Intimate partner violence during pregnancy in COVID-19 pandemic: a cross-sectional study from South-west of Iran.

BACKGROUND: Intimate partner violence (IPV) against pregnant women can cause several complications for the mother and her baby, which are life-threatening. Thus, we aimed to find the prevalence of IPV and its associated factors in pregnant women in Shiraz, Iran. METHODS: This cross-sectional study was conducted among pregnant mothers in Shiraz between July 2020 and January 2021. The questionnaire consisted of four parts: demographic data, socio-economic status (SES), obstetric and medical history, and questions about IPV. Univariate analysis was performed using Chi-square, McNemar, or Fisher's exact test, and variables with p-value < 0.20 were included in Logistic regression. The odds ratio and CI 95% for variables with p-value < 0.05 were considered statistically significant. RESULTS: The overall prevalence of IPV was 93.1% among 830 pregnant women in Shiraz. Psychological violence was the most prevalent type (92.9%), followed by sexual (11%) and physical (7.7%) violence. High SES (OR = 3.21, (CI:1.61-6.41)) was the only risk factor for overall violence, and the age group, 30-34, was a risk factor for physical violence. Mother-desired pregnancy (OR = 26 (Cl:0.09-0.79)) and father-desired pregnancy (OR = 0.91, (CI:0.22-3.80)) were protective factors against physical and sexual violence, respectively. Furthermore, Psychological violence and sexual violence increased during COVID-19 Pandemic (P.value < 0.05). CONCLUSION: According to the obtained results, the prevalence of IPV during pregnancy in Shiraz was very concerning, especially psychological violence. Improving conflict-solving skills among family members and addressing economic problems could be considered by health policymakers when designing interventional programs and policies to reduce IPV during pregnancy.

Adiponectin and leptin levels of patients after sleeve gastrectomy, Roux-en-Y gastric bypass, and single anastomosis sleeve ileal bypass surgeries.

Background: Bariatric surgery is an appropriate treatment for obese patients with metabolic syndrome. Adipose tissue is an active endocrine tissue secreting leptin and adiponectin that affect body metabolism. Nowadays, a high incidence of metabolic syndrome with an increased risk of serious diseases has been detected in Shiraz. This study aimed to assess the levels of leptin and adiponectin as well as the adiponectin-to-leptin ratio in three different bariatric surgeries among obese patients in Shiraz. The results will play an important role in physicians' choice of surgery by distinguishing the effects of these three bariatric surgeries. Materials and Methods: The serum adiponectin and leptin levels were measured using enzyme-linked immunosorbent assay. Blood glucose, lipid profile, weight, and liver enzyme level were measured before and 7 months after surgery. Results: This clinical trial was conducted on 81 obese patients who underwent sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and single anastomosis sleeve ileal (SASI) bypass surgeries. The results revealed a decrease in fasting blood sugar and triglyceride (TG) levels 7 months after the surgeries. In addition, decrease of body mass index (BMI) was more significantly in the SASI group (12.8 ± 3 4.95) compared to the Roux-en-Y gastric group (8.56 ± 4.61) (P = 0.026). Besides, a more significant improvement in liver function was observed in SG (P < 0.05). Furthermore, the results revealed a significant difference among the three groups regarding the increase in the adiponectin level (P = 0.039). Decrease in the leptin level and increase in the adiponectin level were more significant after the RYGB surgery compared to the SG group (P < 0.05). Conclusion: The three bariatric surgeries were effective in increasing the adiponectin level and decreasing the leptin levels. The surgeries also changed the metabolic risk factors including TGs, high-density lipoprotein, fasting blood glucose, and BMI.

Gender difference in determinant factors of being overweight among the 40-70-year-old population of Kharameh cohort study, Iran.

