Effect of ginger (Zingiber officinale) intake on human serum lipid profile: Systematic review and meta-analysis.

Dyslipidemia is associated with an increased risk of cardiovascular events. Effect of ginger supplementation on lipid profile in humans remains controversial particularly in diabetic patients. A systematic search was performed covering PubMed, Medline, and Scopus, Web of Science (ISI), and Google scholar from January 2010 to January 2022. Inclusion criteria were randomized controlled clinical trials (RCT) study design, at least one of lipid profile components triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C) measured before and after ginger consumption. For quantitative data synthesis, a random-effects model was applied. Pooled data showed that ginger intake reduced TC (SMD -0.44; 95% CI: -0.86, -0.02; p = 0.025) and TG (SMD -0.61; 95% CI: -1.14, -0.08; p = 0.024) levels significantly, but it has no significant effect on improving HDL-C (SMD 0.40; 95% CI: -0.01, 0.80; p = 0.057) and LDL-C (SMD -0.34; 95% CI: -0.81, 0.13; p = 0.153). Ginger supplementation decreased TG in obese and diabetic subjects more efficiently. In terms of ginger dose, the result of meta-regression found to be significant only for TC, so that increasing daily doses of ginger reduces TC levels by (ß: -0.67; 95% CI: -1.28, -0.07; p = 0.028). Therefore, ginger could be considered as an effective lipid lowering nutraceuticals.

Meta-analysis and health risk assessment of toxic heavy metals in muscles of commercial fishes in Caspian Sea.

Heavy metals from contaminated seafood can have serious consequences for human health. Several studies on the amount of heavy metals in Caspian Sea fish have been conducted to ensure their food safety. This meta-analysis aimed to investigate the levels of five toxic heavy metals; Lead (Pb), Cadmium (Cd), Mercury (Hg), Chromium (Cr), and Arsenic (As) in muscles of commercial fishes of the Caspian Sea with assessing their health risk of developing oral cancer in terms of fish collection place and fish type. A systematic search was performed, and the random effect model was applied for meta-analysis. Finally, 14 studies with 30 different sets of results were included. Our results showed that the pooled estimates for Pb, Cd, Hg, Cr, and As were 0.65 mg/kg (0.52, 0.79), 0.08 mg/kg (0.07, 0.10), 0.11 mg/kg (0.07, 0.15), 1.77 mg/kg (1.26, 2.27), and 0.10 mg/kg (- 0.06, 0.26) respectively. The levels of Pb and Cd were higher than their (FAO/WHO) maximum limits. The Estimated Daily Intake (EDI) of Pb and Cd in Mazandaran, and Hg in Gilan were more than Total Daily Intake (TDI) limits. The consumers' non-carcinogenic risk (THQ) for Hg in Mazandaran and Gilan, and As in Gilan, was unsafe. Carcinogenic risk (CR) for Cr and Cd in all three provinces, and for As in Mazandaran and Gilan, was greater than 1*10 - 4 and was unsafe. The lowest and highest risk levels of oral cancer were for Rutilus kutum and Cyprinus carpio respectively.

Effect of fenugreek consumption on serum lipid profile: A systematic review and meta-analysis.

