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.

WT-1, BAALC, and ERG Expressions in Iranian Patients with Acute Myeloid Leukemia Pre- and Post-chemotherapy.

Purpose: Acute myeloid leukemia (AML) is the most prevalent acute leukemia in adults. It possesses different cytogenetic and molecular features. The expression of Wilms tumor-1 (WT1), brain and acute leukemia, cytoplasmic (BAALC) and ETS-related gene (ERG) might be considered as prognostic factors in AML patients. The aim of this study was to determine the mRNA expressions of WT-1, BAALC and ERG genes in bone marrow of mononuclear cells and their effects on complete remission in the Iranian AML patients, pre- and post- chemotherapy. Methods: Forty AML patients with normal karyotype were evaluated. The mRNA gene expressions were measured with quantitative real-time PCR in bone marrow of mononuclear cells of AML patients at the baseline and after chemotherapy. The subtypes of AML and flow cytometry panel were also assessed. Complete remission (CR) after the treatment was addressed for all patients. Results: The mRNA expressions of WT-1, BAALC and ERG were significantly decreased after the treatment (p = 0.001, 0.017, 0.036). WT-1 mRNA expression was inversely correlated with CR after chemotherapy (P =0.024). There was also significant correlation between baseline expression of BAALC and CR (P =0.046). No significant correlation was observed between ERG and CR pre- and post- chemotherapy (P =0.464 and 0.781). There was also significant correlation between BAALC mRNA expression and CD34+ (P <0.001). Conclusion: The present study showed that WT-1 decreased significantly after standard chemotherapy which could have favorable effects on CR. Also, the high expression of BAALC could have a poor prognostic role in AML patients. The identification of these gene expressions can be an efficient approach in targeted therapy among AML patients.

Vitamin D supplementation has no effect on matrix metalloproteinases-2, -9, and tissue inhibitor matrix metalloproteinase-1 in subjects with metabolic syndrome: A pilot study.

The present randomized, double-blind, placebo controlled study aimed to evaluate the effect of vitamin D supplementation on matrix metalloproteinases-2, -9 (MMP-2 and MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in subjects with metabolic syndrome. Forty-six eligible subjects were randomly assigned to either vitamin D or placebo groups for 16 weeks. The participants were asked to take 50,000 IU vitamin D or matching placebo every week. Metabolic and anthropometric indices, serum MMP-2, MMP-9, TIMP-1 and high-sensitivity C-reactive protein (hsCRP) were assessed before and after intervention. Moreover, dietary intake, sun exposure and physical activity were also determined. The trial was registered at http://www.irct.ir (No. IRCT201409033140N14). Participants were 40.20 ± 4.60 y and 45.50% males. Compared to the baseline values, MMP-9 and TIMP-1 concentrations were decreased after 16 weeks in the intervention group (p = 0.03 and p = 0.04, respectively). However, the changes of MMP-2, MMP-9, TIMP-1 and hsCRP in the intervention group were not significant compared to the placebo group (p > 0.05). Furthermore, the metabolic or anthropometric indices between two study groups remained unchanged (p > 0.05). The findings of the present study demonstrated no effect of vitamin D supplementation on MMP-2, MMP-9 and TIMP-1 concentrations in subjects with metabolic syndrome. However, there is a need for more longitudinal trials to investigate the role of vitamin D on atherosclerosis and cardiovascular diseases in subjects with metabolic syndrome.

The antioxidant activity of artichoke (Cynara scolymus): A systematic review and meta-analysis of animal studies.