BACKGROUND: Iranians face being overweight as one of the most common health problems, which is more prevalent among women. This study aimed to identify gender differences in determinants of being overweight in 40- to 70-year-old participants from Kharameh, Iran. METHODS: This cross-sectional study was conducted during 2015-2016. The total 10,663 inhabitants of Kharameh, Iran, aged 40-70 years old, were target population. Those with a body mass index (BMI) < 18.5 or > 29.9 were excluded. A checklist composed of socio-demographic, lifestyle, and BMI items was used; a p-value < 0.05 was considered significant. RESULTS: Overall, 53.4% of 8222 participants were overweight. The prevalence of overweight women (62.7%) was significantly higher (p <  0.001) than men (43.6%). The logistic regression model for men showed that being overweight was more likely among men with cigarette smoking history (OR = 1.49) and those with a moderate physical activity level (OR = 1.35), but less likely among those with a higher socio-economic status (SES) (OR = 0.74). Among women, being overweight was associated with high SES (OR = 1.61), an education level below high school diploma (OR = 1.57) and primary school education (OR = 1.50), being married (OR = 2.39), widowed (OR = 2.11) and having a greater calorie intake (OR = 1.01). Being overweight was less likely among employed women (OR = 0.85), those with cigarette smoking history (OR = 0.65), and those with high (OR = 0.72) and intensive physical activity (OR = 0.73). CONCLUSIONS: This study revealed the gender differences in determining factors affecting being overweight. As being overweight was more prevalent among women, the priority of health policies to control this issue should also be focused on women.

Depression and anxiety among pregnant mothers in the initial stage of the Coronavirus Disease (COVID-19) pandemic in the southwest of Iran.

|BACKGROUND: Women are at a higher risk for depression progression, especially during pregnancy. The current study purposed to investigate depression, anxiety, and stress levels of pregnant mothers in the initial stage of the COVID-19 infection in the southwest of Iran. METHODS: This cross-sectional study was conducted during March and April, 2020, in Shiraz, Iran. Pregnant mothers registered in maternity clinics affiliated with Shiraz University of Medical Sciences were included. An online self-administered checklist was used. It included socio-demographic, obstetric and medical histories, and the short form of the Depression Anxiety Stress Scales (DASS-21) to evaluate depression, anxiety, and stress. A p-value < 0.05 was considered significant. RESULTS: In total, 540 pregnant mothers answered the questionnaire. 83.5% had no comorbidity. Abnormal depression scores were significantly higher in those who had no insurance (OR = 2.5) and in those with poor self-rated health (SRH) (OR = 27.8). Pregnant mothers with lower SRH and two or more comorbidities had a higher chance of having an abnormal level of anxiety subscale (6.9, 3.7 times, retrospectively). CONCLUSION: The results revealed that an abnormal level of depression was associated with SRH and medical insurance status. Moreover, the number of comorbidities and poor SRH significantly increased the chance of achieving abnormal anxiety levels in pregnant mothers during the COVID-19 pandemic.

Children of mothers who experience high psychological distress during pregnancy are more susceptible to cognitive and behavioral problems. Few studies have reported the psychological distress of pregnant mothers during the COVID-19 pandemic, and it may be considered as a risk factor for child developmental disorders.In total, 540 out of 920 registered pregnant mothers in maternity clinics affiliated with Shiraz University of Medical Sciences answered the online questionnaire and were included in this study. An online self-administered data gathering tool was used so that the respondents felt more secure. The data gathering tool had three main parts: socio-demographic, obstetric and medical histories, and the short form of the Depression Anxiety Stress Scales (DASS-21) which consisting of 21 questions, 7 in each subscale; depression (DASS-D), anxiety (DASS-A) and stress (DASS-S).Pregnant mothers who had two or more comorbidities or those with lower self-rated health (SRH) had a higher chance of having an abnormal anxiety level. Depression levels were higher in pregnant mothers who had no insurance. Additionally, depression symptoms were more prevalent in pregnant mothers who had low health status than in those with good or intermediated SRH.In conclusion, the COVID-19 pandemic contributes to a significant increase in depression and anxiety symptoms among pregnant mothers. Moreover, lack of insurance, poor SRH, and having comorbidities are significantly associated with increasing depressive and anxiety scores.

Neuraminidase Inhibitors and Hospital Length of Stay: A Meta-analysis of Individual Participant Data to Determine Treatment Effectiveness Among Patients Hospitalized With Nonfatal 2009 Pandemic Influenza A(H1N1) Virus Infection.

