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.

Obesity and thyroid cancer: unraveling the connection through a systematic review and meta-analysis of cohort studies.

Background: The relationship between adiposity indicators and thyroid cancer (TC) risk has garnered increasing attention due to the rising prevalence of obesity and its potential impact on cancer incidence. We conducted a comprehensive meta-analysis to investigate this association across various effect measures. Method: Until July 2022, a comprehensive search of databases was conducted to identify cohort studies that assessed the association between adiposity and the development of TC. Meta-analysis was performed using random effects models. Subgroup analyses were conducted to explore heterogeneity. Publication bias was assessed using Begg's tests. Results: A systematic literature search identified 27 eligible studies reporting odds ratios (OR), relative risks (RR), or hazard ratios (HR) as effect measures. Pooling the studies irrespective of the effect measure, a significant positive association between adiposity indicators and TC risk was observed, yielding an effect estimate of 1.16 (95% CI 1.12-1.21). The combined effect estimate for OR/RR studies was 1.10 (95%CI 1.04-1.17), while HR studies yielded an effect estimate of 1.20 (95%CI 1.13-1.26). Subgroup analyses revealed associations across different age groups, obesity indices, and regions, with some variations based on effect measure. Meta-regression identified follow-up duration as a confounding factor only in HR studies. Conclusion: The synthesis of 27 studies with diverse designs and populations underscores a robust positive association between adiposity and TC risk, providing compelling evidence for the potential role of increased adiposity in TC development. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-024-01425-3.

Impact of omega-3 fatty acids supplementation on the gene expression of peroxisome proliferator activated receptors-γ, α and fibroblast growth factor-21 serum levels in patients with various presentation of metabolic conditions: a GRADE assessed systematic review and dose-response meta-analysis of clinical trials.

There is some debate about the effects of omega-3 fatty acids on the regulation of adipose tissue related genes. This systematic review and meta-analysis aimed to evaluate the effects of omega-3 fatty acids supplementation on the gene expression of peroxisome proliferator activated receptors (PPAR-α and PPAR-γ) and serum fibroblast growth factor-21 (FGF-21) levels in adults with different presentation of metabolic conditions. To identify eligible studies, a systematic search was conducted in the Cochrane Library of clinical trials, Medline, Scopus, ISI Web of Science, and Google Scholar up to April 2022. Eligibility criteria included a clinical trial design, omega-3 fatty acids supplementation in adults, and reporting of at least one of the study outcomes. Effect sizes were synthesized using either fixed or random methods based on the level of heterogeneity. Fifteen studies met the inclusion criteria. Omega-3 fatty acids supplementation significantly increased the PPAR-γ (10 studies) and PPAR-α (2 studies) gene expression compared to the control group (WMD: 0.24; 95% CI: 0.12, 0.35; p < 0.001 and 0.09; 95% CI: 0.04, 0.13; p < 0.001, respectively). Serum FGF-21 (8 studies) levels exhibited no significant change following omega-3 fatty acids supplementation (p = 0.542). However, a dose-response relationship emerged between the dose of omega-3 fatty acids and both PPAR-γ gene expression and serum FGF-21 levels. Overall, this study suggests that omega-3 fatty acids supplementation may have positive effects on the regulation of adipose tissue related genes in patients with various presentation of metabolic condition. Further research is needed to validate these findings and ascertain the effectiveness of this supplementation approach in this population. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?, CRD42022338344.

Prevalence of overweight and obesity among Iranian population: a systematic review and meta-analysis.

BACKGROUND: Obesity is a major risk factor for chronic diseases. Politicians and practitioners should be aware of the dramatic increase in obesity and its subsequent complications to prevent associated health risks. This systematic review aimed to provide better insight into the prevalence of overweight and obesity in the Iranian population. METHOD: An evaluation was conducted on all published observational studies from both national (SID, Irandoc, Iranmedex) and international (Web of Knowledge, PubMed, Scopus) sources, which reported the prevalence of overweight/obesity among normal population samples, between January 2012 and December 2021. RESULT: A total of 152 eligible studies were included in this meta-analysis. Of the 152 selected studies, 74 reported the prevalence of overweight/obesity in patients aged ≤ 18 years, and 61 studies in adults. In the rest of the articles (17 studies), the results were reported for a combination of these age groups. The prevalence of overweight and obesity in Iran was estimated at 20.1 (95% CI 17.92-22.30) and 13.44 (95% CI 11.76-15.22), respectively. This percentage (95% CI) was 11.71 (10.98-12.46) for overweight and 8.08 (7.02-9.22) for obesity in those aged ≤ 18 years, and 35.26 (32.61-37.99) for overweight and 21.38 (19.61-23.20) for obesity in those aged > 18 years. The overall prevalence of overweight and obesity in the entire population was 35.09% (95% CI 31.31-38.98). CONCLUSION: As obesity is on the rise in Iran, we should seek both weight loss strategies and ways to control comorbidities associated with high BMI.

Association between thyroid function and obesity phenotypes in healthy euthyroid individuals: an investigation based on Tehran Thyroid Study.

