Effect of probiotic yogurt on gestational diabetes mellitus: A systematic review and meta-analysis.

BACKGROUND AND AIMS: Gestational diabetes mellitus is one of the important complications of pregnancy and is related to many adverse events. There is evidence that probiotics can be considered a preventive and therapeutic option in gestational diabetes mellitus. In this meta-analysis, we have focused on the effect of probiotic yogurt as a natural product on gestational diabetes mellitus. METHODS: A systematic literature search was done through PUBMED/Medline, Google Scholar, Cochrane Library, and EBSCO up to December 2022. This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines for the evaluation of the effect of probiotic yogurt on gestational diabetes mellitus. RESULTS: Four manuscripts with a total of 533 participants were included in this meta-analysis. There was a statistically significant association between probiotic yogurt and reduced risk of gestational diabetes mellitus (Pooled OR 0.35; 95% CI 0.19-0.62; I2 = 0.0%). Furthermore, the mean reduction in the fasting plasma glucose was significantly higher in the probiotic yogurt groups (Hedges' g = -0.37; 95% CI -0.68 to -0.05; I2 = 0.0%). CONCLUSION: This meta-analysis suggests that probiotic yogurt lowers the risk of gestational diabetes mellitus. Also, it is related to a significant reduction in fasting plasma glucose. These findings promise that probiotic yogurt could be regarded as a safe and low-cost therapy and preventive option for gestational diabetes mellitus. However, more randomized controlled trials with different doses and more probiotic strains with varying systems of delivery are warranted.

Prevalence of Vesicoureteral Reflux in Children with Urinary Tract Infection.

Vesicoureteral reflux (VUR) is reported in 30%-50% of children affected by urinary tract infection (UTI). We aimed to investigate the frequency of VUR in children presenting with UTI and the changes in its prevalence from birth up to 18 years. This research was an observational retrospective study in the nephrology clinic of an academic tertiary hospital during 2003-2016. Patients with UTI subjected to direct cystourethrography were enrolled (908 patients, 86.23% of girls and 13.77% of boys). They were aged from 3 days to 214 months (33 ± 33.2 months). VUR was observed in 419 of 908 (46.14%) cases. High-grade VUR (VUR Grades IV-V) and VUR were significantly more prevalent in boys (P = 0.001 for both). Only 9.2% of the VUR subjects were diagnosed after 5 years of age. The patients with VUR developed UTI at a significantly younger age compared with those without VUR (P = 0.0001). Abnormal kidney ultrasound results were significantly more common in patients with VUR than in those without VUR (P = 0.0001). The prevalence of VUR in the 1st, 2nd, 3rd, 4th, and 5th years of life was estimated to be 56.64%, 48.2%, 49.46%, 35.8%, and 45.07%, respectively. The highest and lowest VUR prevalence was 56.64% (1st year of life) and 0% (13-18 years). In addition, severe VUR was not an uncommon finding, and affected 10.7% of the total population. The results indicated a decrease in the prevalence of VUR with increased age when considering the five main age subgroups of childhood.

Diagnostic Values of Kidney Ultrasonography for Vesicoureteral Reflux (VUR) and High Grade VUR.

INTRODUCTION: Vesicoureteral reflux (VUR) is a well-known risk factor for urinary tract infection (UTI). We aim to define diagnostic values of kidney ultrasonography (US) as a predictor of VUR and high grades VUR in children presented by UTI. METHODS: This retrospective study was conducted during October 2003 to 2016. Children aged ≤ 18 years with history of UTI who had underwent kidney US and direct cystography [voiding cystourethrography (VCUG) or radionuclide cystography (RNC)] enrolled in the study. Diagnostic values of hydronephrosis, hydro ureter, renal scaring, hydroureteronephrosis, decreased kidney size and abnormal kidney US for diagnosis of VUR and high grades VUR (grades IV-V) were evaluated. RESULTS: Hydro-ureter, renal scaring, and hydroureteronephrosis were significantly more prevalent in VUR+ versus VUR- cases, also in higher grades compared with lower grades (grades I-III) VUR (P < .05 for all). Additionally, hydronephrosis was more common in VUR+ compared with VUR- patients (P < .0001). As a predictor of VUR and higher grades of VUR, abnormal kidney US had the highest sensitivity (24.87% and 40.84%, respectively), abnormal kidney US and hydro ureter reached the highest NPV (70.42% and 81.27%, respectively), hydroureteronephrosis and hydro ureter showed the highest accuracy (68.51% and 82.21%, respectively) . CONCLUSION: Kidney US is a valuable screening test, abnormal renal US significantly increases the probability of VUR and high grades VUR , but if used as the only screening test , about 2/3 and 1/3 and 20% of VUR , high grades VUR and grade V VURs will be missed. DOI: 10.52547/ijkd.5966.

The role of vitamin D in prevention of type 2 diabetes. A meta-analysis.

BACKGROUND AND AIMS: Recently, there are evidences that have shown vitamin D homeostasis has an impact in the development of type 2 diabetes. However, still it is unclear if vitamin D supplementation reduces the risk of overt diabetes. This meta-analysis of cross-sectional studies and RCTs was conducted to evaluate the role of vitamin D in prevention of type 2 diabetes and to elucidate this controversial topic. METHODS: A systematic search for English-language literature was done via PUBMED/Medline and Google Scholar up to March 2020. Based on a fixed and random effects model, the OR, HR and 95% CI were used to evaluate the combined risk. This study followed Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) Guidelines. RESULTS: After eligibility assessment 10 studies with a total of 34,882 participants were included in meta-analysis. Meta-analysis of cross-sectional studies suggested that there was a statistically significant association between the vitamin D and type 2 Diabetes; the pooled OR (95%CI) was 1.77 [1.51, 2.07] (P < 0.001). Meta-analysis of RCTs have shown that there was no statistically significant association between vitamin D supplementation and prevention of type 2 Diabetes, the pooled HR (95%CI) was 0.89 [0.77, 1.02] (P = 0.08). CONCLUSION: In conclusion, this meta-analysis suggests that there is association between the vitamin D and type 2 diabetes. However, the result of RCTs suggests emphasis of future studies for genetic factors such as polymorphic variants of the VDR gene as one factor in this complex process.

Vitamin D, the gut microbiome and inflammatory bowel disease.

Vitamin D has an important role in bone metabolism but recently has been recognized as an immunoregulator, and this has led to investigations on the effect of Vitamin D supplementation in various autoimmune diseases and its anti-inflammatory effects. There is some evidence that Vitamin D can regulate gastrointestinal inflammation. In addition, previous studies have shown that Vitamin D can affect the gut microbiome. The aim of this review is to evaluate the effect of Vitamin D on inflammatory processes, especially its relation to the inflammatory bowel disease (IBD) and gut microbiome. There is some evidence that Vitamin D can regulate gastrointestinal inflammation, with epidemiological studies showing that individuals with higher serum Vitamin D have a lower incidence of IBD, particularly Crohn's disease. Vitamin D changes transcription of cathelicidin and DEFB4 (defensin, beta 4) that can affect the gut microbiome. Several cell types of the immune system express Vitamin D receptor, and hence the use of Vitamin D in immune regulation has some potential. Furthermore, Vitamin D deficiency leads to dysbiosis of gut microbiome and reported to cause severe colitis. Vitamin D supplementation is low cost and available and can be a therapeutic option.