Various studies have shown that Trigonella foenum-graecum (fenugreek) supplementation has lipid-lowering activity. This meta-analysis was performed to evaluate the effect of fenugreek supplementation on human serum lipid profile. Data sources were PubMed, EMBASE, Scopus, and Coherence library which were searched systematically from January 2000 up to December 2019. Inclusion criteria were randomized clinical trial (RCT) study design, at least one of lipid profile components (triglyceride [TG], total cholesterol [TC], low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol) levels measured before fenugreek use and one of the lipid components level reported as result. The pooled weighted mean difference (MD) and its 95% confidence interval (CI) were calculated and pooled using a random-effect model. Only articles published in English were considered. Fifteen RCTs involving 281 cases consumed fenugreek and 255 control cases in controlled group (11 articles) and 136 cases in uncontrolled group (4 articles) were analyzed in our study. Pooled data of indicated a significant impact of fenugreek supplementation on lowering TC (-1.13 [-1.88, -0.37]; p = .003), low-density lipoprotein (LDL) (-1.26 [-2.09, -0.43]; p = .003), and TG (-1.07 [-1.82, -0.33]; p = 0.005) and increasing the high-density lipoprotein (HDL) level (0.70 [0.07, 1.34]; p = .03) compared with the control group. There were no significant differences in TC, TG, and LDL between pre- and post-fenugreek studies in the noncontrolled studies however, the result of combination of four studies without control group showed a significant increase in mean HDL (0.81 [0.33,1.29]; p-value = .001). The results of subgroup analysis showed that the fenugreek reduced the TG and LDL and increases HDL levels in diabetic subjects more effectively. Fenugreek supplementation significantly improved lipid profile (LDL, TG, TC, and HDL). It could be considered as an effective lipid-lowering medicinal plant. Further high-quality studies are needed to firmly establish the clinical efficacy of the plant.

Inclusion of Pediococcus acidilactici as probiotic candidate in diets for beluga (Huso huso) modifies biochemical parameters and improves immune functions.

Administration of probiotic candidates in fish has generally been shown as a useful strategy to improve growth performance, survival, digestive enzyme activity, and gut microbiota. Unfortunately, the sero-immunological responses of different fish to different probiotic candidates are poorly understood. The present study assessed the effect of Pediococcus acidilactici as a probiotic on the biochemical and immunological parameters of beluga. Fish (248.32 ± 10.21 g) were fed a control diet (without P. acidilactici( and three different doses of P. acidilactici-supplemented diets (107, 108, and 109 CFUg-1 diets) for 8 weeks. On week 8, blood and serum were sampled. Dose-dependent increase of immunological parameters (respiratory burst activity, lysozyme content, serum antibacterial activity, and total immunoglobulin) and biochemical parameters (total protein and albumin levels) was observed. However, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were significantly increased in the juvenile beluga fed by 109 CFUg-1 P. acidilactici-supplemented diet compared to the other groups. Based on the results of this evaluation, it is reasonable to conclude that the inclusion of P. acidilactici as probiotic in diets for juvenile beluga improves the sero-immunological parameters of the fish and should be considered by farmers as a strategy to improve fish health.

Identification of Toxoplasma gondii in-vivo induced antigens by cDNA library immunoscreening with chronic toxoplasmosis sera.

Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii. Chronically-infected individuals with a compromised immune system are at risk for reactivation of the disease. In-vivo induced antigen technology (IVIAT) is a promising method for the identification of antigens expressed in-vivo. The aim of the present study was to apply IVIAT to identify antigens which are expressed in-vivo during T. gondii infection using sera from individuals with chronic toxoplasmosis. Forty serum samples were pooled, pre-adsorped against three different preparations of antigens, from each in-vitro grown T. gondii and Escherichia coli XLBlue MRF', and then used to screen a T. gondii cDNA expression library. Sequencing of DNA inserts from positive clones showed eight open reading frames with high homology to T. gondii genes. Expression analysis using quantitative real-time PCR showed that SAG1-related sequence 3 (SRS3) and two hypothetical genes were up-regulated in-vivo relative to their expression levels in-vitro. These three proteins also showed high sensitivity and specificity when tested with individual serum samples. Five other proteins namely M16 domain peptidase, microneme protein, elongation factor 1-alpha, pre-mRNA-splicing factor and small nuclear ribonucleoprotein F had lower RNA expression in-vivo as compared to in-vitro. SRS3 and the two hypothetical proteins warrant further investigation into their roles in the pathogenesis of toxoplasmosis.

Identification and real-time expression analysis of selected Toxoplasma gondii in-vivo induced antigens recognized by IgG and IgM in sera of acute toxoplasmosis patients.

