Effect of Orlistat on anthropometrics and metabolic indices in children and adolescents: a systematic review and meta-analysis.

BACKGROUND: Childhood obesity is one of the main concerns of public health. Considering its long-term adverse health effect, various studies investigated the effect of drug therapy on anthropometric parameters and provided mixed results. In this systematic review and meta-analysis, we aimed to determine the effect of Orlistat on anthropometrics and biochemical parameters in children and adolescents. MATERIALS AND METHODS: The databases of PubMed, Scopus, and Web of Science were searched until September 2022. Experimental and semi-experimental studies were included if they evaluated the effect of Orlistat on obesity-related parameters in children and reported the before and after anthropometric values. A revised Cochrane risk-of-bias (Rob2) was used to evaluate the methodological quality. STATA software version 16.0 was used for the meta-analysis of the random-effect model. RESULTS: Of 810 articles retrieved in the initial search, four experimental and two semi-experimental studies were selected for systematic review. The result of the meta-analysis of experimental studies indicated the significant effect of Orlistat on waist circumference (SMD: -0.27, 95% CI: -0.47, -0.07) and serum insulin level (SMD: -0.89, 95% CI: -1.52, 0.26). However, there were no significant effects of orlistat on body weight, body mass index, lipid profile, and serum glucose level. CONCLUSION: The present meta-analysis showed the significant effect of Orlistat on the reduction of waist circumference and insulin level in overweight and obese adolescents. However, due to the paucity of studies included in the meta-analysis, more prospective studies with longer duration and more sample sizes will be needed in this age group.

Comparing the detection rate of postpartum diabetes in early and 4-12 week postpartum screening tests in women with gestational diabetes mellitus: A systematic review and meta-analysis.

Gestational Diabetes Mellitus (GDM) is one of the critical risk factors for diabetes mellitus (DM). An early postpartum test done in the first few postpartum days can increase the screening rate in women with GDM. Therefore, this systematic review and meta-analysis aimed to combine and analyze data from different studies reporting the detection rate of postpartum diabetes in early and 4-12 week postpartum screening tests in women with GDM. ProQuest, Web of Science, EMBASE, PubMed, Cochrane, and Scopus were searched for English articles from January 1985 to January 2021. Two independent reviewers selected the eligible studies, and the outcomes of interest were extracted. The quality of studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for diagnostic test accuracy studies. Sensitivity and specificity, negative likelihood ratio (NLR), and positive likelihood ratio (PLR) were calculated for the early postpartum oral glucose tolerance test (OGTT). Of 1944 initially identified articles, four studies were included. The sensitivity and specificity of the early test were 74% and 56%, respectively, and the PLR and NLR were calculated as 1.7 and 0.4, respectively. The sensitivity of the early test was higher than the specificity. Based on this sensitivity and specificity, normal cases could be distinguished from abnormal cases, including diabetes and glucose intolerance. Early postpartum OGTT can be advised before hospital discharge. Early testing is a practical option in patients with GDM. Further studies are required to evaluate the early test detection rate for DM and glucose intolerance separately.

Circulating chemerin level and the risk of nonalcoholic fatty liver disease: a systematic review and meta-analysis.

Purpose: Chemerin is participating in inflammation procedure and it has role in developing metabolic diseases. In the term of nonalcoholic fatty liver disease (NAFLD), the result of published studies are conflicting. So, in this study, the results of different studies investigating the relationship between chemerin level and NAFLD were summarized. Method: The databases of PubMed, Scopus, Web of Science, and Embase were systematically searched until October 2022. The inclusion criteria were as follow: measured the mean chemerin level in adults and children with NAFLD and compared it with non-NAFLD population or reported the association between chemerin level and NAFLD. The methodological quality was assessed by the Joanna Briggs Institute (JBI) tool. The meta-analysis was done by STATA software. The pooled results were stated as the standardized mean difference (SMD) and odds ratio (OR) with 95% confidence interval (CI). Results: Sixteen studies were included in the systematic review, of which 13 studies remained for meta-analysis. The mean serum chemerin level was not significantly different between the groups [SMD: 0.52, 95% CI: -0.35, 1.39]. Moreover, there was no significant correlation between the chemerin level and NAFLD [OR: 1.01, 95% CI: 1, 1.02]. Besides, subgroup analysis indicated a significant correlation between serum chemerin level and NAFLD in children [OR: 1.02, 95% CI: 1.01, 1.03]. Conclusion: There were no significant differences in chemerin levels between the NAFLD and healthy adults; however, the association was significant in children. However, due to the lack of studies in this age group, the conclusion should be made with caution. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01187-4.

