omega-3 index.
He, X, Yu, H, Fang, J, Qi, Z, Pei, S, Yan, B, Liu, R, Wang, Q, Szeto, IM, Liu, B, et al
Food & function. 2023;(21):9506-9517
Abstract
Both epidemiological and preclinical studies have shown the benefits of n-3 polyunsaturated fatty acid (n-3 PUFA) on dementia and cognitive impairment, yet the results of clinical randomized controlled trials (RCTs) performed to date are conflicting. The difference in the baseline omega-3 index (O3i) of subjects is a potential cause for this disparity, yet this is usually ignored. The present meta-analysis aimed to evaluate the effect of n-3 polyunsaturated fatty acid (n-3 PUFA) on cognitive function in the elderly and the role of baseline O3i. A systematic literature search was conducted in PubMed, Embase, Cochrane Library, and Web of Science up to June 27th, 2023. The mean changes in the mini-mental state examination (MMSE) score were calculated as weighted mean differences by using a fixed-effects model. Fifteen random controlled trials were included in the meta-analysis. Pooled analysis showed that n-3 PUFA supplementation did not significantly improve the MMSE score (WMD = 0.04, [-0.08, 0.16]; Z = 0.62, P = 0.53; I2 = 0.00%, P(I2) = 0.49). Out of the 15 studies included in the meta-analysis, only 7 reported O3i at baseline and outcome, so only these 7 articles were used for subgroup analysis. Subgroup analysis showed that the MMSE score was significantly improved in the higher baseline O3i subgroup (WMD = 0.553, [0.01, 1.095]; I2 = 0.00%, P(I2) = 0.556) and higher O3i increment subgroup (WMD = 0.525, [0.023, 1.026]; I2 = 0.00%, P(I2) = 0.545). The overall effect demonstrated that n-3 PUFA supplementation exerted no improvement on global cognitive function. However, a higher baseline O3i and higher O3i increment were associated with an improvement in cognitive function in the elderly.
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Effect of SGLT2 Inhibitors and Metformin on Inflammatory and Prognostic Biomarkers in Type 2 Diabetes Patients.
Cao, Y, Liang, N, Liu, T, Fang, J, Zhang, X
Endocrine, metabolic & immune disorders drug targets. 2023;(4):530-547
Abstract
OBJECTIVE To assess the combined effect of Sodium-Glucose Transporter 2 Inhibitors (SGLT2i) and metformin treatment on inflammatory and prognostic biomarkers in patients with T2DM. METHODS Using the search terms "Sodium-Glucose Transporter 2 Inhibitors," "Diabetes Mellitus, Type 2," and "randomized controlled trial," we screened the literature on PubMed, Cochrane Library, Embase, and Web of Science according to the inclusion and exclusion criteria. The studies selected were grouped to determine the combined effect of SGLT2i and metformin on inflammatory markers in patients with T2DM. Results were expressed using continuous variables, combined into weighted mean differences (WMD) and 95% confidence intervals (CI). The study was registered under the PROSPERO number CRD42022296480. RESULTS Meta-analysis showed that, compared with the control and metformin treatment groups, the SGLT2i coupled with metformin group was more effective in reducing C-reactive protein (CRP) (WMD, -0.185, 95% CI, -0.330 to -0.040, P < 0.05), tumor necrosis factor (TNF-α) (WMD, -0.628, 95% CI, -1.046 to -0.210, P < 0.05), uric acid (WMD, -0.653, 95% CI, -0.734 to -0.572, P < 0.05), leptin (WMD, -3.663, 95% CI, -4.812 to -2.515, P < 0.05), glycated hemoglobin (HbA1c) (WMD = -0.172, 95% CI, -0.255 to -0.089, P < 0.05), and estimated glomerular filtration rate (eGFR)(WMD = 0.978, 95% CI (0.027, 1.928), P = 0.044). In parallel, we performed a Trial Sequential Analysis (TSA) of and the results showed reliable conclusions. CONCLUSION SGLT2i combined with metformin reduced inflammation levels and significantly improved glycemic control and prognosis in patients with T2DM.
