The genetic basis of early-onset hereditary ataxia in Iran: results of a national registry of a heterogeneous population.

BACKGROUND: To investigate the genetics of early-onset progressive cerebellar ataxia in Iran, we conducted a study at the Children's Medical Center (CMC), the primary referral center for pediatric disorders in the country, over a three-year period from 2019 to 2022. In this report, we provide the initial findings from the national registry. METHODS: We selected all early-onset patients with an autosomal recessive mode of inheritance to assess their phenotype, paraclinical tests, and genotypes. The clinical data encompassed clinical features, the Scale for the Assessment and Rating of Ataxia (SARA) scores, Magnetic Resonance Imaging (MRI) results, Electrodiagnostic exams (EDX), and biomarker features. Our genetic investigations included single-gene testing, Whole Exome Sequencing (WES), and Whole Genome Sequencing (WGS). RESULTS: Our study enrolled 162 patients from various geographic regions of our country. Among our subpopulations, we identified known and novel pathogenic variants in 42 genes in 97 families. The overall genetic diagnostic rate was 59.9%. Notably, we observed PLA2G6, ATM, SACS, and SCA variants in 19, 14, 12, and 10 families, respectively. Remarkably, more than 59% of the cases were attributed to pathogenic variants in these genes. CONCLUSIONS: Iran, being at the crossroad of the Middle East, exhibits a highly diverse genetic etiology for autosomal recessive hereditary ataxia. In light of this heterogeneity, the development of preventive strategies and targeted molecular therapeutics becomes crucial. A national guideline for the diagnosis and management of patients with these conditions could significantly aid in advancing healthcare approaches and improving patient outcomes.

A randomized clinical trial investigating the impact of magnesium supplementation on clinical and biochemical measures in COVID-19 patients.

BACKGROUND: This study sought to examine the impact of magnesium supplementation on clinical outcomes and biochemical factors among hospitalized patients with COVID-19. METHODS: This double-blind, randomized clinical trial was conducted at Razi Hospital, Ahvaz, Iran, between September 2021 and March 2022. Participants aged 18-70 years with moderate disease severity were enrolled. Magnesium supplementation (300 mg daily) was administered to the intervention group, while the control group received a placebo. Clinical outcomes, including the need for oxygen therapy, oxygen saturation, respiratory rate, fever, hs-CRP and TNF-α levels, as well as quality of life and mental health, were assessed. Blood samples were collected to measure biochemical variables. RESULTS: The main result was the count of individuals requiring oxygen therapy. Additional outcomes comprised of oxygen saturation, respiratory rate, fever, hs-CRP and TNF-α levels, as well as quality of life and mental health. Out of 64 participants, 60 completed the study. The results showed that magnesium supplementation significantly reduced the number of patients requiring oxygen therapy (9 vs. 14; P < 0.001). Moreover, the magnesium group demonstrated improved oxygen saturation compared to the control group (4.55 ± 2.35 vs. 1.8 ± 1.67; P < 0.001). Furthermore, we observed a noteworthy enhancement in the quality of life and depression score in the magnesium group. No significant differences were observed in respiratory rate, fever, hs-CRP, and TNF-α levels (P > 0.05). CONCLUSION: The findings suggest that magnesium supplementation may have beneficial effects on clinical outcomes and arterial oxygen saturation in COVID-19 patients. More investigation is necessary to delve into its potential mechanisms and long-term effects on patient outcomes. TRIAL REGISTRATION: This study is registered on Iranian Registry of Clinical Trials (IRCT) under identifier IRCT20210413050957N1. (The registration date: May 1, 2021).

The association between healthy eating index-2015 with anthropometric, cardiometabolic and hepatic indices among patients with non-alcoholic fatty liver disease.