The impact of sound stimulations during pregnancy on fetal learning: a systematic review.

BACKGROUND: The developing nervous system in utero is exposed to various stimuli with effects that may be carried forward to the neonatal period. This study aims to investigate the effects of sound stimulation (music and speech) on fetal memory and learning, which was assessed later in neonatal period. METHODS: The MEDLINE (pubmed), Scopus, EMBASE, and Cochrane Library were searched. Two reviewers selected the studies and extracted the data independently. The quality of eligible studies was assessed using The Joanna Briggs Institute Critical Appraisal Checklist for Randomized Controlled Trials (RCTs). RESULTS: Overall 3930 articles were retrieved and eight studies met the inclusion criteria. All of the included studies had good general quality; however, high risk of selection and detection bias was detected in most of them. Fetal learning was examined through neonatal electrocardiography (ECG), electroencephalography (EEG), habituation tests, and behavioral responses. Seven studies showed that the infants had learned the fetal sound stimulus and one study indicated that the prenatally stimulated infants performed significantly better on a neonatal behavior test. There was considerable diversity among studies in terms of sound stimulation type, characteristics (intensity and frequency), and duration, as well as outcome assessment methods. CONCLUSIONS: Prenatal sound stimulation including music and speech can form stimulus-specific memory traces during fetal period and effect neonatal neural system. Further studies with precisely designed methodologies that follow safety recommendations, are needed.

Akkermansia muciniphila: from its critical role in human health to strategies for promoting its abundance in human gut microbiome.

Akkermansia muciniphila, a frequent colonizer in the gut mucous layer of individuals, has constantly been recognized as a promising candidate for the next generation of probiotics due to its biological advantages from in vitro and in vivo investigations. This manuscript comprehensively reviewed the features of A. muciniphila in terms of its function in host physiology and frequently utilized nutrition using the published peer-reviewed articles, which should present valuable and critical information to scientists, engineers, and even the general population. A. muciniphila is an important bacterium that shows host physiology. However, its physiological advantages in several clinical settings also have excellent potential to become a probiotic. Consequently, it can be stated that there is a coherent and direct relation between the biological activities of the gut microbiota, intestinal dysbiosis/eubiosis, and the population of A. muciniphila in the gut milieu, which is influenced by various genetical and nutritional factors. Current regulatory barriers, the need for large-scale clinical trials, and the feasibility of production must be removed before A muciniphila can be extensively used as a next-generation probiotic.

Prevalence of Asthma in East Azerbaijan Adult Population and Its Determinants Factors: A Cross-Sectional Study from the Northwest of Iran.

Background: Asthma is one of the most common chronic respiratory diseases. It is estimated that more than 400 million people will suffer from it by 2025. This study aims to determine the prevalence of asthma in East Azerbaijan and investigate the association between asthma and some environmental and demographic factors. Materials and Methods: This is a cross-sectional study based on a major Lifestyle Promotion Project (LPP) conducted in the districts of East Azerbaijan, including 2641 participants aged 15 to 65 years of the general population selected through probability proportional to size (PPS) multistage stratified cluster sampling. We used the World Health Survey questionnaire about doctor-diagnosed asthma to determine the prevalence of asthma. Age, smoking status, physical activity level, socioeconomic variables such as job and education level, and body mass index (BMI) were used as covariates in regression models. A questionnaire was used to obtain socio-demographic information and smoking status. The short form of the International Physical Activity Questionnaire was used to estimate the level of physical activity (IPAQ). Results: The mean age of participants was 40.9 ± 12.05 years including 1242 (47 %) males and 1399 (53 %) females. The prevalence of asthma was 3.3 %. The frequency of smokers was significantly higher in the asthmatic group compared with the non-asthmatic group (OR=2.33 [1.76-3.31]; p=0.03). There was no significant association between asthma and other demographic and lifestyle characteristics. Obesity has also played a significant role in the development of asthma. Conclusion: According to the results of this study, obesity and smoking have played a significant role in the development of asthma but there is no statistically significant relationship between socioeconomic and demographic factors.

Prevalence of metabolic syndrome in East Azerbaijan-Iran and its determinants factors.