BACKGROUND: The effect of neuraminidase inhibitor (NAI) treatment on length of stay (LoS) in patients hospitalized with influenza is unclear. METHODS: We conducted a one-stage individual participant data (IPD) meta-analysis exploring the association between NAI treatment and LoS in patients hospitalized with 2009 influenza A(H1N1) virus (A[H1N1]pdm09) infection. Using mixed-effects negative binomial regression and adjusting for the propensity to receive NAI, antibiotic, and corticosteroid treatment, we calculated incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Patients with a LoS of <1 day and those who died while hospitalized were excluded. RESULTS: We analyzed data on 18 309 patients from 70 clinical centers. After adjustment, NAI treatment initiated at hospitalization was associated with a 19% reduction in the LoS among patients with clinically suspected or laboratory-confirmed influenza A(H1N1)pdm09 infection (IRR, 0.81; 95% CI, .78-.85), compared with later or no initiation of NAI treatment. Similar statistically significant associations were seen in all clinical subgroups. NAI treatment (at any time), compared with no NAI treatment, and NAI treatment initiated <2 days after symptom onset, compared with later or no initiation of NAI treatment, showed mixed patterns of association with the LoS. CONCLUSIONS: When patients hospitalized with influenza are treated with NAIs, treatment initiated on admission, regardless of time since symptom onset, is associated with a reduced LoS, compared with later or no initiation of treatment.

The effects of quercetin supplementation on lipid profiles and inflammatory markers among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized controlled trials.

Aims: This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to determine the effect of quercetin administration on lipid profiles and inflammatory markers among patients with metabolic syndrome (MetS) and related disorders.Methods: We searched systematically online databases including Cochrane Library, EMBASE, MEDLINE, and Web of Science to identify the relevant RCTs until November 2018. Q-test and I2 statistics were applied to assess heterogeneity among included studies. Data were combined using fixed- or random-effects model and presented as standardized mean difference (SMD) with 95% confidence interval (CI).Results: Out of 591 citations, 16 RCTs were included in the meta-analysis. The pooled findings showed that quercetin consumption significantly decreased total-cholesterol (SMD = -0.98; 95% CI, -1.48, -0.49; p < 0.001; I2: 94.0), LDL-cholesterol (SMD = -0.88; 95% CI, -1.35, -0.41; p < 0.001; I2: 92.7) and C-reactive protein (CRP) levels (-0.64; 95% CI, -1.03, -0.25; p = 0.001; I2: 90.2). While, quercetin supplementation did not significantly affect triglycerides (TG) (SMD = -0.32; 95% CI, -0.68, 0.04; p = 0.08; I2: 84.8), HDL-cholesterol (SMD = 0.20; 95% CI, -0.20, 0.24; p = 0.84; I2: 70.6), interleukin 6 (IL-6) (SMD = -0.69; 95% CI, -1.69, 0.31; p = 0.17; I2: 94.5) and tumor necrosis factor-alpha (TNF-α) levels (SMD = -0.06; 95% CI, -0.25, 0.14; p = 0.58; I2: 35.6)Conclusions: In summary, the current meta-analysis demonstrated that quercetin supplementation significantly reduced total-cholesterol, LDL-cholesterol, and CRP levels, yet did not affect triglycerides, HDL-cholesterol, IL-6 and TNF-α among patients with MetS and related disorders.

The effects of resveratrol intake on weight loss: a systematic review and meta-analysis of randomized controlled trials.

This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize the effect of resveratrol intake on weight loss. We searched the following databases until July 2018: MEDLINE, EMBASE, Web of Science and Cochrane Central Register of Controlled Trials. Data were pooled using the inverse variance method and expressed as standardized mean difference (SMD) with 95% confidence intervals (95% CI). Out of 831 reports, 36 RCTs were eligible for including to our meta-analysis. The pooled results, using random-effects model showed that resveratrol supplementation significantly decreased body weight (SMD = -0.17; 95% CI, -0.33, -0.01; P = 0.03; I2: 62.6), body mass index (BMI) (SMD = -0.20; 95% CI, -0.35, -0.05; P = 0.01; I2: 60.6), fat mass (SMD = -0.32; 95% CI, -0.62, -0.03; P = 0.03; I2: 77.9) and waist circumference (WC) (SMD = -0.42; 95% CI, -0.68, -0.16; P = 0.001; I2: 75.2), and significantly increased lean mass (SMD = 1.21; 95% CI, 0.75, 1.67; P < 0.001; I2: 87.6). We found no significant effect of resveratrol administration on leptin (SMD = -0.20; 95% CI, -0.68, 0.27; P = 0.40; I2: 85.3) and adiponectin levels (SMD = 0.08; 95% CI, -0.39, 0.55; P = 0.74; I2: 91.0). Resveratrol supplementation significantly decreased body weight in obese patients (SMD -0.43; 95% CI, -0.60, -0.26) compared with other diseases (SMD 0.02; 95% CI, -0.29, 0.33), and type 2 diabetes mellitus (SMD -0.17; 95% CI, -0.37, 0.02). Overall, the current meta-analysis demonstrated that resveratrol intake significantly reduced weight, BMI, WC and fat mass, and significantly increased lean mass, but did not affect leptin and adiponectin levels.