BACKGROUND: Obesity, cardiovascular diseases, and metabolic disorders are common problems among participants with non-alcoholic fatty liver disease (NAFLD). However, the association between these problems and the healthy eating index-2015 (HEI-2015) remains unknown. Although the HEI-2015 originated from American dietary guidelines, its comprehensive evaluation of diet quality provides valuable insights for various populations, including Iranians. Therefore, the objective of this study was to investigate the association between anthropometric, hepatic, and cardio-metabolic indices with HEI-2015 scores in participants with NAFLD. METHODS: We conducted a cross-sectional analysis of data from the Hoveyzeh Cohort Study, which included adults aged 35 to 70 years between 2016 and 2018. A total of 664 participant with NAFLD (452 females and 212 males) were included in the analysis. The HEI-2015 was assessed using the Food Frequency Questionnaire (FFQ). Various indices, including the body shape index (ABSI), atherogenic index of plasma (AIP), visceral adiposity index (VAI), lipid accumulation product (LAP), cardiometabolic index (CMI), lipoprotein combine index (LCI), AST/ALT ratio, ALD/NAFLD index, and hepatic steatosis index (HSI), were calculated. RESULTS: No significant differences were observed in anthropometric, cardio-metabolic, and hepatic indices across the quartiles of HEI-2015. However, among participants with NAFLD, men had significantly higher AIP and LCI levels, while women had significantly higher BMI, ABSI, VAI, LAP, and CMI levels. Additionally, women with NAFLD exhibited higher AST/ALT and HSI levels but lower ALD/NAFLD levels compared to men with NAFLD. Linear regression analysis among men with NAFLD revealed a significant negative correlation between HEI-2015 score and HSI in both the unadjusted model (ß=-0.131, SE = 0.058, p = 0.024) and the adjusted model for energy intake (ß=-0.129, SE = 0.058, p = 0.028). CONCLUSION: The present study demonstrated a correlation between lower HEI-2015 scores and an increased risk of steatosis in men with NAFLD. Moreover, our findings highlighted gender-related differences in NAFLD and cardio-metabolic disorders.

Assessment of the appropriate cutoff points for anthropometric indices and their relationship with cardio-metabolic indices to predict the risk of metabolic associated fatty liver disease.

BACKGROUND: Research on Metabolic Associated Fatty Liver Disease (MAFLD) is still in its early stages, with few studies available to identify and predict effective indicators of this disease. On the other hand, early diagnosis and intervention are crucial to reduce the burden of MAFLD. Therefore, the aim of this research was to investigate the effectiveness of eleven anthropometric indices and their appropriate cut-off values as a non-invasive method to predict and diagnose MAFLD in the Iranian population. METHODS: In this cross-sectional study, we analyzed baseline data from the Hoveyzeh Cohort Study, a prospective population-based study conducted in Iran that enrolled a total of 7836 subjects aged 35 to 70 years from May 2016 through August 2018. RESULTS: The optimal cut-off values of anthropometric indices for predicting MAFLD risk were determined for waist circumference(WC) (102.25 cm for males and 101.45 cm for females), body mass index (BMI) (27.80 kg/m2 for males and 28.75 kg/m2 for females), waist-to-hip ratio (WHR) (0.96 for both males and females), waist-to-height ratio (WHtR) (0.56 for males and 0.63 for females), body adiposity index (BAI) (23.24 for males and 32.97 for females), visceral adiposity index (VAI) (1.64 for males and 1.88 for females), weight-adjusted waist index (WWI) (10.63 for males and 11.71 for females), conicity index (CI) (1.29 for males and 1.36 for females), body roundness index (BRI) (4.52 for males and 6.45 for females), relative fat mass (RFM) (28.18 for males and 44.91 for females) and abdominal volume index (AVI) (18.85 for males and for 21.37 females). VAI in males (sensitivity: 77%, specificity: 60%, Youden's Index: 0.37) and RFM in females (sensitivity: 76%, specificity: 59%, Youden's Index: 0.35) were found to have higher sensitivity and specificity compared to other anthropometric indices. Furthermore, anthropometric indices demonstrated statistically significant correlations with various hepatic and cardiometabolic indices. Among these, the strongest positive correlations were observed between WC, BMI, BAI, BRI, and AVI with the Hepatic Steatosis Index (HSI), TyG-BMI, and TyG-WC, as well as between VAI and the Atherogenic Index of Plasma (AIP), Lipid Accumulation Product (LAP), Cardiometabolic Index (CMI), and the Triglyceride and Glucose (TyG) Index. CONCLUSION: Anthropometric indices are effective in predicting MAFLD risk among Iranian adults, with WWI, VAI, and RFM identified as the strongest predictors. The proposed cutoff values could serve as a straightforward and non-invasive methods for the early diagnosis of MAFLD.

The association between dietary inflammatory index with some cardio-metabolic risk indices among the patients with type 2 diabetes from Hoveyzeh cohort study: a cross-sectional study.