Current evidence has shown antioxidant activity of artichoke as a potent source of antioxidant compounds. However, it seems that the antioxidant activity of artichoke has not yet been reviewed. Therefore, the present study was designed to perform a systematic review of human studies, animal models, and in vitro systems and to conduct a meta-analysis of animal studies on the antioxidant effects of artichoke. We searched four electronic databases till April 2018 using relevant keywords. All English language articles were assessed. For animal studies, standardized mean difference was pooled using a random effects model. The included studies were evaluated for eligibility and risk of bias. Thirty-nine articles (two human, 23 animal, and 14 in vitro studies) were reviewed. The results of in vitro systems supported the antioxidant effect of artichoke, whereas limited clinical trials indicated no change or a slight improvement of antioxidant status. Finding of animal studies indicated that artichoke extract supplementation increased superoxide dismutase, catalase, glutathione, and glutathione peroxidase level in liver, as well as, decreased malondialdehyde level in liver and plasma of animals with induced disease significantly compared with comparison group. This meta-analysis provided convincing evidence for antioxidant activity of artichoke in animals.

The effects of vitamin D supplementation on proatherogenic inflammatory markers and carotid intima media thickness in subjects with metabolic syndrome: a randomized double-blind placebo-controlled clinical trial.

PURPOSE: Metabolic syndrome may predispose to cardiovascular diseases. Since, in recent studies, vitamin D is advocated for cardioprotective roles, this study was designed to investigate the effects of vitamin D supplementation on proatherogenic inflammatory markers and common carotid intima media thickness in subjects with metabolic syndrome. METHODS: This randomized double blind clinical trial was conducted in Tabriz, Iran. Eligible subjects (n = 80) with metabolic syndrome were recruited thorough advertisement and randomized to receive either vitamin D (50,000 IU/week) or matching placebo for 16 weeks. Interlukin-6, high sensitivity C-reactive protein, vascular cell adhesion molecule-1, E-selectin, and common carotid intima media thickness were measured at the beginning and end of the study. The study was registered at http://www.irct.ir (code: IRCT201409033140N14). RESULTS: Sixteen weeks supplementation with vitamin D increased median of serum 25-hydroxy vitamin D [25(OH)D] and mean calcium levels (p < 0.001) in the intervention group. There was also a significant difference in parathyroid hormone level at the end of the study (p < 0.001). Vitamin D treatment reduced IL-6 level after 16 weeks (p = 0.027). Compared to baseline, vascular cell adhesion molecule-1 and E-selectin levels decreased significantly in vitamin D treated subjects; however, there were no significant differences between two groups. No effect of vitamin D supplementation was observed in either common carotid intima media thickness or high sensitivity C-reactive protein concentrations at the end of the study (p > 0.05). CONCLUSIONS: Vitamin D supplementation improved some proatherogenic inflammatory markers in subjects with metabolic syndrome. No changes of high sensitivity C-reactive protein and carotid intima media thickness were shown after 16 weeks.

Validity, Reliability and Feasibility of the Eating Behavior Pattern Questionnaire (EBPQ) among Iranian Female Students.

BACKGROUND: The aim of this study was to assess the validity, reliability and feasibility of eating behavior pattern questionnaire (EBPQ) in female university students. METHODS: In this study, after forward-backward translation, the questionnaire was reviewed by a panel of nutritionists and a psychologist and further thirty participants for the content validity measurement. The translated and modified questionnaire was completed by 225 female students of Tabriz University in 2013. Principle axis factoring, confirmatory factor analysis and known group analysis were conducted for construct, convergent and discriminant validity. Internal consistency and test-retest reliability were assessed by Cronbach's α coefficient and intra-class correlation coefficient (ICC). Ceiling and floor effects were also performed for evaluating the feasibility of the instrument. RESULTS: By using exploratory factor analysis, nine factors were extracted. Confirmatory factor analysis confirmed the convergent validity. Cronbach 's αand ICC were ranged between 0.55 to 0.78 and 0.67 to 0.89, respectively. The significant difference for some three subscales between diabetes and healthy subjects determined the discriminant validity. No ceiling and floor effects were found. CONCLUSION: Our findings demonstrate the initial validity, reliability and feasibility of the Iranian version of EBPQ as a useful tool for eating behavior studies in young females.

Folate and homocysteine levels and their association with dietary intakes in Iranian patients infected with Helicobacter pylori: a case-control study.