The effects of resveratrol on lipid profiles and liver enzymes in patients with metabolic syndrome and related disorders: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: There are current trials investigating the effect of resveratrol supplementation on lipid profiles and liver enzymes among patients with metabolic syndrome (MetS) and related disorders; however, their findings are controversial. This systematic review and meta-analysis were aimed to determine the effects of resveratrol supplementation on lipid profiles and liver enzymes among patients with MetS and related disorders. METHODS: We performed a comprehensive search of the following online databases up to November 2018: Cochrane Library, PubMed, Embase, and Web of Science. The relevant articles were assessed for quality of studies using the Cochrane risk of bias tool. RESULTS: Out of 2459 citations, 31 articles were appropriate for including to the current meta-analysis. The pooled results indicated that resveratrol use significantly decreased total cholesterol [weighted mean difference (WMD) = - 7.65 mg/dL; 95% CI, - 12.93, - 2.37; P < 0.01; I2: 83.4%] and increased gamma-glutamyl transferase (GGT) concentrations (WMD = 1.76 U/l; 95% CI, 0.58, 2.94; P < 0.01; I2: 20.1%). We found no significant effect of resveratrol supplementation on triglycerides (WMD = - 5.84 mg/dL; 95% CI, - 12.68, 1.00; P = 0.09; I2: 66.8%), LDL- (WMD = -2.90 mg/dL; 95% CI, - 10.88, 5.09; P = 0.47; I2: 96.0%), HDL-cholesterol (WMD = 0.49 mg/dL; 95% CI, - 0.80, 1.78; P = 0.45; I2: 74.0%), alanine aminotransferase (ALT) (WMD = -0.14 U/l; 95% CI, - 3.69, 3.41; P = 0.93; I2: 79.6%), and aspartate aminotransferase (AST) (WMD = -0.34 U/l; 95% CI, - 2.94, 2.27; P = 0.80; I2: 88.0%) concentrations. CONCLUSIONS: This meta-analysis demonstrated that resveratrol supplementation among patients with MetS and related disorders significantly reduced total cholesterol and increased GGT concentrations, but did not affect triglycerides, LDL-, HDL-cholesterol, ALT, and AST concentrations. This data suggests that resveratrol may have a potential cardio-protective effect in patients with MetS and related disorders.

Hookah Smoking: A Potentially Risk Factor for First-Ever Ischemic Stroke.

OBJECTIVE: Hookah consumption, as a common non-cigarette tobacco product, is wrongly considered as less harmful. Moreover, little is known about hookah consumption and risk of ischemic stroke. The current study aimed to assess the association between hookah consumption and first-ever ischemic stroke (FEIS). METHODS: This case-control study was performed on individuals admitted at a tertiary referral center in Shiraz, Southern Iran between October 1, 2018 and September 20, 2019. We compared FEIS patients with randomly selected stroke-free individuals as a control group. Using a multiple logistic regression analysis, we assessed the association between hookah consumption and FEIS. RESULTS: A total of 208 FEIS patients (mean age 65.2 ± 15.9 years) and 212 age and sex-matched controls (mean age 63.2 ± 14.4) were recruited. The prevalence of vascular risk factors and comorbidities including ischemic heart disease, hypertension, diabetes mellitus, dyslipidemia, atrial fibrillation, cigarette smoking, and sleep apnea was higher in patients with FEIS than their control counterparts. After adjusting for a wide range of confounders, including socioeconomic factors, hookah consumption was still an independent risk factor for FEIS (odds ratio: 3.2, 95% CI: 1.7-6.1). CONCLUSION: Hookah consumption is associated strongly with FEIS. Public awareness about risk of hookah consumption should be raised.

The effects of statin use on inflammatory markers among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized controlled trials.