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Effects and safety of Ginkgo biloba on blood metabolism in type 2 diabetes mellitus: a systematic review and meta-analysis.
Zou, H, Fang, J, Han, Y, Hu, X, Meng, J, Huang, F, Xu, H, Lu, C, Wang, Y, Zhang, L, et al
Frontiers in endocrinology. 2023;:1231053
Abstract
BACKGROUND There has existed controversy regarding the use of Ginkgo biloba (GKB) for blood metabolism among type 2 diabetes mellitus(T2DM) patients, and we tried to analyze the effects and safety of GKB on T2DM patients. METHODS We conducted a literature search between January 2003 and December 2022 of seven online databases (PubMed, Scopus, Embase, Google Scholar, Web of Sciences, Cochrane Library, and China National Knowledge Infrastructure). A systematic literature review and meta-analysis were performed to compare the effects and safety of GKB among T2DM patients. Four groups of parameters were extracted and analyzed: hemorheology parameters, lipid profile, glycemic control markers, and adverse events. RESULTS In the end, 13 eligible articles with 11 indicators among 1573 patients were included. In the hemorheology parameters section, GKB showed significantly lower plasma viscosity (PV) (SMD=-0.91, 95%CI [-1.45, -0.36], P<0.01) and hematocrit (Hct) (SMD=-0.60, 95%CI [-0.97, -0.24], P<0.01) than the control group. GKB shoed higher velocity of the dorsalis pedis artery (VDPA) (SMD=0.51, 95%CI [0.26, 0.76], P<0.01) and ankle brachial index (ABI) (SMD=0.71, 95%CI [0.32, 1.10], P<0.01) than the control. In both the lipid profile and glycemic control markers sections, we did not find any difference between GKB and control groups, including total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), hemoglobin A1c (HbA1c), and fasting serum glucose (FSG). In addition, we saw no difference in adverse events (AE). The sensitivity analysis and funnel plot showed that the results in this research were robust and had no publication bias. CONCLUSION In conclusion, GKB might safely reduce the risk of peripheral arterial or even systemic cardiovascular disease. However, GKB did not directly improve lipid and blood glucose levels in T2DM patients. SYSTEMATIC REVIEW REGISTRATION https://inplasy.com/, identifier INPLASY202350096.
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Myo-inositol supplementation for the prevention of gestational diabetes: A meta-analysis of randomized controlled trials.
Li, L, Fang, J
European journal of obstetrics, gynecology, and reproductive biology. 2022;:38-43
Abstract
INTRODUCTION It is elusive to use myo-inositol supplementation to prevent gestational diabetes, and this meta-analysis aims to study the efficacy of myo-inositol supplementation for the prevention of gestational diabetes. METHODS Several databases including PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systemically searched from inception to October 2021, and we included the randomized controlled trials (RCTs) assessing the effect of myo-inositol supplementation on the incidence of gestational diabetes. RESULTS Seven eligible RCTs were included in this meta-analysis. Compared with control group in pregnant women, myo-inositol supplementation could lead to remarkably reduced incidence of gestational diabetes (OR = 0.32; 95% CI = 0.15 to 0.72; P = 0.005), reduced 2-h glucose OGTT (MD = -5.29; 95% CI = -10.24 to -0.34; P = 0.04), increased gestational age at birth (MD = 0.96; 95% CI = -1.67 to 3.87; P = 0.005) and decreased incidence of preterm delivery (OR = 0.35; 95% CI = 0.17 to 0.70; P = 0.003), but exhibited no obvious influence on birth weight (MD = -22.82; 95% CI = -121.95 to 76.32; P = 0.65). CONCLUSIONS Myo-inositol supplementation is recommended to prevent gestational diabetes with caution due to some heterogeneity.
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Effects of Probiotic Preparations on Inflammatory Cytokines in Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis.
