Effect of Metformin on the Prognosis of Gastric Cancer Patients with Type 2 Diabetes Mellitus: A Meta-Analysis Based on Retrospective Cohort Studies.

Background: Metformin is one of the most common drugs for type 2 diabetes mellitus (T2DM) treatment. In addition, metformin intends to have a positive effect on the prognosis of several cancers. However, the therapeutic effect of metformin on gastric cancer (GC) remains controversial. This study explores and updates the therapeutic effect of metformin in GC patients with T2DM. Methods: We searched through PubMed, Embase, Web of Science, and the Cochrane Library for relevant articles by July 2022. The relationship between metformin therapy and the prognosis of GC patients with T2DM was evaluated based on the hazard ratio (HR) at a 95% confidence interval (95% CI). Overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) were the primary outcomes analyzed. Results: Seven retrospective cohort studies with a combined 2,858 patients met the inclusion criteria. OS and CSS were reported in six studies, and PFS was reported in four studies. Pooled results showed that, compared to the nonmetformin group, the prolonged OS (HR = 0.72, p = 0.001), CSS (HR = 0.81, p = 0.001), and PFS (HR = 0.70, p = 0.008) of the experimental group may be associated with the exposure to metformin. Conclusion: Metformin may have a beneficial effect on the prognosis of GC patients with T2DM.

Effect of HIV-1 Protease Inhibitor on IL-18 and IL-1ß in Rats with Insulinoma.

This study is aimed at investigating the treatment effectiveness of HIV-1 protease inhibitor for rats with insulinoma and its effects on interleukin-1ß (IL-1ß) and interleukin-18 (IL-18). A total of 40 6-week-old nude mice were included in this study. We randomly assigned 20 rats for insulinoma modeling and divided them into model A and B groups. Another 20 rats were randomly divided into control A and B groups. Rats from the model A and control A groups were given HIV-1 protease inhibitors. The expression profiles of IL-18 and IL-1ß, clinical indicators, water maze test results, oxidative stress damage, and changes in neurological functions in rats from each group were recorded. The expression levels of IL-18 and IL-1ß, insulin level, the ratio of immunoreactive insulin to plasma glucose (IRI/G), escape latency, reactive oxygen species (ROS), and amyloid ß-protein (Aß) level were lower in the model A group than in the model B group while fasting blood glucose, platform crossing times, and superoxide dismutase (SOD) were higher in the model A group than in the model B group. The insulin level and hippocampus Aß level were lower in the control A group than in the control B group. In contrast, other indicators in the control A group were not significantly different from those in the model B group. HIV-1 protease inhibitor is effective in the treatment of insulinoma in rats. It can significantly reduce IL-18 and IL-1ß and protect the neurological functions in rats and has broad prospects for clinical application.

Effects of Intermittent Fasting in Human Compared to a Non-intervention Diet and Caloric Restriction: A Meta-Analysis of Randomized Controlled Trials.

Background: The popularity of applying intermittent fasting (IF) has increased as more and more people are trying to avoid or alleviate obesity and metabolic disease. This study aimed to systematically explore the effects of various IF in humans. Methods: The randomized controlled trials (RCTs) related to IF vs. non-intervention diet or caloric restriction (CR) were retrieved in PubMed, Web of Science, Cochrane Library database, and Embase. Extraction outcomes included, but were not limited to, weight, body mass index (BMI), waist circumference (WC), fasting glucose, and triglyceride (TG). Results: This study includes 43 RCTs with 2,483 participants. The intervention time was at least 1 month, and the median intervention time was 3 months. Contrasting results between IF and non-intervention diet showed that participants had lower weight (weighted mean difference (WMD) = 1.10, 95% CI: 0.09-2.12, p = 0.03) and BMI after IF (WMD = 0.38, 95% CI: 0.08-0.68, p = 0.01). The WC of participants after IF decreased significantly compared with the non-intervention diet (WMD = 1.02, 95% CI: 0.06-1.99, p = 0.04). IF regulated fat mass (FM) more effectively than non-intervention diet (WMD = 0.74, 95% CI: 0.17-1.31, p = 0.01). The fat-free mass of people after IF was higher (WMD = -0.73, 95% CI: (-1.45)-(-0.02), p = 0.05). There was no difference in fasting blood glucose concentrations between participants in the after IF and non-intervention diet groups. The results of insulin concentrations and HOMA-IR, though, indicated that IF was significantly more beneficial than non-intervention diet (standard mean difference (SMD) = -0.21, 95% CI: 0.02-0.40, p = 0.03, and WMD = 0.35, 95% CI: 0.04-0.65, p = 0.03, respectively). Cholesterol and TG concentrations in participants after IF were also lower than that after a nonintervention diet (SMD = 0.22, 95% CI: 0.09-0.35, p = 0.001 and SMD = 0.13, 95% CI: 0.00-0.26, p = 0.05, respectively). IF outcomes did not differ from CR except for reduced WC. Conclusion: Intermittent fasting was more beneficial in reducing body weight, WC, and FM without affecting lean mass compared to the non-intervention diet. IF also effectively improved insulin resistance and blood lipid conditions compared with non-intervention diets. However, IF showed less benefit over CR.