Current evidence suggests that statin use decreases the incidence of cardiovascular diseases (CVD) through reducing LDL cholesterol and decreasing inflammation. Metabolic syndrome (MetS) is usually associated with increased inflammatory markers and increased risk of CVD. We conducted a systematic review and meta-analysis to determine the effect of statin use on inflammatory markers including C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-1 (IL-1) among patients with MetS and related disorders. PubMed, EMBASE, Web of Science databases, and Cochrane Library were searched for randomized controlled trials (RCTs) through April 2018. Three independent investigators evaluated study eligibilities, extracted data, and assessed study quality using the Cochrane Collaboration risk of bias tool and Jadad's quality scales. Heterogeneity was determined using Cochran's Q statistic and I-square (I2) test. Based on the heterogeneity results, we pooled data using random-effect or fixed effect models presented as standardized mean differences (SMD) and corresponding 95% confidence intervals (CI). One hundred thirteen RCTs (19,644 patients) were included in our meta-analysis. The pooled results using random effects model showed that statin use statistically significantly decreased CRP level (SMD= -0.97; 95% CI, -1.10, -0.85; P < 0.001; I2: 95.1%), TNF-α (SMD= -1.88; 95% CI, -2.40, -1.38; P < 0.001; I2: 97.2%), IL-6 (SMD= -1.67; 95% CI, -1.98, -1.34; P < 0.001; I2: 96.5%), and IL-1 concentrations (SMD= -8.35; 95% CI, -10.49, -6.22; P < 0.001; I2: 98.4%) among patients with MetS and related disorders. Our meta-analysis showed beneficial effects of statin use on reducing inflammatory markers in patients with MetS and related disorders.

The effects of ginger intake on weight loss and metabolic profiles among overweight and obese subjects: A systematic review and meta-analysis of randomized controlled trials.

This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to summarize the effect of ginger intake on weight loss, glycemic control and lipid profiles among overweight and obese subjects. We searched the following databases through November 2017: MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. The relevant data were extracted and assessed for quality of the studies according to the Cochrane risk of bias tool. Data were pooled using the inverse variance method and expressed as Standardized Mean Difference (SMD) with 95% Confidence Intervals (95% CI). Heterogeneity between studies was assessed by the Cochran Q statistic and I-squared tests (I2). Overall, 14 studies were included in the meta-analyses. Fourteen RCTs with 473 subjects were included in our meta-analysis. The results indicated that the supplementation with ginger significantly decreased body weight (BW) (SMD -0.66; 95% CI, -1.31, -0.01; P = 0.04), waist-to-hip ratio (WHR) (SMD -0.49; 95% CI, -0.82, -0.17; P = 0.003), hip ratio (HR) (SMD -0.42; 95% CI, -0.77, -0.08; P = 0.01), fasting glucose (SMD -0.68; 95% CI, -1.23, -0.05; P = 0.03) and insulin resistance index (HOMA-IR) (SMD -1.67; 95% CI, -2.86, -0.48; P = 0.006), and significantly increased HDL-cholesterol levels (SMD 0.40; 95% CI, 0.10, 0.70; P = 0.009). We found no detrimental effect of ginger on body mass index (BMI) (SMD -0.65; 95% CI, -1.36, 0.06; P = 0.074), insulin (SMD -0.54; 95% CI, -1.43, 0.35; P = 0.23), triglycerides (SMD -0.27; 95% CI, -0.71, 0.18; P = 0.24), total- (SMD -0.20; 95% CI, -0.58, 0.18; P = 0.30) and LDL-cholesterol (SMD -0.13; 95% CI, -0.51, 0.24; P = 0.48). Overall, the current meta-analysis demonstrated that ginger intake reduced BW, WHR, HR, fasting glucose and HOMA-IR, and increased HDL-cholesterol, but did not affect insulin, BMI, triglycerides, total- and LDL-cholesterol levels.

The effects of caffeine intake on weight loss: a systematic review and dos-response meta-analysis of randomized controlled trials.