Liu, T, Wang, X, Li, R, Zhang, ZY, Fang, J, Zhang, X
Current pharmaceutical biotechnology. 2021;(10):1338-1349
Abstract
OBJECTIVE To summarize and assess the effects of probiotic preparations on inflammatory cytokine levels in patients with Chronic Kidney Disease (CKD). METHODS We searched through the PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), and Wan Fang databases for Randomized Controlled Trials (RCTs) that report the impact of probiotic preparations on inflammatory cytokines in CKD patients. Outcomes were composed of serum levels of CReactive Protein (CRP), Interleukin 6 (IL-6), Tumor Necrosis Factor-α (TNF-α), serum urea, creatinine, uric acid, Para-Cresol Sulfate (PCS), and Indoxyl-Sulfate (IS). The Mean Differences (MDs) with 95% Confidence Intervals (CIs) were considered as effect estimates. Sensitivity analysis and Egger's linear regression test were performed to evaluate the stability of results and publication bias. This study was registered with PROSPERO number CRD42020176557. RESULTS AND DISCUSSION Sixteen studies met the inclusion criteria. Evidence showed that serum CRP levels were decreased in the intervention group (WMD, -12.29, 95% CI, -16.41 to -8.16, p = 0). The IL-6 was significantly reduced only in the prebiotic group (SMD, -0.73, 95% CI, -1.3 to -0.16, p = 0.012). However, no reduction was observed in TNF-α (SMD, -0.07, 95% CI, -0.51 to 0.38, p = 0.772). Moreover, there was no significant change in serum uremic toxin, including creatine, urea, uric acid, PCS, and IS. CONCLUSION Probiotic preparations decrease the serum levels of inflammatory cytokines in CKD patients but do not affect the serum uremic toxin levels. The results of this meta-analysis suggest essential guidance for treatment decisions in clinical practice.
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Efficacy of antifungal drugs in the treatment of oral candidiasis: A Bayesian network meta-analysis.
Fang, J, Huang, B, Ding, Z
The Journal of prosthetic dentistry. 2021;(2):257-265
Abstract
STATEMENT OF PROBLEM The comparative efficacy of antifungal drugs on oral candidiasis remains unclear. PURPOSE The purpose of this Bayesian network meta-analysis was to investigate the efficacy of antifungal drugs on oral candidiasis. MATERIAL AND METHODS Databases, including PubMed, The Cochrane Library, and Web of Science, were accessed from the dates of their establishment to October, 2018, to collect randomized controlled trials (RCTs) of different antifungal drugs for oral candidiasis. A network meta-analysis was then conducted by using R and Stata 12.0 software programs. RESULTS A total of 31 RCTs involving 4042 participants were included. The meta-analysis showed that, in the treatment of oral candidiasis in reducing the mycological cure rate, itraconazole capsules, itraconazole oral solution, miconazole buccal tablets, miconazole oral gel, clotrimazole, fluconazole, ketoconazole, nystatin, and amphotericin B were better than a placebo. Miconazole oral gel, fluconazole, and ketoconazole were better than nystatin. The network meta-analysis also showed that the effects of antifungal drugs in reducing the mycological cure rate in oral candidiasis were better than those of a placebo: itraconazole capsule (OR=1.20, 95% CrI: 1.07-1.34), itraconazole oral solution (OR=1.50, 95% CrI: 1.14-1.86), miconazole buccal tablet (OR=2.80, 95% CrI: 1.20-4.50), miconazole oral gel (OR=2.90, 95% CrI: 1.70-4.30), clotrimazole (OR=3.80, 95% CrI: 1.65-5.95), fluconazole (OR=2.40, 95% CrI: 1.10-3.80), ketoconazole (OR=3.40, 95% CrI: 1.76-7.04), nystatin (OR=2.50, 95% CrI: 1.43-3.57), and amphotericin B (OR=2.60, 95% CrI: 1.91-3.29). The SUCRA values for each antifungal drug were as follows: placebo (6.80%), itraconazole capsule (51.2%), itraconazole oral solution (75.2%), miconazole buccal tablet (34.4%), miconazole oral gel (76.9%), clotrimazole (64.8%), fluconazole (79.3%), ketoconazole (50.7%), nystatin (15.7%), and amphotericin B (44.4%). CONCLUSIONS Antifungal drugs have efficacy in the treatment of oral candidiasis. The effect of fluconazole in reducing the risk of the mycological cure rate in oral candidiasis was better than that of other drugs.