BACKGROUND: Toxoplasma gondii is an obligate intracellular zoonotic parasite of the phylum Apicomplexa which infects a wide range of warm-blooded animals, including humans. In this study in-vivo induced antigens of this parasite was investigated using in-vivo induced antigen technology (IVIAT) and pooled sera from patients with serological evidence of acute infection. METHODS: The pooled sera was first pre-absorbed against three different preparations of antigens from in-vitro-grown cells of each T. gondii and E. coli XL1-Blue MRF', subsequently it was used to screen T. gondii cDNA phage expression library. Positive clones from each group were subjected to quantitative real-time PCR expression analysis on mRNA of in-vivo and in-vitro grown parasites. RESULTS: A total of 29 reactive clones from each IgM and IgG immunoscreenings were found to have high homology to T. gondii genes. Quantitative real-time PCR expression analysis showed that 20 IgM-detected genes and 11 IgG-detected genes were up-regulated in-vivo relative to their expression levels in-vitro. These included genes encoding micronemes, sterol-regulatory element binding protein site, SRS34A, MIC2-associated protein M2AP, nucleoredoxin, protein phosphatase 2C and several hypothetical proteins. A hypothetical protein (GenBank accession no. 7899266) detected by IgG had the highest in-vivo over in-vitro fold change of 499.86; while another up-regulated hypothetical protein (GenBank accession no. 7898829) recognized by IgM showed high sensitivity (90%) and moderate specificity (70%) in detecting T. gondii antibodies when tested with 20 individual serum samples. CONCLUSION: The highly up-regulated genes and the corresponding proteins, in particular the hypothetical proteins, may be useful in further studies on understanding the disease pathogenesis and as potential vaccine candidates.

Comorbidities with Familial Hypercholesterolemia (FH): A Systematic Review.

Familial hypercholesterolemia (FH) is linked to high levels of low-density lipoprotein cholesterol (LDL-C), atherosclerotic, and aortic stenosis to a lesser extent. We looked at the incidence of prevalent comorbid disorders other than cardiovascular disease (CVD), such as diabetes, chronic kidney disease (CKD), hypertension, and cancer in heterozygous FH (HeFH) patients. PubMed, Web of Science, and Google Scholar were searched systematically for studies reporting comorbidities in FH patients. Finally, 23 studies were included after excluding duplicates, papers with unrelated titles, reviews, abstracts, and papers with not sufficient data. Results showed that among the comorbidities that have been studied; FH patients had a greater prevalence of CKD. In terms of diabetes, the data are inconsistent, with some research indicating a higher prevalence of diabetes in FH patients and mostly indicating the opposite. Polymorphism study showed that hypertension has been linked to FH; however, the prevalence of the hypertensive subjects varies among FH groups. In comparison to the general population, cancer was found to have a lower or similar prevalence in FH patients. More research is needed in this area due to the variability of the results of the relationship between diabetes and FH and the small number of studies on cancer. In conclusion only CKD can be considered as an important and prevalent comorbidity in FH population after CVDs.

Effect of Oat (Avena sativa L.) Consumption on Lipid Profile With Focus on Triglycerides and High-density Lipoprotein Cholesterol (HDL-C): An Updated Systematic Review.

Hypercholesterolemia is a significant risk factor for heart disease. The soluble fiber in oat (Avena sativa L.), beta-glucan has been shown to significantly lower serum total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels but not triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) according to previous studies, reviews, and meta-analyses. However, the effect of oat consumption on the TG and HDL-C is controversial and has not been expanded enough. We did this review study to find out about the effect of oat on lipid profile especially TG and HDL-C more specifically and meticulously with their details. After searching PubMed, Web of Science, and Google scholar we included 17 studies in our review. Our results similar to other reviews showed that oat reduced the TC, VLDL, and LDL-C more significantly than TG. Of 17 included studies 6 studies reported reduction of TG level, and only 1 study reported HDL-C improvement followed by oat consumption. A more detailed review of studies that reported positive effects of oat/ beta-glucan consumption on TG showed that in healthy people with normal lipid profile oat intake might reduce TG effectively and also in overweight people/those with diabetes or metabolic syndrome if a higher amount of oat or/and longer duration applied. Consuming oat in conjunction with calorie-reducing diets or using it with DHA can cause a significant TG reduction. It may be concluded that, in addition to lowering TC and LDL-C, a considerable improvement in TG or HDL-C can be accomplished by adjusting factors such as oat consumption dose or consumption duration or utilizing oat in conjunction with a proper diet program. To conclude, more research on this topic is required.