This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to summarize the effect of caffeine intake on weight loss. We searched the following databases until November 2017: MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. The relevant data were extracted and assessed for quality of the studies according to the Cochrane risk of bias tool. We estimated an intake-status regression coefficient (Beta) for each primary study and estimated the overall pooled Beta and SE using random effects meta-analysis on a double-log scale. Heterogeneity between studies was assessed by the Cochran Q statistic and I-squared tests (I2). Thirteen RCTs with 606 participants were included in the meta-analyses. The overall pooled Beta for the effect of caffeine intake was 0.29 (95%CI: 0.19, 0.40; Q = 124.5, I2 = 91.2%) for weigh, 0.23 (95%CI: 0.09, 0.36; Q = 71.0, I2 = 93.0%) for BMI, and 0.36 (95% CI: 0.24, 0.48; Q = 167.36, I2 = 94.0%) for fat mass. For every doubling in caffeine intake, the mean reduction in weight, BMI, and fat mass increased 2 Beta-fold (20.29 = 1.22, 20.23 = 1.17, and 20.36 = 1.28), which corresponding to 22, 17, and 28 percent, respectively. Overall, the current meta-analysis demonstrated that caffeine intake might promote weight, BMI and body fat reduction.

Incidence Rate of Gastric Cancer Adenocarcinoma in Patients With Gastric Dysplasia: A Systematic Review and Meta-Analysis.

Several studies have reported the risk of progression to gastric adenocarcinoma (GAC) in patients with gastric dysplasia (GD); however, the findings are controversial. We performed a systematic review and meta-analysis to study the incidence rate of GAC among patients with GD. Using a comprehensive search strategy, we systematically searched online databases including PubMed, Scopus, EMBASE, Cochrane Library, and Web of Science databases for identifying all relevant original articles through inception until July 2018. Cochran Q and I tests were used to assess heterogeneities between included studies. The incidence rates of GAC and their corresponding 95% confidence intervals (CIs) were pooled using random-effect or fixed-effect models. Of the 1980 retrieved records, 30 eligible articles (61 studies) were included. The overall pooled incidence rate of GAC was 40.36 (95% CI, 27.08-55.71; I, 96.0%) cases per 1000 person-years in patients with GD. Subgroup analysis according to the type of GD indicated the highest incidence rate of GAC was 186.40 (95% CI, 106.63-285.60; I, 94.6%) per 1000 person-years among patients with high-grade dysplasia (HGD) lesions. Although the incidence rates of GAC in low-grade dysplasia (LGD) lesions and in nonclassified lesions were 11.25 (95% CI, 3.91-21.22; I, 89.3%), and 1.40 (95% CI, 0.00-9.71; I, 78.8%), respectively. Compared with patients with LGD lesions, progression rate from GD to GAC was roughly 16 times greater in patients with HGD lesions. As the majority of patients with GAC are diagnosed in an advanced stage our study suggests strict management of HGD lesions to prevent GAC.

The effects of curcumin-containing supplements on biomarkers of inflammation and oxidative stress: A systematic review and meta-analysis of randomized controlled trials.

Besides other benefits, curcumin is getting more recognized for its antioxidant and anti-inflammatory properties, highlighting the importance of curcumin application for chronic disease prevention. This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to assess the influence of curcumin-containing supplements on biomarkers of inflammation and oxidative stress. MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials were searched till January 2018 for eligible studies. The selected studies were evaluated for their quality using the Cochrane risk of bias tool and relevant data were extracted from included studies. Data were pooled using the inverse variance method and expressed as standardized mean difference (SMD) with 95% confidence intervals (95% CI). Fifteen RCTs were included in the final analysis. The meta-analysis indicated that curcumin supplementation significantly decreased interleukin 6 (IL-6) (SMD -2.08; 95% CI [-3.90, -0.25]; p = 0.02), high-sensitivity C-reactive protein (hs-CRP) (SMD -0.65; 95% CI [-1.20, -0.10], p = 0.02), and malondialdehyde (MDA) concentrations (SMD -3.14; 95% CI [-4.76, -1.53], p < 0.001). Though, curcumin supplementation had no significant effect on tumor necrosis factor-alpha (SMD -1.62; 95% CI [-3.60, 0.36]; p = 0.10) and superoxide dismutase levels (SMD 0.34; 95% CI [-1.06, 1.74], p = 0.63). Overall, this meta-analysis suggests that taking curcumin-containing supplements may exert anti-inflammatory and antioxidant properties through a significant reduction in IL-6, hs-CRP, and MDA levels.