The association between Helicobacter pylori (HP) infection and concentration of folate or homocysteine are still unclear. The aim of the present study was to assess the effect of  HP infection on folate and homocysteine concentrations in patients infected with HP and healthy participants. We also assessed dietary intakes of folate, vitamins B6 and B12 in two groups. In this case-control study, 44 participants with HP-infection and 46 healthy controls were studied. Participants were recruited from those referred to the central laboratory of Tabriz University of Medical Sciences. Blood samples were collected to determine serum folate and homocysteine levels. The presence of both IgG and IgA in serum was considered as HP positive. Dietary intakes were assessed in all participants by 24-hour dietary recalls by trained interviewers for three days. The mean concentration of serum folate was significantly lower in HP-positive patients than in controls (8.49 nmol/L vs. 10.95 nmol/L, respectively; P=0.01). Although the mean concentration of serum homocysteine differed between groups, statistical significance was missed (HP infected patients: 9.35 µmol/L; healthy participants: 8.96 µmol/L; P=0.064). Macro- and micronutrient intakes showed no significant difference between participants with and without HP infection. In logistic regression models, there was a negative correlation between folate concentration and HP infection even after controlling for confounding factors (OR=0.82; CI95%=0.79-0.97). In this study, authors showed that a negative association presents between HP infection and serum  folate concentrations, but the homocysteine status was not differed significantly between HP-positive and HP-negative participants.

Regular consumption of both vitamin D- and calcium- and vitamin D-fortified yogurt drink is equally accompanied by lowered blood lipoprotein (a) and elevated apoprotein A1 in subjects with type 2 diabetes: a randomized clinical trial.

OBJECTIVE: Cardiovascular disease (CVD) is the major morbidity and cause of death in diabetic subjects. Observational studies have shown the association of low vitamin D status with poor glycemic control, atherogenic lipid profile, and CVD. However, the possible link between circulating 25-hydroxycholecalciferol and apoproteins (Apo A1 and B) and the atherogenic lipoprotein (a) [Lp(a)] has not been documented to date. METHODS: Ninety subjects with type 2 diabetes (T2D) aged 30-60 years from both sexes were randomly allocated to one of the 3 groups to receive 2 bottles a day of either (1) plain doogh (PD; containing 150 mg calcium and no detectable vitamin D/250 mL); (2) vitamin D-fortified doogh (DD; containing 150 mg calcium and 500 IU vitamin D/250 mL); or (3) calcium- and vitamin D-fortified doogh (CDD; containing 250 mg calcium and 500 IU vitamin D/250 mL) for 12 weeks. Anthropometric, dietary, and laboratory assessments, including Apo A1, Apo B, and Lp(a), were done. RESULTS: Improvement of vitamin D status in DD and CDD groups, compared to PD, resulted in a significant increase in Apo A1 (mean changes 0.22 ± 0.38, 0.20 ± 0.27 and 0.01 ± 0.35 g/L, respectively, p = 0.047) and a significant decrease in serum Lp(a) (mean changes -0.08 ± 0.30, -0.08 ± 0.31, and 0.14 ± 0.25 µmol/L, respectively, p = 0.011). There was no significant difference between DD and CDD groups. Serum Apo B did not change significantly in any of the groups. CONCLUSIONS: Significant amelioration of serum Apo A1 and Lp(a) following improvement of vitamin D status in T2D subjects may have preventive implications against long-term diabetic complications, notably CVD. This trial was registered at ClinicalTrials.gov as NTC01229891.

Improvement of vitamin D status via daily intake of fortified yogurt drink either with or without extra calcium ameliorates systemic inflammatory biomarkers, including adipokines, in the subjects with type 2 diabetes.