Introduction: Metabolic syndrome (MetS) is a prevalent metabolic disorder with increasing prevalence attributed to extended life expectancy. This study aims to investigate MetS prevalence and its determinants in the East-Azerbaijan population. Methods: Conducted as a cross-sectional study within the East Azerbaijan region, this research is based on a major Lifestyle Promotion Project. The study encompasses 700 participants aged 15 to 65 years, representing the general population and selected using probability proportional to size multistage stratified cluster sampling. MetS diagnoses were conducted using the adult Panel III criteria. Data on socio-demographics, smoking status, and physical activity levels were collected through questionnaires. Results: Among participants, the mean age was 42.4±12.38 years, and the mean body mass index was 27.69±4.94 kg/m2. The MetS group exhibited higher mean age and body mass index compared to the non-MetS group (P<0.001). The prevalence of MetS in the population was 34.2%, with higher rates in females (37.1%) compared to males (30.5%), though this difference wasn't statistically significant (P=0.11). Notably, a substantial distinction was observed between the two groups regarding education levels (P<0.001). Conclusion: The study reveals a significant association between increasing age and higher prevalence of MetS. Furthermore, lower educational levels were linked to an elevated prevalence of MetS. While other socio-demographic factors didn't demonstrate statistically significant relationships, these findings emphasize the importance of targeted interventions and education in mitigating MetS risks.

Systematic review and meta-analysis of the effect of garlic in patients with non-alcoholic fatty liver disease.

BACKGROUND: We aimed to conduct a systematic review and meta-analyses to examine the therapeutic effect of garlic on non-alcoholic fatty liver disease (NAFLD). METHODS: We searched PubMed, Scopus, Web of Science, and Embase databases for retrieving articles investigating the impact of garlic on NAFLD patients. The comprehensive meta-analysis software version 2.0 was used for statistical analysis. The standardized mean difference with a 95% confidence interval (CI) was reported and the effect size was calculated. RESULTS: A preliminary search yielded a total of 293 articles. After screening articles based on inclusion criteria, four articles were included in the final analyses. This systematic review included 186 patients with NAFLD. The result of the meta-analysis showed significant differences between the garlic and placebo groups regarding changes in alanine aminotransferase, aspartate aminotransferase, total cholesterol, low-density lipoprotein-cholesterol, triglyceride, and fasting blood sugar. Moreover, the probability of a decrease in hepatic steatosis was 2.75 times lower in the garlic group compared with the placebo group (RR [95% CI]: 2.75 [1.79, 4.23], p-value<0.001). CONCLUSION: This meta-analysis demonstrates that garlic supplementation had a positive effect on hepatic steatosis, liver enzyme levels, and metabolic profile of patients with NAFLD. However, considering the potential limitation of the included studies, more high-quality clinical trials are needed.

Effect of salt reduction interventions in lowering blood pressure: A comprehensive systematic review and meta-analysis of controlled clinical trials.

BACKGROUND: Excessive salt intake results in hypertension (HTN), which is a major risk factor for cardiovascular disease (CVD). This review and meta-analysis aimed to evaluate the effect of salt reduction interventions on systolic blood pressure (SBP) and diastolic blood pressure (DBP). METHODS: Studies were identified via systematic searches of the databases, including PubMed, Embase, Scopus, and Web of Science. All the studies examining the effectiveness of salt reduction interventions on blood pressure (BP), regardless of age, sex, and HTN status, were included in the systematic review, and eligible studies were used in the meta-analysis. A random-effect model was applied for quantitative data synthesis. RESULTS: A total of 50 trials extracted from 40 articles (21 trials on nutrition education,10 on self-help materials,17 on salt substitutes, and 2 on food reformulation) were included in the systematic review. The pooled results of 44 eligible trials showed that salt substitution and nutrition education interventions had significant effects on both SBP (WMD: -7.44 mmHg, P<0.001 and WMD: -2.75 mmHg, P<0.001, respectively), and DBP (WMD: -3.77 mmHg, P<0.001 and WMD: -2.11 mmHg, P<0.001, respectively). Furthermore, using self-help materials led to a significant reduction in SBP among subjects aged 25-60 years (WMD: -2.60 mmHg, P = 0.008); it also decreased both SBP and DBP among those who were hypertensive (WMD: -3.87 mmHg, P = 0.003 and WMD: -2.91 mmHg, P<0.001, respectively). CONCLUSION: Our results supported that salt substitution and nutrition education are effective nutrition strategies to lower BP. It seems that multi-component approaches could be more effective in improving BP status. However, further trials are required.

