Decreased plasma n6 : n3 polyunsaturated fatty acids ratio interacting with high C-peptide promotes non-alcoholic fatty liver disease in type 2 diabetes patients.

AIMS/INTRODUCTION: To explore relationships between polyunsaturated fatty acids (PUFA) and non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes, and whether insulin action has an interactive effect with PUFA on NAFLD progression. MATERIALS AND METHODS: We extracted clinical and omics data of 482 type 2 diabetes patients from a tertiary hospital consecutively from April 2018 to April 2019. NAFLD was estimated by ultrasound at admission. Plasma fasting n3 and n6 fatty acids were quantified by liquid chromatography-tandem mass spectrometry analysis. Restricted cubic spline nested in binary logistic regression was used to select the cut-off point, and estimate odds ratios and 95% confidence intervals. Additive interactions of the n6 : n3 ratio with insulin action for NAFLD were estimated using relative excess risk due to interaction, attributable proportion due to interaction and synergy index. Relative excess risk due to interaction >0, attributable proportion due to interaction >0 or synergy index >1 indicates biological interaction. Spearman correlation analysis was used to obtain partial correlation coefficients between PUFA and hallmarks of NAFLD. RESULTS: Of 482 patients, 313 were with and 169 were without NAFLD. N3 ≥800 and n6 PUFA ≥8,100 µmol/L were independently associated with increased NAFLD risk; n6 : n3 ratio ≤10 was associated with NAFLD (odds ratio 1.80, 95% confidence interval 1.20-2.71), and the effect size was amplified by high C-peptide (odds ratio 8.89, 95% confidence interval 4.48-17.7) with significant interaction. The additive interaction of the n6 : n3 ratio and fasting insulin was not significant. CONCLUSION: Decreased n6 : n3 ratio was associated with increased NAFLD risk in type 2 diabetes patients, and the effect was only significant and amplified when there was the co-presence of high C-peptide.

The Effect of Lactobacillus Consumption on Human Blood Pressure: a Systematic Review and Meta-Analysis of Randomized Controlled Trials.

OBJECTIVES: Previous clinical studies have shown controversial results regarding the effect of Lactobacillus supplementation on blood pressure (BP). The purpose of this systematic review and meta-analysis is to examine the effect of Lactobacillus consumption on BP. METHODS: Eligible randomized controlled trials (RCTs) were searched from five electronic databases until May 2020. In total, 18 studies were included in our meta-analysis. Quality of the selected studies was assessed, and a random-effects model was used to calculate the overall effect sizes of weighted mean differences (WMD). This systematic review was registered in PROSPERO with the number: CRD42019139294. RESULTS: Lactobacillus consumption significantly reduced systolic blood pressure (SBP) by -2.74 mmHg (95% confidence interval, -4.96 to -0.51) and diastolic blood pressure (DBP) by -1.50 mmHg (95% confidence interval, -2.44 to -0.56) when comparing with the control group. Subgroup analysis showed that type 2 diabetes mellitus (T2DM) patients, Asian individuals, or borderline hypertension participants were more sensitive to daily consumption of Lactobacillus. And the effect of Lactobacillus on BP-reduction was more significant in capsule form, with the dose was above 5 × 109 colony-forming unit (CFU)/day or lasted for more than 8 weeks. CONCLUSIONS: Our present study suggests that Lactobacillus consumption in capsule form when the daily dose is above 5 × 109 CFU for more than 8 weeks can decrease SBP or DBP in T2DM patients, borderline hypertension participants or Asian individuals.

Protective effect of gonadotropin-releasing hormone agonist against chemotherapy-induced ovarian dysfunction: A meta-analysis.

The protective effects of gonadotropin-releasing hormone agonist (GnRHa) against ovarian chemotherapy induced-toxicity have not completely been demonstrated and the impact of chemotherapy on ovarian dysfunction remains unclear. The present meta-analysis aimed to evaluate the efficiency of GnRHa and to determine whether GnRHa could influence the long-term survival rate of patients with cancer. A total of 12 clinical randomized controlled trials were included, consisting of 1,413 patients who were divided into the GnRHa group (n=705) and the control group (n=708). The meta-analysis revealed that GnRHa may significantly improve the menstrual function recovery rate in patients who received chemotherapy [RR=1.29, 95% confidence interval (CI)=1.09-1.54, P=0.004] and reduce the rate of premature ovarian failure (RR=0.47, 95% CI=0.31-0.71, P=0.0004). However, it had no effect on the pregnancy rate (RR=1.40, 95% CI=0.98-1.98, P=0.06), on the rate of disease-free survival and overall survival of patients (disease-free survival rate: RR=1.04, 95% CI=0.95-1.13, P=0.40; overall survival rate: RR=1.02, 95% CI=0.90-1.16, P=0.72). In conclusion, GnRHa may reduce chemotherapy-induced ovarian dysfunction without compromising or influencing the therapeutic effects of chemotherapy.

Meta-analysis of the use of amniotic membrane to prevent recurrence of intrauterine adhesion after hysteroscopic adhesiolysis.

BACKGROUND: Various adjuvant therapies have failed to improve clinical symptoms and pregnancy rates among patients with moderate-to-severe intrauterine adhesion. OBJECTIVES: To evaluate the ability of amniotic membrane to prevent the recurrence of intrauterine adhesion after hysteroscopic adhesiolysis. SEARCH STRATEGY: The Cochrane Library, Embase, and PubMed databases were searched for articles published before December 31, 2017, using the terms: ("amnion") and ("intrauterine adhesions" or "Asherman syndrome" or "IUA" or "endometrial injury" or "uterine adhesion" or "hysteroscopic" or "hysteroscopic adhesiolysis"). SELECTION CRITERIA: Randomized controlled trials of amniotic membrane therapy after hysteroscopic adhesiolysis. DATA COLLECTION AND ANALYSIS: Four studies were included in the meta-analysis (300 patients in total). Dichotomous outcomes were expressed as relative risk (RR) with 95% confidence intervals (CIs). Continuous variables were expressed as mean difference. MAIN RESULTS: Amniotic membrane increased menstrual blood volume after hysteroscopic adhesiolysis (mean difference 6.15, 95% CI 4.20-8.11; P<0.001). By contrast, this treatment did not affect the rates of intrauterine adhesion recurrence (RR 0.84, 95% CI 0.61-1.16; P=0.290); pregnancy (RR 1.40, 95% CI 0.78-2.50; P=0.260); or spontaneous abortion (RR 0.88, 95% CI 0.38-1.99; P=0.750). CONCLUSIONS: The use of amniotic membrane increased menstrual blood volume but failed to improve other measures assessed in the current meta-analysis.