CONTEXT: Systemic inflammation is thought to have a central role in diabetic long-term complications. OBJECTIVE: The aim of this study was to investigate the effects of vitamin D either with or without extra calcium on certain inflammatory biomarkers in the subjects with type 2 diabetes (T2D). DESIGN, SETTING, AND PARTICIPANTS: This was a double-blind, randomized, controlled trial conducted over 12 wk in 90 T2D subjects aged 30-60 yr from both sexes. INTERVENTION: Subjects were randomly allocated to one of three groups to receive two 250-ml bottles a day of plain Persian yogurt drink or doogh (PD, containing 150 mg calcium and no detectable vitamin D(3)/250 ml), vitamin D-fortified doogh (DD, containing 500 IU vitamin D(3) and 150 mg calcium/250 ml), or calcium + vitamin D(3)-fortified doogh (CDD, containing 500 IU vitamin D(3) and 250 mg calcium/250 ml). OUTCOME MEASURES: The changes in inflammatory markers were evaluated. RESULTS: Compared to the baseline values, highly sensitive C-reactive protein, IL-1ß, IL-6, fibrinogen, and retinol binding protein-4 concentrations significantly decreased in both the DD and CDD groups. Although the decrement in highly sensitive C-reactive protein and fibrinogen was more in CDD compared to DD (-4.0 ± 8.5 vs. -1.3 ± 2.8 mg/liter, and -0.40 ± 0.74 and -0.20 ± 0.52 mg/liter, respectively), the differences were not significant. There was a significant increase in serum adiponectin in both the DD and CDD groups (51.3 ± 65.3 vs. 57.1 ± 33.8 µg/liter; P < 0.05). Mean adiponectin changes in CDD were significantly higher than in PD (P = 0.021). CONCLUSIONS: Daily intake of vitamin D-fortified doogh improved inflammatory markers in T2D subjects, and extra calcium conferred additional benefit only for the antiinflammatory adipokine, i.e. adiponectin.

Is vitamin D status a determining factor for metabolic syndrome? A case-control study.

This study was undertaken to assess vitamin D status in nonmenopausal women with metabolic syndrome (MeS) and to evaluate its possible role in inflammation and other components of MeS. A case-control study was conducted during late fall and winter 2009-10. A total of 375 women with waist circumference (WC) ≥88 cm were examined to find 100 who met MeS criteria according to the National Cholesterol Education Program (NCEP)/Adult Treatment Panel (ATP) III criteria (NCEP/ATP III). Of those without MeS, 100 age- and residence area-matched women were selected as a control group. Anthropometric and laboratory evaluations were performed. Waist-to-hip ratio (WHR), body mass index (BMI), homeostatic model of insulin resistance (HOMA-IR) and body fat mass (FM) were also evaluated. Women with MeS had significantly higher BMI, waist circumference (WC) and FM but lower serum osteocalcin than controls. There was no significant difference in serum 25 hydroxyvitamin D (25[OH]D), intact parathyroid hormone (iPTH) or vitamin D status between the two groups. Serum highly sensitive C-reactive protein (hsCRP) concentration was significantly higher in the MeS group, compared to the controls (3.4 ± 3.3 vs 2.0 ± 1.9 mg/L, P < 0.001). The difference remained significant even after controlling for BMI (P = 0.011), WC (P = 0.014) and FM (P = 0.005). When comparison was made only in those subjects with insulin resistance (HOMA-IR > 2.4), hsCRP was still higher in the MeS group (n = 79) than in the control group (n = 61) (P < 0.001). When data were categorized according to vitamin D status, in the MeS group significantly higher plasma glucose concentrations were observed in subjects with vitamin D deficiency compared to those with insufficiency or sufficiency (104.0 ± 11.7, 83.0 ± 11.3 and 83.2 ± 9.9 mg/dL, respectively, P < 0.001). Interestingly, their WC or WHR did not show any significant difference. In stepwise regression analysis, 25(OH)D was the main predictor of both hsCRP and plasma glucose. Vitamin D status may, at least in part, be a determining factor of systemic inflammation and the related metabolic derangements of MeS.

Daily consumption of vitamin D- or vitamin D + calcium-fortified yogurt drink improved glycemic control in patients with type 2 diabetes: a randomized clinical trial.