The Effects of Folate Supplementation on Diabetes Biomarkers Among Patients with Metabolic Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Although several studies have evaluated the effect of folate supplementation on diabetes biomarkers among patients with metabolic diseases, findings are inconsistent. This review of randomized controlled trials (RCTs) was performed to summarize the evidence on the effects of folate supplementation on diabetes biomarkers among patients with metabolic diseases. Randomized-controlled trials (RCTs) published in PubMed, EMBASE, Web of Science and Cochrane Library databases up to 1 September 2017 were searched. Two review authors independently assessed study eligibility, extracted data, and evaluated risk of bias of included studies. Heterogeneity was measured with a Q-test and with I2 statistics. Data were pooled by using the fix or random-effect model based on the heterogeneity test results and expressed as standardized mean difference (SMD) with 95% confidence interval (CI). A total of sixteen randomized controlled trials involving 763 participants were included in the final analysis. The current meta-analysis showed folate supplementation among patients with metabolic diseases significantly decreased insulin (SMD -1.28; 95% CI, -1.99, -0.56) and homeostasis model assessment of insulin resistance (HOMA-IR) (SMD -1.28; 95% CI, -1.99, -0.56). However, folate supplementation did not affect fasting plasma glucose (FPG) (SMD -0.30; 95% CI, -0.63, 0.02) and hemoglobin A1C (HbA1c) (SMD -0.29; 95% CI, -0.61, 0.03). The results of this meta-analysis study demonstrated that folate supplementation may result in significant decreases in insulin levels and HOMA-IR score, but does not affect FPG and HbA1c levels among patients with metabolic diseases.

The Effects of Vitamin D Supplementation on Markers Related to Endothelial Function Among Patients with Metabolic Syndrome and Related Disorders: A Systematic Review and Meta-Analysis of Clinical Trials.

This systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted to summarize the effect of vitamin D supplementation on endothelial function among people with metabolic syndrome and related disorders. Cochrane library, Embase, PubMed, and Web of Science database were searched to identify related RCTs published up 20th May 2018. To check heterogeneity a Q-test and I2 statistics were used. Data were pooled by using the random-effect model and standardized mean difference (SMD) was considered as summary effect size. Twenty-two trials of 931 potential citations were found to be eligible for current meta-analysis. The pooled findings by using random effects model indicated that vitamin D supplementation to individuals with MetS and related disorders significantly increased flow-mediated dilatation (FMD) (SMD=1.10; 95% CI, 0.38, 1.81, p=0.003). However, it did not affect pulse-wave velocity (PWV) (SMD=0.04; 95% CI, -0.25, 0.33, p=0.80) and augmentation index (AI) (SMD=0.07; 95% CI, -0.25, 0.40; p=0.65). Overall, this meta-analysis demonstrated that vitamin D supplementation to patients with metabolic syndrome and related disorders resulted in an improvement in FMD, but did not influence PWV and AI.

The Effects of Vitamin D Supplementation on Biomarkers of Inflammation and Oxidative Stress Among Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The current systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize the effect of vitamin D supplementation on biomarkers of inflammation and oxidative stress among women with polycystic ovary syndrome (PCOS). Cochrane library, Embase, PubMed, and Web of Science database were searched to identify related randomized-controlled articles (RCTs) published up to November 2017. Two researchers assessed study eligibility, extracted data, and evaluated risk of bias of included RCTs, independently. To check heterogeneity Q-test and I2 statistics were used. Data were pooled by using the random-effect model and standardized mean difference (SMD) was considered as summary effect size. Seven RCTs were included into our meta-analysis. The findings showed that vitamin D supplementation in women with PCOS significantly decreased high-sensitivity C-reactive protein (hs-CRP) (SMD -1.03; 95% CI, -1.58, -0.49; p <0.001) and malondialdehyde (MDA) (SMD -1.64, 95% CI -2.26 to -1.02, p <0.001), and significantly increased total antioxidant capacity (TAC) levels (SMD 0.86, 95% CI 0.08 to 1.64, p=0.03). Vitamin D supplementation had no significant effect on nitric oxide (NO) (SMD 0.11, 95% CI -0.44 to 0.66, p=0.69) and total glutathione (GSH) levels (SMD 0.54, 95% CI -0.20 to 1.28, p=0.15). Overall, the current meta-analysis demonstrated that vitamin D supplementation to women with PCOS resulted in an improvement in hs-CRP, MDA and TAC, but did not affect NO and GSH levels.