AIMS: We investigated whether thyroid function could be associated with obesity phenotypes amongst euthyroid individuals. MATERIALS AND METHODS: A cross-sectional analysis was conducted among healthy, euthyroid subjects. The study participants were chosen from the Tehran Thyroid Study (TTS). We analyzed 2988 euthyroid adults and classified them into four obesity phenotype groups: metabolically healthy normal weight (MHNW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obese (MUO). The statistical differences between thyroid hormones between various obesity phenotypes according to age and sex was compared using analysis of covariance (ANCOVA). RESULTS: It was found that MHNW participants had higher levels of FT4 when compared with metabolically healthy or unhealthy obese subjects (P < 0.001), even after adjustment for the confounding variables. No difference was observed in the levels of TSH (P = 0.260) among obesity phenotypes. In the subgroup analysis according to the age, a significant difference was observed in the level of FT4 only in subjects with age < 55 years (P = 0.001). However, analyzing men and women separately did not show a significant difference in the FT4 level among obesity phenotypes (P > 0.05). CONCLUSION: "Metabolically abnormality" was independently related to low normal FT4 levels in overweight/obese euthyroid individuals. There is a need for further research to understand how low FT4 levels are linked to metabolically unhealthy states in euthyroid individuals.

Association between different metabolic phenotypes and the development of hypothyroidism: 9 years follow-up of Tehran thyroid study.

Purpose: The association between metabolic phenotypes and thyroid function has not yet been established; therefore, this study examined whether different metabolic phenotypes are associated with the development of hypothyroidism. Methods: Study participants were selected from the Tehran Thyroid Study (TTS). A total of 3338 euthyroid adults were included and categorized into four obesity phenotype groups: metabolically healthy normal weight (MHNW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obese (MUO). The participants were assessed at baseline and during three follow-up studies at three-year intervals. Multiple logistic regression analysis was used to examine the relationship between metabolic phenotypes and the development of hypothyroidism. Results: In the total population, the chi-square test was only significant (P=0.008) in 3rd year with a higher prevalence of hypothyroidism in the MUNW phenotype, followed by MHO, MUO, and MHNW. Moreover, in the 3rd and 9th years of follow-up, hypothyroidism was more prevalent in MUO only in male subjects (P=0.002 and 0.035, respectively). In the unadjusted model, the MHO phenotype increased the odds of hypothyroidism compared with the MHNW phenotype (OR=1.51; 95% CI=1.04, 2.18; P-value=0.031). After adjusting for confounding factors, the odds of hypothyroidism were higher in the MUNW (OR=1.86; 95% CI=1.17, 2.96; P-value=0.008), MHO (OR=1.71; 95% CI=1.09, 2.67; P-value=0.018), and MUO (OR=1.64; 95% CI=1.03, 2.62; P-value=0.036) phenotypes than in the MHNW group. The MUNW phenotype increased the risk of hypothyroidism compared to MHNW, only in males. However, in females, the MHO phenotype increased the risk of hypothyroidism compared to MHNW. Conclusion: Both obesity and metabolic abnormalities are associated with hyperthyroidism. Healthy metabolic and weight maintenance were associated with a lower risk of hypothyroidism in males and females.

Changes in Bone Turnover Markers after Roux-en-Y Gastric Bypass Versus Sleeve Gastrectomy: a Systematic Review and Meta-Analysis.

This systematic review and meta-analysis was performed to compare the alterations in bone turnover markers between SG and RYGB. A literature search was conducted in PubMed, Medline, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases to find the studies. There was significant less increment in osteocalcin [WMD = - 5.98, 95% CI (- 9.30, - 2.47) P < 0.01] and parathyroid hormone (PTH) [WMD = - 9.59, 95% CI (- 15.02, - 4.16) P < 0.01] in the SG group compared to the RYGB group. No significant differences were seen in change of C-terminal telopeptide of type I collagen (CTX), N-terminal propeptide of type I collagen (PINP), Ca, and 25(OH)-D between SG and RYGB groups. According to our meta-analysis, bone formation markers appear to have more increment following RYGB than SG. This observation is accompanied by a larger increase in PTH after RYGB patients compared to SG patients. PROSPERO: CRD42022308985.

Obesity, Diabetes Mellitus, and Metabolic Syndrome: Review in the Era of COVID-19.

Coronavirus disease 2019 (COVID-19), a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is now at pandemic levels leading to considerable morbidity and mortality throughout the globe. Patients with obesity, diabetes, and metabolic syndrome (MetS) are mainly susceptible and more probably to get severe side effects when affected by this virus. The pathophysiologic mechanisms for these notions have not been completely known. The pro-inflammatory milieu observed in patients with metabolic disruption could lead to COVID-19-mediated host immune dysregulation, such as immune dysfunction, severe inflammation, microvascular dysfunction, and thrombosis. The present review expresses the current knowledge regarding the influence of obesity, diabetes mellitus, and MetS on COVID-19 infection and severity, and their pathophysiological mechanisms.