BACKGROUND: The dietary inflammatory index (DII) serves as a tool to assess the inflammatory impact of an individual's diet. This study aimed to investigate the association between DII and some cardio-metabolic risk indices among patients with T2DM. METHODS: Data from the Hoveyzeh Cohort Study, encompassing 2045 adults with T2DM, were analyzed. DII scores were calculated based on food frequency questionnaires. Anthropometric measurements and biochemical tests were performed to assess cardio-metabolic risk factors. RESULTS: Higher DII scores were positively associated with elevated triglyceride levels, triglyceride-glucose (TyG) index, lipid accumulation product (LAP), anthropometric indices including a body shape index (ABSI), body roundness index (BRI), body mass index (BMI), hip, waist circumferences (WC), and waist-to-height ratio (all Ptrend < 0.05). Notably, no significant association was observed between DII and fasting blood sugar (FBS) levels (Ptrend > 0.05). Additionally, dietary intake analysis revealed a negative correlation between DII scores and intake of fiber, fruits, vegetables, legumes, fish, seafood, dairy products, magnesium, and vitamins A, C, D, and E (all Ptrend < 0.05). Conversely, higher DII scores were associated with increased consumption of red meat, processed meat, refined cereals, potatoes, and soft drinks (all Ptrend < 0.05). CONCLUSION: This study underscores the critical link between dietary inflammation, assessed by the DII score, and a multitude of cardio-metabolic risk factors in patients with T2DM. Notably, while the study did not find a significant association between DII and fasting blood sugar levels, it identified robust associations with novel anthropometric and biochemical indices indicative of cardio-metabolic risk. These findings highlight the potential of dietary interventions as a cornerstone strategy for managing T2DM and mitigating its associated complications.

Kidney stones and dietary intake in adults: a population-based study in southwest Iran.

BACKGROUND: The prevalence of kidney stones is on the rise globally. Several risk factors, including lifestyle, contribute to the formation of kidney stones. Nevertheless, there is a contentious debate about the relationship between diet and kidney stones. Therefore, our study aimed to assess the relationship between macronutrients and micronutrients and the formation of kidney stones. METHODS: This population-based cross-sectional study was conducted in the baseline phase of the Hoveyzeh Cohort Study, focusing on adults aged 35-70 in southwest Iran. The information on demographic characteristics, anthropometrics, kidney stone history, and food frequency was collected. Chi-square and t-tests were utilized to assess the relationship between categorical and numerical variables with kidney stones. The ANCOVA and logistic regression models were used to evaluate the relationships while controlling for confounding factors. RESULTS: Among 10,009 participants, the overall prevalence of kidney stones was 18.77% (95% CI: 17.99-19.53). A higher intake of carbohydrates [OR = 1.02 (95% CI:1.002-1.03), p = 0.026] and copper [OR = 1.04 (95% CI:1.01-1.09), p = 0.025] were found to be associated with kidney stones. No associations were found between the other assessed macronutrients or micronutrients and kidney stones (p-tvalues > 0.05). CONCLUSION: Our study's findings indicate a correlation between diet and the formation of kidney stones. However, the relationship between dietary factors and kidney stones is complex, and further research is needed.

The effect of soy isoflavones supplementation on metabolic status in patients with non-alcoholic fatty liver disease: a randomized placebo controlled clinical trial.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) accounts as a crucial health concern with a huge burden on health and economic systems. The aim of this study is to evaluate the effect of soy isoflavones supplementation on metabolic status in patients with NAFLD. METHODS: In this randomized clinical trial, 50 patients with NAFLD were randomly allocated to either soy isoflavone or placebo groups for 12 weeks. The soy isoflavone group took 100 mg/d soy isoflavone and the placebo group took the similar tablets containing starch. Anthropometric indices, blood lipids, glycemic parameters and blood pressure were measured at the beginning and at the end of the study. RESULTS: At the end of week 12 the level of serum triglyceride (TG), low density lipoprotein (LDL) and total cholesterol (TC) was significantly decreased only in soy isoflavone group compared to baseline (P < 0.05). Although waist circumference (WC) decreased significantly in both groups after 12 weeks of intervention (P < 0.05), hip circumference (HC) decreased significantly only in soy isoflavone group (P = 0.001). No significant changes observed regarding high density lipoprotein (HDL) and blood pressure in both groups. At the end of the study, serum glucose level was significantly decreased in the placebo group compared to baseline (P = 0.047). No significant changes demonstrated in the soy isoflavone group in regard to glycemic parameters (P > 0.05). CONCLUSIONS: This study revealed that soy isoflavones could significantly reduce TG, LDL TC, WC and HC in NAFLD patients. TRIAL REGISTRATION: The Ethics committee of Ahvaz Jundishapur University of Medical Sciences approved the protocol of the present clinical research (IR.AJUMS.REC.1401.155). The study was in accordance with the Declaration of Helsinki. This study's registered number and date are IRCT20220801055597N1 and 20.09.2022, respectively at https://fa.irct.ir .