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Diagnostic Performance of Retinopathy in the Detection of Diabetic Nephropathy in Type 2 Diabetes: A Systematic Review and Meta-Analysis of 45 Studies.
Jiang, S, Yu, T, Zhang, Z, Wang, Y, Fang, J, Yang, Y, Liu, L, Li, W
Ophthalmic research. 2019;(2):68-79
Abstract
AIMS: To conduct an evidence-based evaluation of diabetic retinopathy (DR) for the diagnosis of diabetic nephropathy (DN) in type 2 diabetics with kidney disease. METHODS We systematically searched PubMed, EMBASE, and the Cochrane Library from inception to June 27, 2018, including the reference lists of identified primary studies. A study was included if it (1) used DR as a diagnostic test for DN; and (2) used histological evaluation of renal tissues as the reference standard. RESULTS The analysis included 45 studies (4,561 patients). A bivariate analysis yielded a sensitivity of 0.67 (95% CI 0.61-0.74) and a specificity of 0.78 (95% CI 0.73-0.82). The summary receiver operating characteristic curve analysis provided an area under the curve (AUC) of 0.79 (95% CI 0.76-0.83). In a setting of 41% prevalence of DN, the probability of DN would be 68% if the test of DR was positive, and the probability of DN would be 23% if it was negative. In addition, although the mean specificity of proliferative DR for the detection of DN was 0.99 (95% CI 0.45-1.00), the mean sensitivity was 0.34 (95% CI 0.24-0.44), and the AUC was 0.58 (95% CI 0.53-0.62). CONCLUSIONS DR is helpful in diagnosing DN in persons with type 2 diabetes and kidney disease, but the severity of DR may not parallel the presence of DN.
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Long-term antithrombotic treatment in intracranial hemorrhage survivors with atrial fibrillation.
Korompoki, E, Filippidis, FT, Nielsen, PB, Del Giudice, A, Lip, GYH, Kuramatsu, JB, Huttner, HB, Fang, J, Schulman, S, Martí-Fàbregas, J, et al
Neurology. 2017;(7):687-696
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Abstract
OBJECTIVE To perform a systematic review and meta-analysis of studies reporting recurrent intracranial hemorrhage (ICH) and ischemic stroke (IS) in ICH survivors with atrial fibrillation (AF) during long-term follow-up. METHODS A comprehensive literature search including MEDLINE, EMBASE, Cochrane library, clinical trials registry was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We considered studies capturing outcome events (ICH recurrence and IS) for ≥3 months and treatment exposure to vitamin K antagonists (VKAs), antiplatelet agents (APAs), or no antithrombotic medication (no-ATM). Corresponding authors provided aggregate data for IS and ICH recurrence rate between 6 weeks after the event and 1 year of follow-up for each treatment exposure. Meta-analyses of pooled rate ratios (RRs) were conducted with the inverse variance method. RESULTS Seventeen articles met inclusion criteria. Seven observational studies enrolling 2,452 patients were included in the meta-analysis. Pooled RR estimates for IS were lower for VKAs compared to APAs (RR = 0.45, 95% confidence interval [CI] 0.27-0.74, p = 0.002) and no-ATM (RR = 0.47, 95% CI 0.29-0.77, p = 0.002). Pooled RR estimates for ICH recurrence were not significantly increased across treatment groups (VKA vs APA: RR = 1.34, 95% CI 0.79-2.30, p = 0.28; VKA vs no-ATM: RR = 0.93, 95% CI 0.45-1.90, p = 0.84). CONCLUSIONS In observational studies, anticoagulation with VKA is associated with a lower rate of IS than APA or no-ATM without increasing ICH recurrence significantly. A randomized controlled trial is needed to determine the net clinical benefit of anticoagulation in ICH survivors with AF.