Prioritizing population-based nutrition-related interventions to prevent and control hypertension in Iran: a multi-criteria decision-making approach.

BACKGROUND: Numerous nutrition-related policy options and strategies have been proposed to tackle hypertension and other risk factors of non-communicable diseases (NCDs). In this study, we developed a comparative analysis using a multi-criteria decision-making (MCDM) model for prioritizing population-based nutrition-related interventions to prevent and control hypertension in Iran. METHODS: We employed a combination of Delphi technique and Analytic Hierarchy Process (AHP) method as the methodological tool to prioritize decision alternatives using multiple criteria. The prominent assessment criteria and intervention strategies were derived using a literature review, focus group discussion (n = 11), and a 2-round modified Delphi technique with specialists and experts involved in different stages of health policy-making (round 1: n = 50, round 2: n = 46). Then, the AHP was used to determine the weightage of the selected interventions and develop the decision-making model. The sensitivity analysis was performed to test the stability of the priority ranking. RESULTS: Nine alternative interventions were included in the final ranking based on eight assessment criteria. According to the results, the most priority interventions to prevent and control hypertension included reformulation of food products to contain less salt and changing the target levels of salt in foods and meals, providing low-sodium salt substitutes, and reducing salt intake through the implementation of front-of-package labeling (FOPL). The results of the sensitivity analysis and a comparison analysis suggested that the assessment model performed in this study had an appropriate level of robustness in selecting the best option among the proposed alternatives. CONCLUSION: MCDM techniques offer a potentially valuable approach to rationally structuring the problem, along with the opportunity to make explicit the judgments used as part of the decision-making model. The findings of this study provide a preliminary evidence base to guide future decisions and reforms aiming to improve appropriate population-based interventions for tackling hypertension and other risk factors of NCDs.

The Effect of an Earthquake Experienced During Pregnancy on Maternal Health and Birth Outcomes.

OBJECTIVE: Maternal health in pregnancy and birth outcomes were compared between pre- and post-Varzaghan earthquake. METHODS: In this retrospective descriptive study, before and after the earthquake, 550 and 450 women were enrolled respectively. Neonatal weight, height, and head circumference, as well as maternal weight gain and hemoglobin (Hb) levels were obtained using medical records at health centers. Chi-square test and Independent t-test were used to analyze differences in pregnancy outcomes. A P-value less than 0.05 was considered significant. RESULTS: A significant increase in inadequate gestational weight gain (44.1% vs 58.9%) was observed (P = 0.043) before and after the earthquake. The mean hemoglobin level in the first trimester before the earthquake was significantly higher than after the earthquake (P = 0.001). Before-after earthquake comparisons showed that the mean birth weight, birth height, and birth head circumference were decreased significantly (P < 0.05). In addition, the rates of preterm birth (18.91% vs 10.90%), abortion (17.11% vs 10.54%), and stillbirth (3.78% vs 1.82%) were increased significantly after the earthquake (P < 0.05). CONCLUSIONS: Earthquake causes inadequate gestational weight gain and decreased hemoglobin levels, which lead to adverse birth outcomes. More longitudinal and well-designed studies are desired to investigate the longitudinal consequences of disasters on susceptible groups.

Effect of Beverage Consumption Frequency on DMFT Index among Iranian Adult Population: An AZAR Cohort Study.

Background: Given the effect of oral and dental condition on emotional and physical health and the different effects of beverage consumption on decayed, missing, and filled teeth (DMFT) as one of the indicators of oral health in different populations, this study aimed to investigate the effect of beverage consumption and its frequency on DMFT among Iranian adult population. Materials and Methods: The data of this cross-sectional study were obtained from AZAR (Azerbaijan) cohort, conducted on 15,006 adults aged 35 to 70 years old in Shabestar County, Iran. Demographic and nutritional data were collected by nutritionists through the "Food Frequency Questionnaire," and DMFT index by general practitioners trained by a dentist according to the World Health Organization (WHO) guidelines. Beverages including milk, doogh, natural fruit juice, black tea, nonalcoholic beer, coffee, sugar-sweetened beverages, and artificial fruit juice were studied. Results: A total of 14,966 adults with the mean age of 49.64 ± 9.28 were enrolled. The participants' mean DMFT value was 21.27 ± 8.95. Weekly consumption of tea and coffee beverages resulted in 13% (95% confidence interval: 3% to 22%) lower DMFT compared to daily consumption (p=0.01). However, there was no association between DMFT and other beverages. Conclusion: The higher DMFT values with the daily consumption of tea and coffee beverages showed that a part of adults' oral health is affected by beverages; therefore, this should be considered by healthcare authorities in order to manage carries development in the communities.