High genetic heterogeneity of leukodystrophies in Iranian children: the first report of Iranian Leukodystrophy Registry.

Leukodystrophies (LDs) are a heterogeneous group of progressive neurological disorders and characterized by primary involvement of white matter of the central nervous system (CNS). This is the first report of the Iranian LD Registry database to describe the clinical, radiological, and genomic data of Persian patients with leukodystrophies. From 2016 to 2019, patients suspicious of LDs were examined followed by a brain magnetic resonance imaging (MRI). A single gene testing or whole-exome sequencing (WES) was used depending on the neuroradiologic phenotypes. In a few cases, the diagnosis was made by metabolic studies. Based on the MRI pattern, diagnosed patients were divided into cohorts A (hypomyelinating LDs) versus cohort B (Other LDs). The most recent LD classification was utilized for classification of diagnosed patients. For novel variants, in silico analyses were performed to verify their pathogenicity. Out of 680 registered patients, 342 completed the diagnostic evaluations. In total, 245 patients met a diagnosis which in turn 24.5% were categorized in cohort A and the remaining in cohort B. Genetic tests revealed causal variants in 228 patients consisting of 213 variants in 110 genes with 78 novel variants. WES and single gene testing identified a causal variant in 65.5% and 34.5% cases, respectively. The total diagnostic rate of WES was 60.7%. Lysosomal disorders (27.3%; GM2-gangliosidosis-9.8%, MLD-6.1%, KD-4.5%), amino and organic acid disorders (17.15%; Canavan disease-4.5%, L-2-HGA-3.6%), mitochondrial leukodystrophies (12.6%), ion and water homeostasis disorders (7.3%; MLC-4.5%), peroxisomal disorders (6.5%; X-ALD-3.6%), and myelin protein disorders (3.6%; PMLD-3.6%) were the most commonly diagnosed disorders. Thirty-seven percent of cases had a pathogenic variant in nine genes (ARSA, HEXA, ASPA, MLC1, GALC, GJC2, ABCD1, L2HGDH, GCDH). This study highlights the most common types as well as the genetic heterogeneity of LDs in Iranian children.

Association between oral contraceptives with lipid profile: results from Hoveyzeh cohort study (HCS).

BACKGROUND: Oral contraceptives (OCs) affect lipid metabolism, which can cause hyperlipidemia, a risk factor for cardiovascular diseases. The study was designed to evaluate the possible changes in lipid profile due to using OCs. METHODS: A cross-sectional study was conducted from April 2016 to August 2018 among women from the baseline phase Hoveyzeh cohort study (HCS). Sociodemographic data, anthropometric measurements, physical activity, and biochemical blood tests were measured for every participant. Multiple logistic regression was used to adjust the potential confounders. RESULTS: Among 2272 participants, 1549 women were OC users, and 723 women were non-user OCs. The mean lipid profile levels were higher in OC users than in non-user OCs. Odds of abnormal Total cholesterol (TC) in OC users were significantly higher than those of non-users OCs [OR = 1.29 (95% CI;1.05 to 1.58)]. Also, the Odds of abnormal low-density lipoprotein (LDL) in OC users was 12% higher than in non-user OCs. However, no significant relationship between abnormal LDL with Oral Contraceptive Pills (OCPs) was observed. CONCLUSIONS: The mean lipid profile was higher in OC users compared to non-user OCs. This finding highlights the need for public health strategies to prevent and detect hyperlipidemia in user OCs.

Effects of chocolate on cognitive function in healthy adults: A systematic review and meta-analysis on clinical trials.

Cognitive function is defined as performance in objective tasks that need conscious mind effort. It has been shown that consuming foods rich in flavanols causes neurobiological effects and improves learning, memory, and global cognitive function. This study aimed to investigate the impact of chronic chocolate consumption on cognitive function in healthy adults based on published trials. The PICO strategy was applied to examine the research question in this study. Researchers searched the Web of Science, Science Direct, Pubmed, Scopus, Cochrane Library, and Google Scholar databases. Related articles of randomized controlled trials that evaluated the chronic effect of chocolate on cognitive function were selected (all published from their inception to February 2021). The difference in means of the last and first measurements was the main effect measure between the control and intervention groups. For quantitative data synthesis, weighted mean difference (WMD) and 95% confidence interval (CI) were performed in the random effect model. Of the initial 340 articles identified, seven trials met the eligibility criteria. Chronic chocolate intake significantly reduced executive function time (WMD: -11.77, 95% CI: -22.49, -1.05, p = 0.03) of the participants. Further, the language and executive function (WMD: 6.38, 95% CI: 5.97, 6.80, p < 0.001) was raised by 6.38 times after the intervention with chocolate. We could not perform subgroup analysis due to insufficient trials and significant heterogeneity in some studies. It is concluded that daily consumption of cocoa may provide short and middle-term effects on young adults and make them better cognitive performance in learning, memory, and attention.