BACKGROUND: Low serum concentrations of 25-hydroxyvitamin D [25(OH)D] have been associated with impaired glucose tolerance and diabetes. OBJECTIVE: This study aimed to compare the effects of daily intake of vitamin D- or vitamin D(3) + calcium-fortified yogurt drink on glycemic status in subjects with type 2 diabetes (T2D). DESIGN: Ninety diabetic subjects were randomly allocated to 3 groups to consume plain yogurt drink (PY; containing no vitamin D and 150 mg Ca/250 mL), vitamin D-fortified yogurt drink (DY; containing 500 IU vitamin D(3) and 150 mg Ca/250 mL), or vitamin D + calcium-fortified yogurt drink (DCY; containing 500 IU vitamin D(3) and 250 mg Ca/250 mL) twice per day for 12 wk. Fasting serum glucose (FSG), glycated hemoglobin (Hb A(1c)), homeostasis model assessment of insulin resistance (HOMA-IR), serum lipid profile, and percentage fat mass (FM) were assessed before (baseline) and after the intervention. RESULTS: In both the DY and DCY groups, mean serum 25(OH)D(3) improved (+32.8 ± 28.4 and +28.8 ± 16.1 nmol/L, respectively; P < 0.001 for both), but FSG [-12.9 ± 33.7 mg/dL (P = 0.015) and -9.6 ± 46.9 mg/dL (P = 0.035)], Hb A(1c) [-0.4 ± 1.2% (P < 0.001) and -0.4 ± 1.9% (P < 0.001)], HOMA-IR [-0.6 ± 1.4 (P = 0.001) and -0.6 ± 3.2 (P < 0.001)], waist circumference (-3.6 ± 2.7 and -2.9 ± 3.3; P < 0.001 for both), and body mass index [in kg/m(2); -0.9 ± 0.6 (P < 0.001) and -0.4 ± 0.7 (P = 0.005)] decreased significantly more than in the PY group. An inverse correlation was observed between changes in serum 25(OH)D(3) and FSG (r = -0.208, P = 0.049), FM (r = -0.219, P = 0.038), and HOMA-IR (r = -0.219, P = 0.005). CONCLUSION: Daily intake of a vitamin D-fortified yogurt drink, either with or without added calcium, improved glycemic status in T2D patients. This trial was registered at clinicaltrials.gov as NCT01229891.

Predictors of serum levels of high sensitivity C-reactive protein and systolic blood pressure in overweight and obese nondiabetic women in Tehran: a cross-sectional study.

OBJECTIVE: Extra fat mass is usually accompanied by metabolic as well as clinical derangements, including systemic inflammation and high blood pressure. This study aimed to evaluate the associations among anthropometric indicators, blood levels of high-sensitivity C-reactive protein (hsCRP), lipid profile, blood glucose, insulin resistance, and blood pressure and determine the actual predictors of hsCRP and blood pressure in overweight/obese nondiabetic women in Tehran. SUBJECTS AND METHODS: A total of 200 women with body mass index (BMI) of ≥25 kg/m² were enrolled in a cross-sectional study. Dietary intake and anthropometric as well as laboratory evaluations, including fasting plasma glucose (FPG), lipid profile, serum insulin, and hsCRP, were performed for all the subjects. Pearson (r) and Spearman (r(s)) correlation coefficients and multivariate linear regression analysis were used to establish a model to predict hsCRP and systolic blood pressure (SBP) variations. RESULTS: Although serum hsCRP directly correlated with levels of FPG, triglycerides (TG), total cholesterol, BMI, and waist circumference (WC), its strongest association was found with percent of body fat mass (FM) (r(s) = 0.326, p < 0.001). Also, SBP directly correlated with FPG, TG, and FM, but it was more strongly correlated with BMI (r = 0.343, p < 0.001) and WC (r(s) = 0.350, p < 0.001). No association was found between blood or anthropometric variables and dietary data. In different regression models, WC and FM were the predictors of hsCRP, but BMI was the significant predictor of SBP. CONCLUSION: Adiposity in Iranian middle-aged women can affect both inflammatory biomarkers and SBP, thus predisposing for metabolic syndrome and further morbidities. We identified FM and WC as the predictors of serum hsCRP levels and BMI as the predictor of SBP in our population.