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Neurodevelopmental delay with critical congenital heart disease is mainly from prenatal injury not infant cardiac surgery: current evidence based on a meta-analysis of functional magnetic resonance imaging.
Li, Y, Yin, S, Fang, J, Hua, Y, Wang, C, Mu, D, Zhou, K
Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2015;(6):639-48
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Abstract
OBJECTIVE No consensus has been reached regarding whether brain injury related to congenital heart disease (CHD) is caused by infant cardiac surgery and/or prenatal injury resulting from the CHD. We performed this meta-analysis to identify the likely cause of neurodevelopmental delay in CHD patients. METHODS We carried out a literature search without language restriction in December 2013, retrieving records from PubMed, EMBASE, the Cochrane Library and the World Health Organization trials center, to identify studies applying functional magnetic resonance imaging (fMRI) evaluation of brain function before surgery and, in some cases, after surgery (both immediate term and short term postoperatively). The preoperative and postoperative fMRI results were extracted, and meta-analysis was performed using Revman 5.1.1 and STATA 11.0, according to the guidelines from the Cochrane review and MOOSE groups. RESULTS The electronic search yielded 937 citations. Full text was retrieved for 15 articles and eight articles (nine studies) were eligible for inclusion: six studies (n = 312 cases) with fMRI analysis before surgery and three (n = 36 cases) with complete perioperative fMRI analysis. The overall average diffusivity of CHD cases was significantly higher than that of controls, with a summarized standard (std) mean difference of 1.39 (95% CI, 0.70-2.08), and the fractional anisotropy was lower in CHD cases, with a summarized mean difference of -1.43 (95% CI, -1.95 to -0.91). N-acetylaspartate (NAA)/choline (Cho) for the whole brain was significantly lower in CHD cases compared with healthy ones, while lactate/Cho was significantly higher in CHD cases. Immediate term postoperatively, significant changes in NAA/creatine and NAA/Cho, relative to preoperative values, were found. However, the difference did not persist at the short-term follow-up. CONCLUSION This meta-analysis suggests that the delay in neurological development in newborns with CHD is due mainly to prenatal injury, and cardiac surgery might lead to mild brain injuries postoperatively, but fMRI shows recovery within a short period.
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Effect of Carotene and Lycopene on the Risk of Prostate Cancer: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies.
Wang, Y, Cui, R, Xiao, Y, Fang, J, Xu, Q
PloS one. 2015;(9):e0137427
Abstract
BACKGROUND Many epidemiologic studies have investigated the association between carotenoids intake and risk of Prostate cancer (PCa). However, results have been inconclusive. METHODS We conducted a systematic review and dose-response meta-analysis of dietary intake or blood concentrations of carotenoids in relation to PCa risk. We summarized the data from 34 eligible studies (10 cohort, 11 nested case-control and 13 case-control studies) and estimated summary Risk Ratios (RRs) and 95% confidence intervals (CIs) using random-effects models. RESULTS Neither dietary β-carotene intake nor its blood levels was associated with reduced PCa risk. Dietary α-carotene intake and lycopene consumption (both dietary intake and its blood levels) were all associated with reduced risk of PCa (RR for dietary α-carotene intake: 0.87, 95%CI: 0.76-0.99; RR for dietary lycopene intake: 0.86, 95%CI: 0.75-0.98; RR for blood lycopene levels: 0.81, 95%CI: 0.69-0.96). However, neither blood α-carotene levels nor blood lycopene levels could reduce the risk of advanced PCa. Dose-response analysis indicated that risk of PCa was reduced by 2% per 0.2mg/day (95%CI: 0.96-0.99) increment of dietary α-carotene intake or 3% per 1mg/day (95%CI: 0.94-0.99) increment of dietary lycopene intake. CONCLUSIONS α-carotene and lycopene, but not β-carotene, were inversely associated with the risk of PCa. However, both α-carotene and lycopene could not lower the risk of advanced PCa.