The Effect of Eight Weeks of Aquatic Exercises on Muscle Strength in Children with Cerebral Palsy: A Case Study.

Background: Cerebral palsy in children is considered a non-progressive brain injury due to abnormal brain development. The aim of this study was to investigate the effect of eight weeks of aquatic exercises on muscle strength in children with cerebral palsy. Materials and Methods: This study was performed on three boys with cerebral palsy with a mean age of 6.5 years. In this research, a single case study method with A1-B-A2 design has been used. After determining the position of the baseline, the intervention began and during 24 sessions of individual intervention, aquatic exercises were presented to the subjects and all three subjects were followed up for 2 consecutive weeks and one month after the end of the intervention. The strength of the flexor muscles of the arms and legs was measured by a power track dynamometer made by JTECK with a threshold of 4.4 N. Results: Based on the indicators of descriptive statistics and visual analysis, the intervention was effective for all three participants in muscle strength, and the strength of individuals after the intervention has improved compared to the baseline stage (percentage). Information overlap for the first and second participant in the strength of right thigh flexors was 75% and for the third participant was 100%. The strength of the upper and lower torso muscles improved after the end of the training compared to the basic stage. Conclusion: Aquatic exercises can increase the strength of children with cerebral palsy and provide a favorable environment for children with cerebral palsy.

Cardiovascular and Bleeding Events of Ticagrelor Monotherapy after Short-term Dual Antiplatelet Therapy (DAPT) in Diabetics and Non-Diabetics Patients Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis.

INTRODUCTION: Ticagrelor monotherapy after short-term (1-3 months) dual antiplatelet therapy (DAPT) with aspirin and ticagrelor can reduce bleeding without increasing ischemic events after percutaneous coronary intervention (PCI). However, its effect in diabetic and non-diabetic individuals has not been evaluated as a meta-analysis so far. METHOD: This systematic review and meta-analysis were conducted covering PubMed, ISI Web of Science, and Scopus without date restrictions for English published clinical trials. The authors searched the mentioned databases, wherein the screening led to 151 studies, of which 40 were assessed for eligibility, and finally, three studies were included. These trials compared ticagrelor monotherapy after a short duration of aspirin plus ticagrelor with conventional 12 months DAPT. RESULTS: The results showed that the risk of major bleeding (based on Bleeding Academic Research Consortium (BARC) type 3 or 5) for ticagrelor monotherapy subjects was lower in both diabetics and non-diabetics. It was especially significant in non-diabetic patients (HR 95%CI: 0.79(0.64, 0.98); p=0.029). In cardiovascular events assessment, the pooled estimate on cardiac deaths was significantly lower in diabetic subjects treated by ticagrelor monotherapy (HR 95%CI: 0.71(0.51, 1); p=0.05), while this reduction was not significant for non-diabetics (p=0.843) in comparison to patients treated by 12 months DAPT. However, there was no significant decrease or rise in myocardial infarction (MI) and ischemic stroke in patients treated by short-term DAPT strategy. CONCLUSION: In conclusion, discontinuing aspirin after short-duration DAPT could minimize the incidence of cardiac death and BARC type 3 or 5 bleeding in diabetic and non-diabetic patients who underwent PCI, with no increase in MI and ischemic stroke.

Viewpoints on the Role of Transient Receptor Potential Melastatin Channels in Cardiovascular System and Disease: A Systematic Review.