Socioeconomic status and metabolic syndrome in Southwest Iran: results from Hoveyzeh Cohort Study (HCS).

BACKGROUND: Socioeconomic status (SES) strongly predicts morbidity and premature mortality, especially for non-communicable diseases (NCDs). However, the effect of these factors on Metabolic Syndrome (MetS) is not clear yet. This study was conducted to assess the relationship between socioeconomic indicators and MetS. METHODS: In this prospective cohort study, 10,009 people aged 35-70 enrolled from May 2016 to August 2018. The MetS was defined according to The Standard National Cholesterol Education Program (NCEP)-adult treatment panel III (ATP III) or NCEP-ATP III criteria. Demographics and socioeconomic data were gathered face-to-face through trained interviews. Also, lab, anthropometrics, and blood pressure measurements were assayed for participants. Logistic regression was used to estimate the association between SES and MetS, adjusted for the potential confounding factors. RESULTS: The overall prevalence of MetS in the participants was 39.1%. The crude odds ratios were statistically significant for all the assessed variables (p < 0.05). After adjustment for age, sex, physical activity, smoking, and alcohol use as potential confounders, the results indicated significant direct independent associations between skill level (p = 0.006) and Townsend index (p = 0.002) with MetS. In contrast, no significant associations between educational level and wealth status with MetS. CONCLUSION: The results of our study showed that SES is related to MetS. Among the four assessed SES indicators, skilled levels and Townsend score are strongly associated with MetS. We recommend considering people's SES when interventional programs are planned and conducted on MetS in similar communities.

Effects of long-term administration of Multi-Strain Probiotic on circulating levels of BDNF, NGF, IL-6 and mental health in patients with multiple sclerosis: a randomized, double-blind, placebo-controlled trial.

Background: Mental disorders is one of the main causes of disability and lower life expectancy among patients with Multiple Sclerosis (MS). The present trial aimed to examine the efficacy of multi-strain probiotic supplementation on circulating levels of BDNF, NGF, IL-6 and mental health in patients with MS.Methods: This trial was conducted among 70 patients with MS that referred to the MS Association. Patients were randomized into intervention and control groups to receive 2 multi-strain probiotic capsules or placebo, daily for six months. Serum BDNF, NGF and IL-6 was measured by ELISA kits. Mental health parameters were assessed by valid questionnaires in the baseline and end of the study.Results: Of the 70 patients enrolled in this study, 65 subjects were included in the final analysis. From baseline to 6 months, probiotic supplementation resulted in a significant increase in BDNF and a significant reduction in the IL-6 levels (P < 0.001). Our findings revealed that probiotic supplementation compared to placebo caused a significant improvement in the general health questionnaire-28 (GHQ-28) (-5.31 ± 4.62 vs. -1.81 ± 4.23; P = 0.002), Beck Depression Inventory-II (BDI-II) (-4.81 ± 0.79 vs. -1.90 ± 0.96; P = 0.001), Fatigue Severity Scale (FSS) (-3.81 ± 6.56 vs. 0.24 ± 5.44; P = 0.007) and Pain Rating Index (PRI) (-3.15 ± 4.51 vs. -0.09 ± 3.67; P = 0.004). However, we not found any significant difference between the two groups in other factors (P > 0.05).Conclusion: Overall, six months of probiotic supplementation resulted in greater improvement in mental health parameters.

The effects of hot air-dried white button mushroom powder on glycemic indices, lipid profile, inflammatory biomarkers and total antioxidant capacity in patients with type-2 diabetes mellitus: A randomized controlled trial.