The effects of coenzyme Q10 supplementation on lipid profiles among patients with coronary artery disease: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Chronic inflammation and increased oxidative stress significantly contribute in developing coronary artery disease (CAD). Hence, antioxidant supplementation might be an appropriate approach to decrease the incidence of CAD. This systematic review and meta-analysis was aimed to determine the effects of coenzyme Q10 (CoQ10) supplementation on lipid profile, as one of the major triggers for CAD, among patients diagnosed with coronary artery disease. METHODS: EMBASE, Scopus, PubMed, Cochrane Library, and Web of Science were searched for studies prior to May 20th, 2018. Cochrane Collaboration risk of bias tool was applied to assess the methodological quality of included trials. I-square and Q-tests were used to measure the existing heterogeneity across included studies. Considering heterogeneity among studies, fixed- or random-effect models were applied to pool standardized mean differences (SMD) as overall effect size. RESULTS: A total of eight trials (267 participants in the intervention group and 259 in placebo group) were included in the current meta-analysis. The findings showed that taking CoQ10 by patients with CAD significantly decreased total-cholesterol (SMD -1.07; 95% CI, - 1.94, - 0.21, P = 0.01) and increased HDL-cholesterol levels (SMD 1.30; 95% CI, 0.20, 2.41, P = 0.02). We found no significant effects of CoQ10 supplementation on LDL-cholesterol (SMD -0.37; 95% CI, - 0.87, 0.13, P = 0.14), lipoprotein (a) [Lp(a)] levels (SMD -1.12; 95% CI, - 2.84, 0.61, P = 0.20) and triglycerides levels (SMD 0.01; 95% CI, - 0.22, 0.24, P = 0.94). CONCLUSIONS: This meta-analysis demonstrated the promising effects of CoQ10 supplementation on lowering lipid levels among patients with CAD, though it did not affect triglycerides, LDL-cholesterol and Lp(a) levels.

The effects of inositol supplementation on lipid profiles among patients with metabolic diseases: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Several studies have evaluated the effect of inositol supplementation on lipid profiles among population with metabolic diseases; however, the findings are controversial. This review of randomized controlled trials (RCTs) was performed to summarize the evidence of the effects of inositol supplementation on lipid profiles among population with metabolic diseases. METHODS: Relevant RCTs studies were searched in Cochrane Library, EMBASE, MEDLINE, and Web of Science until October 2017. Two researchers assessed study eligibility, extracted data, and evaluated risk of bias of included primary studies, independently. To check for the heterogeneity among included studies Q-test and I2 statistics were used. Data were pooled by using the random-effect model and standardized mean difference (SMD) was considered as summary of the effect size. RESULTS: Overall, 14 RCTs were included into meta-analysis. Pooled results showed that inositol supplementation among patients with metabolic diseases significantly decreased triglycerides (SMD - 1.24; 95% CI, - 1.84, - 0.64; P < 0.001), total- (SMD - 1.09; 95% CI, - 1.83, - 0.55; P < 0.001), and LDL-cholesterol levels (SMD - 1.31; 95% CI, - 2.23, - 0.39; P = 0.005). There was no effect of inositol supplementation on HDL-cholesterol levels (SMD 0.20; 95% CI, - 0.27, 0.67; P = 0.40). CONCLUSIONS: Inositol supplementation may result in reduction in triglycerides, total- and LDL-cholesterol levels, but did not affect HDL-cholesterol levels among patients with metabolic diseases. Additional prospective studies regarding the effect of inositol supplementation on lipid profiles in patients with metabolic diseases are necessary.

Associated Factors of Self-Rated Mental Health Status in Southwestern Iran: Using SCAD Regression Model in a Population-Based Study.

This study aimed to investigate the association between self-rated mental health (SRMH) and current health status of an Iranian population. A cross-sectional study was conducted on 3400 individuals selected through random sampling in Shiraz, Iran between January 2014 and March 2015. Data were gathered through face-to-face interviews. Statistical analyses were performed using the SPSS 19.0, and R.3.1.2 software was used for SCAD penalized logistic regression. The mean age of the participants was 38.5 (± 14.1 years). There were significant relationships between better SRMH and younger ages (p < 0.001), and between better SRMH and better self-rated physical health (p < 0.001). Individuals with poor SRMH were more likely to have signs and symptoms of medical diseases. SRMH, a component of self-rated health, was related to a variety of health problems in our study population. Therefore, paying attention to SRMH and mental well-being could be useful in making decision about implementation of preventive measures.