Transient receptor potential (TRP) family play critical roles in cardiovascular system. TRPM family as largest TRP subfamily is non-voltage Ca2+-activated selective channels which has 8 members. This study aimed to discuss the role of TRPM family in cardiovascular system and diseases. Systematic search was performed covering PubMed, ISI Web of Science, and Google Scholar from inception until June 2021 using related keywords and Mesh terms for English studies with human, animal and in-vitro subjects. Finally 10 studies were selected for data extraction. Reviewing the articles showed that TRPM2, TRPM4, TRPM5, TRPM6 and TRPM7 play important roles in cardiovascular system and diseases. TRPM2 could be activated by reactive oxygen species (ROS) and effects on cardiac injury and cardiac fibrosis. TRPM7 and TRPM6 also have been reported to be associated with cardiac fibrosis and atrial fibrosis development respectively. TRPM4 channels contributed to resting membrane potential of cerebral artery smooth muscle cells and atrial contraction. TRPM5 channels are bitter taste sensors and prevent high salt intake and consequently high blood pressure due to the high salt intake. In conclusion based on the proof of the effectiveness of some members of TRPM family in the cardiovascular system, research on other members of this channel group seems to be useful and necessary to find their possible connection to the cardiovascular system.

Effect of Different Types of Aerobic Exercise on Individuals With and Without Hypertension: An Updated Systematic Review.

High blood pressure (BP) is one of the main modifiable risk factors for cardiovascular disease (CVD) and preventing it greatly reduces the vascular consequences of aging and, along with intensive treatment of hypertension, eliminates a large portion of the burden of CVD-related mortality. Many meta-analyses and studies proved that regular aerobic exercise (AE) reduces BP but most of these studies consider only hypertensive populations or only AE but not resistant exercise or their combination. In this review, we aimed to study the effect of different types of physical activity (PA)/AE on various populations including normotensive, prehypertensive, primary hypertensive, and resistant hypertensive with different comorbidities. We searched PubMed, Web of Science, and Google Scholar for English articles with keywords for physical activity, aerobic exercise, and blood pressure from January 2010 until September 2021. Finally, 24 studies were included. Results showed that chronic or acute AE (long-term or short-term), either alone or as combined with different sessions and programs can reduce systolic and diastolic BP in every group including normotensive, prehypertensive, primary hypertensive, resistant hypertensive individuals and diabetic patients and those with kidney problems but not in people with chronic heart failure. Isometric exercise training showed to be useful in reducing BP in all groups either as low intensity or as high intensity but the rate of reduction was different in terms of gender. AE showed to be effective in terms of BP reduction in a different age range. It can be seen that different types and duration of AE independent of the modality and programs and independent of the BP medical situation of individuals have been successful in terms of BP reduction. For those with chronic heart failure, more concern and help might be needed to decrease BP via exercise.

The Effects of 4-Week Aerobic Exercise on the Levels of CCl2, CCl5, and their Respective Receptors in Female BALB/C Mice Suffering from Breast Cancer.

Background: The studies reported that chemokines Chemokine (C-C motif) ligand 2 (CCL2) and Chemokine (C-C motif) ligand 5 (CCL5) have tumor-promoting roles in breast cancer (BC). The aim of the present study was to evaluate the effect of 4 weeks of continuous aerobic exercise (AE) on chemokines CCL2 and CCL5 and their relative receptors in animal model of human BC. Materials and Methods: BALB/c mice were divided randomly into four groups included cancer control (CC) and three other groups. The total duration of the experiment was 14 weeks, including 2 weeks of familiarization of mice with treadmills and three of 4-week periods of experiment. Tumor inoculation and formation were performed in the second 4-week period. Group 1 received AE in the first 4-week, Group 2 received AE in the second 4-week and Group 3 in the third 4-week. Results: The CCL2 was reduced significantly in Groups 1, 2, and 3 compared to control (F3,12= 4705, P = 0.0001). In terms of CCL5, a significant decrease was seen only between Group 3 and control. Western blot results showed a significant reduction in C-C chemokine receptor Type 2 (CCR2) between Group 1 versus CC and Group 2 versus CC (F3,20= 1.812, P = 0.004). In terms of C-C chemokine receptor Type 5 (CCR5) a significant decrease was observed between Group 2 versus control and Group 3 versus control (F3,20= 273.3, P = 0.042), (P = 0.004). Conclusion: It can be concluded that 4-week AE significantly reduces the chemokines CCL2 and CCL5 and their respective receptors levels CCR5 and CCR2 in different stages, and it may have an inhibitory effect on tumor growth.