Sugar-sweetened beverages intake and the risk of obesity in children: An updated systematic review and dose-response meta-analysis.

BACKGROUND: The prevalence of childhood obesity has increased worldwide and has reached alarming proportions. Contradictive results from studies and reviews have fuelled an endless debate on the role of SSBs in the development of childhood obesity. OBJECTIVE: This study aimed to assess the impact of sugar-sweetened beverages (SSBs) intake on body mass index (BMI), body fat percentage (BFP), and waist circumference (WC) among children. METHODS: Databases including PubMed/MEDLINE, Scopus, Cochrane Library, EMBASE, and Web of Science were searched up to August 2021. Observational studies reporting the relation between SSBs intake and BMI, BFP, and WC were included. STATA version 15 was used to analyse the data. RESULTS: In this meta-analysis, 33 studies with 121 282 subjects were included. Excessive SSBs intake was associated with 0.75 kg/m2 increase in BMI in children and adolescents (WMD: 0.75; CI 0.35-1.15; p < 0.001). In addition, high SSBs intake was significantly associated with higher WC (WMD: 2.35 cm; 95% CI, 1.34, 3.37; p = 0.016) and BFP (WMD: 2.81; CI 2.21-3.41; p < 0.001). No departure from linearity was detected in dose-response meta-analysis between SSBs consumption and changes in BMI, WC, and BFP. CONCLUSION: High SSBs consumption was associated with increased BMI, WC, and BFP among children and adolescents. Further large prospective long-term interventions are recommended to confirm the observed relationships.

Nutrient pattern analysis of mineral based, simple sugar based, and fat based diets and risk of metabolic syndrome: a comparative nutrient panel.

BACKGROUND: Although there is growing evidence on the association between nutrient patterns and metabolic risk factors, very little is known about the relationship between nutrient patterns and metabolic syndrome (MetS). The aim of this study was to examine the associations of nutrient patterns with MetS among apparently healthy obese adults living in Tabriz, Iran. METHODS: Three hundred and forty-seven apparently healthy obese (BMI ≥ 30 kg/m2) adults aged 20-50 years were included in this cross-sectional study. Dietary intake of 38 nutrients was assessed by a validated semi-quantitative food frequency questionnaire (FFQ) of 132 food items. Nutrient patterns were determined using factor analysis. The MetS was defined based on the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (ATP III). RESULTS: Three major nutrient patterns were extracted: "Mineral based pattern", "Simple sugar based pattern" and "Fat based pattern". There was no significant association between nutrient patterns and MetS, in the crude model even after adjusting for confounders. There was a significant difference between quartiles in the mineral based pattern for free mass (FFM), diastolic blood pressure (DBP), large Waist circumference (WC) and Waist-to-hip ratio (WHR). In the simple sugar based pattern, we observed a significant association for SBP, DBP, and triglyceride (TG) levels. In addition, the fat based pattern was positively associated with BMI, and weight. CONCLUSIONS: We did not observe any significant association of nutrient patterns with the risk of MetS amongst the apparently healthy obese adult's population. Whereas we confirmed the deleterious effect of the simple sugar and fat based patterns on several metabolic risk factors, our findings also showed that the mineral based pattern is related to healthier metabolic factors in an Iranian population. These results should be approved by future studies to recognize any causal relationship between adherence to specific nutrient patterns and MetS.

Comparison of dietary acid load score between celiac patients and healthy population.

BACKGROUND AND AIMS: In the present study, we assessed the dietary acid load in adult celiac patients and compared it with that of the healthy population to provide more specific dietary recommendations for celiac patients. METHODS: This study was a cross-sectional study that included 130 celiac patients and 462 Non-celiac participants. The 80-item semi-quantitative food frequency questionnaire was used to obtain dietary data. Based on the dietary data, the dietary acid load (DAL), Potential renal net acid load (PRAL), and net endogenous acid production (NEAP) were calculated. RESULTS: The mean PRAL value is negative in the celiac group but positive in the general population. There was a significant difference in the PRAL score between celiac patients and the general population (p < 0.001). The mean NEAP and DAL score were significantly lower in the celiac group compared with the healthy population (P < 0.001). There were no significant differences between gluten-free diet adherents and non-adherents regarding the PRAL, NEAP, and DAL values (P > 0.05). CONCLUSION: We showed that the patients with celiac disease had a significantly less acidogenic diet compared with that of the general population. So, following dies low in gluten may be associated with less acid production spacially in populations at risk of acid/base imbalance.