Background: The inflammatory and metabolic responses to mushroom in type 2 diabetes mellitus (T2DM) are unknown. The study aimed to evaluate the effect of Hot Air-dried White Button Mushroom (HAD-WBM) powder on glycemic status, lipid profile, inflammatory markers, and total antioxidant capacity (TAC) in T2DM patients. Materials and Methods: This randomized controlled trial was conducted at Golestan Hospital, Ahvaz, Iran. Eligible patients were adults aged 20-50 with Type 2 diabetes. Patients were assigned to each group using a randomized block design with block randomization (n = 22, in each group). Randomization was performed by an assistant and group allocation was blinded for the investigator and participants. The intervention and control groups received 16 g/day HAD-WBM or cornstarch powder for 8 weeks. The primary outcomes of interest were fructosamine, fasting blood sugar (FBS), insulin, homeostatic model assessment for insulin resistance, and secondary outcomes were triglyceride, low-density lipoprotein (LDL), high-density lipoprotein, very-LDL, cholesterol, high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and TAC. Results: After 8 weeks, a significant decrease was observed in fructosamine (-0.228 ± 0.36 vs. 0.03 ± 0.38; P = 0.02) and LDL (-13.05 ± 20.67 vs. 0.81 ± 21.79; P = 0.04) in the HAD-WBM group compared to the control group. No significant changes were observed in fasting insulin and FBS between the two groups. However, a significant within-group reduction (-28.00 ± 42.46; P = 0.006) was observed for FBS in the HAD-WBM group. In the HAD-WBM group, insulin resistance reduced significantly at the end of the study (From 4.92 to 3.81; P = 0.016), but it was not significantly different between the two groups. There was no significant difference in TAC, hs-CRP, and IL-6 between the two groups. Conclusion: Considering the results of this study about the beneficial effects of HAD-WBM on the improvement of glycemic indices and LDL in T2DM patients, it is recommended that HAD-WBM could be used to control T2DM.

Ginseng and Cancer-Related Fatigue: A Systematic Review of Clinical Trials.

PURPOSE: The data on the effect of ginseng on general fatigue were previously reviewed. However, there is limited data on the effect of various types of ginseng on cancer-related fatigue (CRF). CRF is one of the most pervasive symptoms of cancer and cancer treatment. The primary objective of the current study was to systematically review trials investigating the safety and efficacy of three different types of ginseng separately used in the treatment protocol for patients with CRF. METHODS: We searched the available online databases for relevant publications up to October 2019. Data were independently extracted by two reviewers. We assessed the risk of bias using the Cochrane Collaboration Review Manager (RevMan, version 5.3) and reported the results in a narrative summary. RESULTS: A total of 210 studies were identified by the initial search, from which seven clinical trials and one retrospective study were included in this systematic review. A total of two clinical trials and one retrospective review examined the impact of American ginseng on CRF symptoms, three studies tested Asian ginseng, and two trials were conducted using Korean ginseng. The quality of the selected studies varied greatly. All three types of ginseng were tolerated well with few low-grade adverse events. American ginseng, containing more than 5% ginsenosides, consumed at the dosage of 2000 mg/day for up to eight weeks significantly reduced fatigue. Asian ginseng, containing ≥ 7% ginsenosides, relieved symptoms of fatigue at the dosage of 400 mg/day in the majority of patients with CRF. Korean ginseng, consumed at the dosage of 3000 mg/day for 12 weeks, decreased symptoms of CRF. CONCLUSIONS: Although our findings support the safety and effectiveness of ginseng in the treatment of CRF, the number of high-quality studies is not adequate to adopt ginseng as a standard treatment option for CRF.

Lycopene Does Not Affect Prostate-Specific Antigen in Men with Non-Metastatic Prostate Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Several randomized controlled trials (RCTs) have investigated the effect of lycopene supplementation on serum levels of prostate-specific antigen (PSA) in patients with prostate cancer. However, results have been inconclusive. We systematically searched PubMed, Embase, and Scopus up to January 2020 to find RCTs investigating the effect of lycopene supplementation on serum levels of PSA in patients with non-metastatic prostate cancer. Using a random-effects model, the reported risk estimates were pooled. A total of six trials were included in the final analysis. we found no significant effect of lycopene on circulating PSA (WMD: -0.60, 95% CI: -2.01, 0.81 µg/L). However, we observed a significant reducing effect when the analysis was confined to studies that included patients with higher baseline levels of PSA (≥6.5 µg/L) (WMD: -3.74 µg/L, 95% CI: -5.15, -2.32, P < 0.001). Subgroup analysis based on the duration of intervention did not result in any significant effect. Non-linear dose-response analysis did not show any significant effects of lycopene dosage (Pnon-linearity = 0.50) and duration of the intervention (Pnon-linearity = 0.63) on serum levels of PSA. Although lycopene supplementation did not produce any reduction in PSA levels overall, a significant reducing effect was observed in patients with higher levels of baseline PSA. Due to the heterogeneity of our results, further high-quality clinical trials with long-term duration are required to determine the efficacy of lycopene in patients with non-metastatic prostate cancer.