Impact of low-carbohydrate diet on serum levels of leptin and adiponectin levels: a systematic review and meta-analysis in adult.

Background: Various studies have evaluated the effects of low-carbohydrate diet (LCD) on serum concentrations of adipokines. Although the association between LCD and serum levels of leptin and adiponectin has been studied extensively, the results were not consistent. Objective: The purpose of this study was to systematically evaluate the effect of LCD on serum levels of leptin and adiponectin. Design: Electronic databases were retrieved in PubMed, Embase, Scopus and Web of Science to search relevant publications. Pooled standard mean difference (SMD) with 95% confidence interval (CI) was calculated by the random-effect model. Cochrane Q test and I2 statistic were used to test heterogeneity. Subgroup analysis and meta-regression were applied to assess possible sources of heterogeneity. Results: A total of thirty-five articles were included in final analysis. Meta-analysis results revealed no statistical association between LCD and adiponectin concentration (WMD: 0.32 ng/ml, 95% CI: - 0.02, 0.66, p=0.062). Subgroup analysis showed that LCD increased adiponectin concentration in subjects under 45 years old and in studies with long term duration intervention. Also, did not observe a significant effect from the LCD on serum concentration of leptin (WMD: - 0.77 ng/ml, 95% CI: -3.15, 1.61, P=0.409). Subgroup analysis did not show any new information. The results of this study did not support the evidence for the positive effects of LCD on serum leptin and adiponectin levels.

Diagnostic accuracy of bilateral inferior petrosal sinus sampling using desmopressin or corticotropic- releasing hormone in ACTH-dependent Cushing's syndrome: A systematic review and meta-analysis.

The current gold standard diagnostic method for Cushing disease (CD) is bilateral inferior petrosal sinus sampling (BIPSS) after corticotropin-releasing hormone (CRH) stimulation. Due to shortages of CRH, BIPSS has been performed with desmopressin (DDAVP) instead. The objective of this systematic review and meta-analysis was to estimate the diagnostic accuracy of BIPSS using DDAVP or CRH for the differential diagnosis of Cushing's syndrome (CS). A literature review was done in PubMed, Scopus, EMBASE, and google scholar databases to derive summary estimates of the overall diagnostic sensitivity and accuracy of BIPSS using DDAVP or CRH in Cushing's syndrome. Pooled sensitivity, specificity, diagnostic odds ratio and summary receiver operating characteristic curves (SROC) for differential diagnosis of Cushing's syndrome in the random-effects models, were computed. Overall, 11 different studies with a total of 612 participants, were eligible for the analysis. Five articles with data on BIPSS using DDAVP, 5 papers on BIPSS using CRH, and another one evaluated the results of stimulation using DDAVP, with or without CRH, for differential diagnosis of Cushing's syndrome. The pooled (95% CI) sensitivity and specificity of BIPSS using DDAVP, were 96% (91-98%) and 1.00 (0.00-1.00), respectively. The area under the SROC curve was 0.95. The pooled (95% CI) sensitivity and specificity of BIPSS using CRH, were 98% (92-99%) and 1.00 (0.00-1.00), respectively, and the area under the SROC curve was 0.98. The I2 index (95% CI) was 0% (0-100%) for both BIPSS using DDAVP and using CRH. As a result, DDAVP stimulation is a safe, effective, less expensive, valuable and available alternative to CRH in the setting of BIPSS for all age groups of patients with CS. Registration code in PROSPERO: CRD42021292531.

Effects of Flaxseed Interventions on Circulating Inflammatory Biomarkers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

There have been various clinical studies on the effect of flaxseed-derived products on circulating inflammatory biomarkers, but the findings from these are contradictory. The aim of the present study was to clarify any association. A comprehensive literature search was conducted from inception to May 2018. From the eligible trials, 32 articles describing studies conducted on adults aged 18-70 y were selected for the meta-analysis. Meta-analyses using the random-effects model were performed to investigate the data and results showed significant effects of flaxseed intake on circulating high-sensitivity CRP (hs-CRP) [weighted mean difference (WMD) = -0.75; 95% CI: -1.19, -0.30; P < 0.001] and TNFα (WMD = -0.38; 95% CI: -0.75,-0.01; P = 0.04). However, no significant changes were found in IL6 concentration (WMD = -0.24; 95% CI: -0.70, 0.21; P = 0.28) and C-reactive protein (CRP) (WMD = -0.34; 95% CI:-0.89, 0.20; P = 0.22). Moreover, by eliminating 1 of the studies from the sensitivity analysis, changes in IL6 concentration were significant (WMD = -0.44; 95% CI: -0.81, -0.08). The changes in inflammatory biomarkers were dependent on study design (parallel or crossover), supplement type (flaxseed, flaxseed oil, or lignan), study quality (high or low), and participants' age and BMI. According to this meta-analysis, flaxseed significantly reduced circulating concentrations of hs-CRP and TNFα, but did not affect IL6 and CRP. Further research is needed to examine the effect of different doses and long-term benefits of flaxseed and its derivatives on inflammatory factors.