The effects of artificial- and stevia-based sweeteners on lipid profile in adults: a GRADE-assessed systematic review, meta-analysis, and meta-regression of randomized clinical trials.

It has been posited that Non-nutritive sweeteners (NNS) intake may affect lipid profile. However, its proven effects on lipid profile are unclear, as clinical studies on this topic have produced inconsistent results. To fill this gap in knowledge, this systematic review and meta-analysis of randomized controlled trials (RCTs) sought to evaluate the effects of artificial- and stevia-based sweeteners consumption on lipid profile markers. To identify eligible RCTs, a systematic search up to April 2021 was completed in PubMed/Medline, Scopus, and EMBASE, using relevant keywords. A random-effect model was utilized to estimate the weighted mean difference (WMD) and 95% confidence (95% CI) for TG, TC, and LDL. On the other hand, a fixed-effect model was used to estimate the WMD and 95% CI for HDL. Fourteen RCTs were included in the present meta-analysis. The pooled analysis revealed that NNS did not affect TG (WMD:-1.31, 95% CI:-5.89, 3.27 mg/dl), TC (WMD:-2.27,95% CI:-7.61,3.07 mg/dl), LDL (WMD:1,95% CI: -2.72, 4.71 mg/dl), and HDL (WMD:0.06, 95% CI:-0.62,0.73 mg/dl). Subgroup analysis showed that NNS may be related to a small, but statistically significant, increase in LDL (WMD:4.23, 95% CI:0.50,7.96 mg/dl) in subjects with normal levels of LDL (<100 mg/dl). We found that consumption of artificial- and stevia-based sweeteners is not associated with lipid profile changes in adults. This study has been registered at PROSPERO (registration number: CRD42021250025).

The Effects of Dyslipidemia in Subclinical Hypothyroidism.

Background Subclinical hypothyroidism (SCH) affects 7.5-8.5% of women and 2.8-4.4% of men globally. Usually, both hypothyroidism and hyperthyroidism are related to cardiovascular and cerebrovascular disease development. The relationship between subclinical hypothyroidism and dyslipidemia has been widely investigated, but the findings remain controversial. Recent evidence shows that serum thyroxine (T4) replacement therapy may improve lipid profiles. The objective of the present study is to assess dyslipidemia among patients with SCH in Benghazi, Libya and compare it with controls. Methods The study was conducted from August 2018 to November 2018 and included 36 patients with SCH. All the patients were around 30 years of age. We also included sex-matched healthy subjects (controls) selected from three diabetes and endocrinology clinics in Benghazi: Alhaya clinic, Alrazy clinic, and Alnukbah clinic. Clinical information and medical history were obtained through a questionnaire from all SCH patients and normal control subjects. Blood samples were collected and analyzed for thyroid-stimulating hormone (TSH), free thyroxine (FT4), total cholesterol (T-Chol), serum triglycerides (STG), low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol (HDL-C). Results Patients with SCH showed significantly higher T-Chol, STG, and LDL-C levels, as well as significantly lower levels of HDL-C in comparison to the healthy controls. No significant correlation was found between TSH and T-Chol, STG, HDL-C, and LDL-C; no significant correlation was found between FT4 and HDL-C either. However, a strong negative correlation was found between FT4 and T-Chol, STG, and LDL-C. Conclusion Our study concluded that SCH is associated with dyslipidemia. We strongly recommend biochemical screening for thyroid dysfunction for all patients with dyslipidemia.