Effect of Endothelial Adhesion Molecules on Atrial Fibrillation: A Systematic Review and Meta-analysis.

Background: Endothelial adhesion molecules (EAMs), and more specifically vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1), belong to a family of immunoglobulin-like molecules and are found to have increased expression in inflamed microvessels. Due to the growing evidence regarding EAM effects on cardiovascular diseases, we aimed to investigate the link between EAMs and atrial fibrillation (AF) to discover the efficacy of EAMs assessment as predictive markers in high-risk patients. Methods: We searched for articles published from January 1990 to April 2022. Two independent researchers selected studies that examined the relationship between VCAM-1 and ICAM-1 levels and AF. Study design, patient characteristics, VCAM-1 and ICAM-1 levels, and measurement methods were extracted from the selected articles. Results: Of 181 records, 22 studies were finally included in the systematic review. Meta-analyses showed a significant difference in serum levels of EAMs in patients with AF compared with patients with sinus rhythms (VCAM-1: mean difference [MD] 86.782, 95% CI 22.805-150.758, p=0.008; ICAM-1: MD 28.439 ng/mL, 95% CI 12.540-44.338, p<0.001). In subgroup analysis of persistent AF, the differences were still significant (VCAM-1: MD 98.046, 95% CI 26.582-169.510, p=0.007; ICAM-1: MD 25.091, 95% CI 12.952-37.230, p<0.001). We also found the mean ranges of VCAM-1 (95% CI 661.394-927.984 ng/mL) and ICAM-1 (95% CI 190.101-318.169 ng/mL) in patients with AF. Conclusion: This study suggests a positive association between serum levels of VCAM-1 and ICAM-1 with AF, but there is a need for further large-scale studies.

Evaluating the effect of nipple stimulation during labour on labour progression in term pregnant women.

This study aimed to assess the effect of nipple stimulation during labour on duration of latent and active phases of labour in the term pregnant women. Pregnant women (222) were divided into two groups of nipple stimulation and control. Duration of latent and active phases of labour, the number of women treated with oxytocin, rate of caesarean section (C-section) and foetal outcomes were compared. The median of the latent phase duration of labour in the intervention and control groups was 3.2 (1.3-6.3) and 4.8 (0.8-3.0) h, respectively (p = .008); however, the median of active phase duration was 2.3 (1.4-3.0) in the intervention group and 2.5 (2.0-3.3) in control group, which was not significantly different (p = .249). Additionally, the number of women treated with oxytocin in nipple stimulation group was significantly (p = .001) less than the control group. More studies are needed to evaluate optimum frequency and duration of nipple stimulation during labour.IMPACT STATEMENTWhat is already known on this subject? In limited studies, nipple stimulation is considered as a low-complication method for stimulating labour at onset.What do the results of this study add? Nipple stimulation can be applied during labour for accelerating latent phase and reducing oxytocin infusion.What are the implications of these findings for clinical practice and/or further research? Nipple stimulation can be applied as a non-pharmacological and non-invasive method allowing patient to control her own labour progression more effectively.

Determinants of health-related quality of life in patients with celiac disease: a structural equation modeling.

BACKGROUND: We aimed to investigate the determinants of Health-related quality of life (HRQOL) in Iranian patients with celiac disease (CD) using the structural equation modeling (SEM). METHODS: In the present cross-sectional study, a total of 170 adult patients with CD were recruited. The information regarding adherence to diet, symptom severity, and HRQOL were collected using the celiac disease adherence test (CDAT), gastrointestinal symptom rating scale (GSRS), and SF-36 questionnaire respectively. Association between various studied variables and HRQOL was assessed using SEM. The standardized regression weights were used to assess total, direct and indirect effects. The model fit indices were used to assess the "goodness of fit" between the hypothesized models. RESULTS: The mean age of participants was 37.57 ± 9.59 years. The results of SEM indicated that the overall fit of our model was acceptable. Adherence to the diet, GSRS score, occupation, and education level was significantly related to PCS of SF-36; and adherence to the diet, GSRS score, and education level were significantly correlated with MCS of SF-36. The analysis of indirect associations indicated that only adherence to diet indirectly via GSRS score was significantly associated with PCS and MCS of SF-36. CONCLUSION: In adult patients with celiac disease, HRQOL was associated with age, education, adherence to GFD, and GSRS score. Additionally, occupation and disease duration were associated with HRQOL only in women and men respectively.