A dietary pattern rich in fruits and dairy products is inversely associated to gestational diabetes: a case-control study in Iran.

BACKGROUND: Gestational diabetes mellitus (GDM) causes many problems for mother and her neonate. A healthy diet plays an important role in preventing GDM. This study aimed to investigate the relationship between major dietary patterns and the GDM. METHODS: 386 healthy and 306 GDM pregnant women (total 693) completed this case-control study. Basic information and anthropometric indices were recorded, and a food frequency questionnaire was completed. For extracting major dietary patterns, the principal component analysis was performed. Multivariable logistic regression models were used to examine whether specific dietary patterns are associated to the GDM. RESULTS: Four dietary patterns were identified: "fruits and dairy products", "red meat and plant-based foods", "snacks and high-fat foods" and "carbohydrate-rich foods". Among these major extracted dietary patterns, "fruits and dairy products" showed an inverse association to the GDM (odds ratio adjusted for confounders: 0.50, confidence interval: 0.284-0.882, p-trend = 0.019, for highest vs. lowest quartile). CONCLUSIONS: It seems using a healthy dietary pattern such as "fruits and dairy products" may decrease GDM risk.

The effects of Taurine supplementation on inflammatory markers and clinical outcomes in patients with traumatic brain injury: a double-blind randomized controlled trial.

BACKGROUND: Traumatic brain injury is a public health concern and is the main cause of death among various types of trauma. The inflammatory conditions due to TBI are associated with unfavorable clinical outcomes. Taurine has been reported to have immune-modulatory effects. Thus, the aim of this study was to survey the effect of taurine supplementation in TBI patients. METHODS: In this study, 32 patients with TBI were randomized into two groups. The treatment group received 30 mg/kg/day of taurine in addition to the Standard Entera Meal and the control group received Standard Entera Meal for 14 days. Prior to and following the intervention, the patients were investigated in terms of serum levels of IL-6, IL-10, hs-CRP and TNF-α as well as APACHEII, SOFA and NUTRIC scores, Glasgow coma scale and weight. In addition, the length of Intensive Care Unit stay, days of dependence on ventilator and 30-day mortality were studied. SPSS software (version 13.0) was used for data analysis. RESULTS: Taurine significantly decreased the serum levels of IL-6 (p = 0.04) and marginally APACHEII score (p = 0.05). In addition, weight loss was significantly lower in taurine group (p = 0.03). Furthermore, taurine significantly increased the GCS (p = 0.03). The groups were not different significantly in terms of levels of IL-10, hs-CRP, and TNF-α, SOFA and NUTRIC scores, 30-day mortality, length of ICU stay and days of dependence on ventilator. CONCLUSION: According to the results of the present study, taurine supplementation can reduce the IL-6 levels as one of the important inflammatory markers in these patients; and enhances the clinical outcomes too. TRIAL REGISTRATION: IRCT, IRCT20180514039657N1 . Registered 22 June 2018.

Effects of resistant starch interventions on circulating inflammatory biomarkers: a systematic review and meta-analysis of randomized controlled trials.

PURPOSE: This study aimed to summarize earlier studies on the effects of RS consumption on the serum levels of inflammatory biomarkers. METHODS: A comprehensive search was done in the electronic databases that published from 1988 up to May 2019. Two reviewers independently performed screening, data extraction, and risk-of-bias assessment. We used from the effect size, as estimated by the mean difference to perform the fixed method meta-analysis. RESULTS: Overall, 13 studies with 14 effect sizes met the inclusion criteria and were included in the final analysis. Sample size of these studies ranged from 15 to 75 and intervention duration ranged from 4 to 14 weeks. Meta-analysis revealed that higher consumption of resistant starch caused a significant reduction in the interleukin 6 (weighted mean difference = - 1.11 pg/mL; 95% CI: - 1.72, - 0.5 pg/mL; P = < 0.001) and tumor necrosis factor alpha (weighted mean difference = - 2.19 pg/mL; 95% CI: - 3.49, - 0.9 pg/mL; P = 0.001) levels. However, no significant changes were found in C-reactive protein concentration (weighted mean difference = - 0.21 mg/L; 95% CI: - 1.06, 0.63 mg/L; P = 0.61). Moreover, the changes in interleukin 6 concentration was dependent on study quality and intervention duration. CONCLUSION: The current meta-analysis indicated that RS intake can improve some inflammatory biomarkers. More research, with a large sample sizes and accurate design is recommended.