Effect and Safety of Castor Oil on Labor Induction and Prevalence of Vaginal Delivery: A Systematic Review and Meta-Analysis.

Background: Castor oil is used in some countries to induce labor, but results on its effectiveness and safety is controversial. This systematic review and meta-analysis aimed to evaluate the effect of castor oil on labor induction and prevalence of vaginal delivery along with investigating its safety. Materials and Methods: PubMed, Scopus, Web of Science, and Google Scholar were searched systematically up to September 2020. Observational studies and Randomized Clinical Trials (RCTs), which assessed the effect of castor oil on labor induction in English and Persian languages using different combinations of the related key terms and Medical Subject Headings (MeSH) terms were collected and analyzed independently by two authors. Random effect model was used for meta-analysis. The studies were included in which the Relative Risk (RR) had been reported with 95% Confidence Intervals (CIs). Results: A total of 12 studies consisting 1653 pregnant women were included. The mean age of women who used castor oil was 24.72 years and in control group was 24.67 years. Results showed that labor induction was significantly higher in castor oil group than control group (RR: 3.27; 95% CI (1.96, 5.46)). Prevalence of vaginal delivery was 81% in the castor oil group and 69% in the control group. Conclusions: It can be concluded that use of castor oil has positive effect on labor induction and increases the prevalence of vaginal delivery. None of the studies considered in this meta-analysis reported any serious harmful effects for the use of castor oil.

Cardiovascular Effects of Cydonia oblonga Miller (Quince).

Cydonia oblonga Miller (quince) is a monotypic genus in the Rosaceae family which used to treat or prevent many medical conditions such as diabetes, cancer, infections, and ulcer. This review will summarize the current state of knowledge available on botany, phytochemistry, and pharmacology of this plant with a focus on its effect on some cardiovascular risk factors such as diabetes, blood pressure, lipid profile, and body weight. Databases of Google Scholar, Web of Science, PubMed, Scopus, and SID were searched systematically for English published articles with no date limitation. There were no human studies found, and all of the studies were conducted on animals or in vitro models. Reviewing of all 12 included articles showed that different types of quince extract have positive effects on cardiovascular-related factors such as blood pressure, diabetes, glucose metabolism, lipid profile, ROS, body weight, liver dysfunction, and thrombosis. An antihypertensive effect of quince showed to be a magnitude that is comparable to captopril and the lipid-lowering effect of quince showed to be a magnitude that is comparable to simvastatin. However, two studies evaluated the effect of quince fruit extract on insulin levels; one of them reported no positive effect, and the other one reported a significant positive effect. It can be concluded that different parts of quince including leaf, seed, and fruit could be used for improving cardiovascular-related factors including blood pressure, glucose metabolism and diabetes, obesity, and lipid-adjusting purposes. Quince was also found to have strong anti-inflammatory and antioxidant capacity. This study paves the way for further studies on the cardiovascular effect of quince consumption as a beneficial nutraceutical in humans.

Familial Hypercholesterolemia (FH) Registry Worldwide: A Systematic Review.