The interaction effect of aerobic exercise and vitamin D supplementation on inflammatory factors, anti-inflammatory proteins, and lung function in male smokers: a randomized controlled trial.

BACKGROUND: This study aimed to investigate the interaction effect of aerobic exercise and vitamin D supplementation on inflammation (TNF-α, IL-6, CC16, SP-D, and CC16/SP-D ratio) and lung function (FEV1, FVC, and FEV1/FVC ratio) in male smokers. METHODS: After applying inclusion criteria, a total of 40 healthy male smokers were recruited in this study. The participants were randomly divided into four groups as follows: Aerobic Exercise + vitamin D Supplementation (AE + VitD, n = 10), Aerobic Exercise (AE, n = 10), vitamin D Supplementation (VitD, n = 10), and Control (C, n = 10). The participants in the AE + VitD and AE groups performed aerobic exercise training (running) up to 50% of the maximum heart rate, three times a week for four weeks. Participants in AE + VitD and VitD groups received 6000 IU/w vitamin D3 for four weeks. The participants in control group did not receive any intervention. Serum tumor necrosis factor (TNF)-α, interleukin (IL)-6, Clara cell protein (CC16), surfactant protein (SP)-D, CC16/SP-D ratio, and lung function (FEV1, FVC, and FEV1/FVC ratio) were measured before and after four weeks of intervention. RESULTS: Serum levels of TNF-α, IL-6, and CC16 decreased significantly in AE + VitD, VitD, and AE groups after four weeks (P < 0.05). Serum SP-D level decreased significantly only in the AE + VitD group (P = 0.011). In addition, FEV1 and FVC increased significantly (P < 0.05) in AE + VitD and AE groups after four weeks of intervention. However, the interventions did not have a significant effect on CC16/SP-D ratio and FEV1/FVC ratio (P > 0.05). Furthermore, serum levels of 1,25-dihydroxyvitamin D increased significantly in AE + VitD and VitD groups (P < 0.05) after four weeks of intervention. However, except for TNF-α, between-group comparisons showed no significant differences in levels of IL-6, CC16, SP-D, CC16/SP-D ratio, FEV1, FVC, FEV1/FVC, and 1,25-dihydroxyvitamin D (P > 0.05). CONCLUSIONS: The results of present study were that aerobic exercise combined with vitamin D supplementation can reduce serum inflammatory factors and anti-inflammatory proteins and improve lung function after four weeks of intervention. Further trials with larger sample size and longer duration are suggested to confirm these results. Trial registration Retrospectively registered. IRCT20180513039637N4. Registration date: 2020/10/20. URL: https://www.irct.ir/search/result?query=IRCT20180513039637N4.

The relationship between preoperative serum vitamin D deficiency and postoperative atrial fibrillation: A systematic review and meta-analysis.

Postoperative atrial fibrillation (POAF) is the most common arrhythmia seen in the first days following cardiac surgeries. Recently, there is a growing discussion regarding the link between vitamin D deficiency and POAF development. This systematic review and meta-analysis of the observational studies aimed at evaluating the association between preoperative vitamin D deficiency and Postoperative atrial fibrillation. In this study, using PubMed, Scopus, Google Scholar, EMBASE, Web of Science, and Cochrane Libraries, we searched for records published before July 2020. Two reviewers screened for studies that examined the relationship between preoperative vitamin D levels and the generation of POAF. Data regarding study design, patient characteristics, definition of atrial fibrillation (AF), type of surgery, vitamin D levels, and measurement methods were extracted. Five studies were included in the meta-analysis. Our primary analysis showed a significant relationship between preoperative levels of vitamin D and POAF development (mean differences (MD) = -2.851, 95% confidence interval (CI) =-5.506 to -0.195; P value 0.035). Our meta-analysis suggested serum vitamin D deficiency is associated with an increased risk of POAF development. Further large scale interventional studies are needed to explore whether vitamin D supplementation will prevent POAF.