Red vine leaf extract (AS 195) can improve some signs and symptoms of chronic venous insufficiency, a systematic review.

AIM: Chronic venous insufficiency (CVI) is common in adults. Some complications include skin changes, edema, heavy legs, muscle cramps, pain, and varicose veins. In traditional medicine, red vine leaf extract (AS 195) has been used to cure the symptoms of CVI. This systematic review was aimed to assess the effects of AS 195 in patients with CVI. MATERIAL AND METHODS: A systematic literature search was performed to identify trials that reported the impact of red vine leaf extract on CVI. The primary outcomes investigated were Leg (limb) volume, calf circumference, ankle circumference, tired and heavy legs, a sensation of tension, tingling sensation, and pain. RESULTS: From the 56 studies, 5 trials were selected according to our inclusion criteria. Red vine leaf extract significantly improved numbers of outcomes (lower leg volume, calf and ankle circumference, tired, heavy legs, tingling sensation, pain, the sensation of tension in the legs, cutaneous microcirculation, and transcutaneous oxygen pressure) in only some trials. The tolerability for red vine leaf extract was reported good or satisfactory. CONCLUSIONS: Red vine leaf extract had a beneficial therapeutic role in patients with CVI. Further high-quality trials are required to be carried out to provide strong evidence.

Are young Iranian women with metabolically healthy obesity at increased risk of CVD incidence?

BACKGROUND: The association between the Metabolically Healthy Obese (MHO) phenotype in the absence of metabolic syndrome and subsequent cardiovascular disease remains unclear. OBJECTIVES: We examined the association between MHO and CVD risk in young Iranian women. METHODS: We studied 183 women aged 20-35 years from a population of 308 candidates. We classified participants into 4 phenotypes. We measured body composition, blood pressure, and biochemical factors in all participants. RESULTS: The Metabolically Healthy Normal Weight (MHNW) and Normal Weight Obese (NWO) phenotypes had no statistical differences in any biochemistry variables. FBS, TG, LDL/HDL, Cholesterol/HDL, hs-CRP, and atherogenic index of plasma (AIP) were all higher in Metabolically Unhealthy Obese (MUO) than MHO individuals, whereas HDL was higher in MHO than in MUO individuals. LDL/HDL and hs-CRP were higher in MHO participants than MHNW participants, whereas HDL-c was higher in MHNW than MHO. CONCLUSIONS: Results of the present study demonstrate that young women displaying the MHO phenotype have a favorable metabolic profile as shown by lower FBS, TG, LDL-c/HDL, Cho/HDL, hs-CRP, and AIP and higher HDL levels than the MUO phenotype. However, MHO individuals were still at greater risk of CVD incidence (lower HDL and higher hs-CRP levels) than MHNW individuals.

CONTEXTO: A associação entre o fenótipo obeso metabolicamente saudável (OMS) na ausência de síndrome metabólica e doença cardiovascular subsequente permanece incerta. OBJETIVOS: Examinamos a associação entre o fenótipo OMS e risco de DCV em jovens iranianas. MÉTODOS: Analisamos 183 mulheres com idade de 20-35 anos de uma população de 308 candidatas. Classificamos as participantes em quatro fenótipos. Mensuramos composição corporal, pressão arterial e fatores bioquímicos em todas as participantes. RESULTADOS: Os fenótipos com peso normal metabolicamente saudável (PNMS) e obeso com peso normal não apresentaram diferenças estatísticas em nenhuma das variáveis bioquímicas. Os níveis de glicemia sanguínea em jejum (GSJ), triglicerídeos (TG), relação LDL/HDL, HDL, proteína C reativa ultrassensível (PCR-us) e índice aterogênico do plasma (IAP) foram mais elevados em obesas metabolicamente não saudáveis (OMNS) do que em indivíduos OMSs, enquanto o HDL foi maior em OMSs do que em indivíduos OMNSs. A relação LDL/HDL e o nível de PCR-us foram mais elevados em participantes OMSs do que em participantes com PNMS, enquanto o HDL foi maior naquelas com PNMS do que nas OMSs. CONCLUSÕES: Os resultados do presente estudo demonstram que mulheres jovens com o fenótipo OMS têm um perfil metabólico favorável, conforme demonstrado pelos níveis menores de GSJ, TG, relação LDL/HDL, HDL, PCR-us e IAP e pelos níveis maiores de HDL em comparação às mulheres com o fenótipo OMNS. Entretanto, indivíduos OMSs ainda apresentavam maior risco de DCV incidente (níveis menores de HDL e maiores de PCR-us) do que indivíduos com PNMS.