Familial hypercholesterolemia (FH) is the most common genetic disease which accelerates the development of premature coronary artery disease (CAD) in young adults if remains untreated. The overall prevalence of FH is currently unknown and is usually underdiagnosed and undertreated worldwide. FH registry in different geographical area is a mission that helps early diagnosis of FH patients in the general population. PubMed, ISI Web of Science, Scopus, and Google Scholar were searched systematically for studies and reports on the FH registry using related keywords. Finally, 27 studies were included in this review. Most of the studies used the CASCADE screening method based on 1 or more than 1 of the 3 well-established FH criteria namely, the Dutch Lipid Clinic Network, Simon Broome Register, or Make Early Diagnosis to Prevent Early Death criteria. Except for a small number of studies that the genetic and molecular methods were used, in other studies only clinical diagnosis was applied. All these studies claimed that the FH registry causes the identification of many new cases as a result of used CASCADE screening and referral to lipid clinics. They concluded that the FH registry increases general and also physician awareness on FH prevalence and its related complications which in the long-term will improve FH management. This indicates that in other parts of the world, the FH registry should be established as well so that more accurate statistics on the prevalence of this disease can be found worldwide which would help in diagnosis and prevention.

Effect of Genistein Intake on Some Cardiovascular Risk Factors: An Updated Systematic Review and Meta-analysis.

Genistein, an isoflavone in soybean products has potential cardio-protective effects and is used also as an alternative for estrogen therapy in postmenopausal women. However, results in this regard are inconsistent and also, not all risk factors related to cardiovascular supportive effects have been meta-analyzed. We searched PubMed, Scopus, ISI Web of Science, and Google Scholar from inception up to October 2020. Random-effects meta-analysis was used for data synthesis. The search included studies with information on genistein supplementation and lipid profile [triglycerides (TG), total cholesterol (TC),low-density lipoprotein (LDL-C), and high-density lipoprotein HDL-C)], systolic and diastolic blood pressure (SBP & DBP), body mass index [BMI] and body weight. Pooled results of studies showed that genistein intake significantly reduced TC [95%CI: -0.49(-0.80, -0.18); P=0.002)], LDL-C [95%CI: -0.60(-1.10, -0.10); P=0.018)] and SBP [95%CI: -0.52(-0.90, -0.14); P=0.007)]. DBP, HLD-C, TG, BMI, and body weight showed no meaningful improvement. Subgroup analysis showed that LDL-C and SBP were reduced more effectively in postmenopausal women with metabolic syndrome. Genistein intake more than 6 months showed a greater effect on lowering cholesterol -0.76(-1.27, -0.24), SBP [-0.39(-0.70, -0.08)] and DBP -0.40(-0.81, -0.00) and increasing TG and LDL-C. This meta-analysis provides consistent evidence that genistein intake reduces the CVD risk factors of TC, LDL-C, and SBP significantly.

An Updated Systematic Review and Meta-Analysis on Association of Serum Lipid Profile With Risk of Breast Cancer Incidence.

Background: This meta-analysis was performed to investigate the effect of serum lipids on the risk of breast cancer incidence. Methods: PubMed, Web of Science, Scopus, and EMBASE were searched systematically from January 1998 to April 2019. Inclusion criteria were English observational studies (cohort or case-control) and the concentration of at least one of the lipid profile components (total cholesterol/triglycerides/low-density lipoprotein cholesterol/high-density lipoprotein cholesterol) measured before a diagnosis of breast cancer (BC). The studies were included in which the relative risk (RR) had been reported with 95% confidence intervals (CIs). A random-effects model was used. Results: A total of 25 studies were found, including 2,882,789 participants in cohort studies with 45,481 cases with BC, and 1983 BC cases and 2963 case-control studies. Combined RR of cohort studies for the highest versus lowest for the BC was LDL-C: 0.95 (95% CI: 0.89-1.01), triglycerides (TG): 0.95 (95% CI: 0.91-0.99; P = 0.02), total cholesterol (TC): 0.98 (95% CI: 0.91-1.05), and HDL-C: 0.86 (95% CI: 0.63-1.18). Combined RR of case-control studies for the highest versus lowest was LDL-C: 1.08 (95% CI: 0.78-1.48), TG: 1.73 (95% CI: 0.94-3.18), TC: 1.02 (95% CI: 0.80-1.29), and HDL-C: 0.79 (95% CI: 0.65-0.97). Conclusions: Based on the results, it can be concluded that only TG but not TC and/or LDL-C had a significant inverse association with the risk of BC incidence. HDL-C showed a significant protective effect against breast cancer in postmenopausal women and case-control studies.

Effect of Microalgae Arthrospira on Biomarkers of Glycemic Control and Glucose Metabolism: A Systematic Review and Meta-analysis.

Diabetes mellitus and insulin resistance are associated with an increased risk of cardiovascular disease (CVD) incidence and a higher rate of CVD-related death. In this study, the effects of Arthrospira (Spirulina) a blue-green algae supplementation on biomarkers of glycemic control and glucose metabolism has been evaluated. PubMed, Scopus, and ISI Web of Science were searched systematically of English human subjects and PubMed for pre-clinical animal studies (rats and mice) from January 2008 until November 2020. The pooled weighted mean difference (MD) and its 95% confidence interval (CI) were calculated and pooled using a random-effect model. Seven clinical and 27 preclinical studies were included. Pooled results of the clinical studies showed that Arthrospira supplementation significantly reduced the fasting blood sugar (FBS): (0.63- 2.90-) 1.77-, total cholesterol (TC): (0.46- ، 4.61-) 2.54-, triglycerides (TG): (0.89- ، 6.54-) 3.71- and increased the high-density lipoprotein cholesterol (HDL-C): (3.86 ، 0.67) 2.27; however, Arthrospira was not significantly effective in terms of reducing the glycated hemoglobin A1c (HbA1C): (1.04 ، 2.23-) 0.59- and low-density lipoprotein cholesterol (LDL-C). Pooled results of preclinical studies showed that Arthrospira supplementation reduced FBS [-10.31 (-12.49, -8.13)] and HbA1C [-5.12 (-8.06, -2.19)] significantly in diabetic animals. Sub-group analysis of clinical studies showed that intervention duration less than 2 months [-2.52 (-4.37, -0.67)] and the dose less than 2 gram [-3.22 (-5.67, -0.76)] showed significant improvement in terms of reducing the FBS in humans. It can be concluded that Arthrospira can be considered as an effective FBS, TG, TC, and HDL-C adjusting nutraceutical agent for diabetes mellitus. Due to the differences in the results of clinical and animal studies in terms of HbA1c, more studies are needed for a definitive conclusion.

Prevalence of Return to Work in Cardiovascular Patients After Cardiac Rehabilitation: A Systematic Review and Meta-analysis.

The present systematic review and meta-analysis aimed to clarify the effects of cardiac rehabilitation (CR) on the prevalence of return to work (RTW) in cardiovascular diseases (CVDs) patients. CR plays a very important role in the management of CVDs and improves the patients' physical activity, quality of life, and a decrease in the cost of healthcare. RTW is the most important goal in the rehabilitation of CVD patients. PubMed, Web of Science, Scopus, and Google scholar were searched systematically from inception up to January 2021 for English published clinical trials and observational studies. In total, 16 studies were analyzed, of them, 8 were controlled studies. Pooled results showed that the mean age of patients was 52.30 (50.04, 54.57). The prevalence of RTW in the CR attending group was 66% (60%, 71%) and in the control group was 58% (47%, 68%). Subgroup analysis showed that the proportion of RTW was higher in white-collars 76% (73%-79%) compared to. blue-collars 63% (56%-70%). Out-patient CR with 72% (61%-81%) RTW was more effective compared to in-patient CR with 62% (44%- 78%) and usual care (control). It can be concluded that CR especially out-patient CR increases the prevalence of RTW but not much. Improved and appropriate CR programs related to each individual's disease and patient condition which follow the valid guidelines might help to increase the effectiveness of CR in terms of RTW.