Risk Correlation Analysis between Polycystic Ovary Syndrome (PCOS) and Serum Visfatin Levels in Middle-Aged Women: Systematic Review and Meta-Analysis.

BACKGROUND: Polycystic ovary syndrome (PCOS) is an endocrine disorder that occurs frequently in women of childbearing age and is associated with insulin resistance. Serum visfatin can affect insulin resistance by binding to insulin receptors and further affect the occurrence and development of PCOS. In this study, we investigated the current status of serum visfatin levels in patients with PCOS through a literature search and meta-analysis. METHODS: We searched online Pubmed, Embase, Web of Science, the Cochrane Library, CNKI (China National Knowledge Infrastructure), CBMdisc (China Biology Medicine disc) databases and registered websites such as the ICTRP (International Clinical Trial Registration Platform) and clinicaltrials.gov (https://clinicaltrials.gov/) for case-control studies on PCOS and visfatin levels, assessed the quality of the included articles with the Newcastle-Ottawa Scale (NOS scale), and combined the comparison of serum visfatin levels between patients with PCOS and healthy individuals from high-quality studies. RESULTS: 20 research papers were included in the quantitative analysis of this study. The combined analysis showed that obese patients with PCOS had statistically significantly higher visfatin levels than healthy people [MD (mean difference) = 12.94, 95% CI (confidence interval) (6.52-19.37), Z = 3.95, p < 0.0001]. Visfatin levels were higher in non-obese patients with PCOS than in healthy people and are statistically significant [MD = 14.98, 95% CI (5.80-24.16), Z = 3.20, p = 0.001]. Heterogeneity in the combined analysis was not related to study location, the publication year of the literature, source of serum samples, but was influenced by the quality of the literature. After excluding the most influential papers, the combined analysis was conducted again, and the conclusion was consistent with that before the exclusion. The results of Egger's test showed no significant publication bias. CONCLUSIONS: High serum visfatin levels are a natural feature of PCOS and are not associated with obesity; Serum visfatin levels may be a potential marker for the diagnosis of PCOS, but their relationship with PCOS and insulin resistance remains worthy of in-depth investigation.

Efficacy of cognitive therapy and behavior therapy for menopausal symptoms: a systematic review and meta-analysis.

BACKGROUND: T long-term effects of cognitive therapy and behavior therapy (CTBT) for menopausal symptoms are unknown, and whether the effects are different between natural menopause and treatment-induced menopause are currently unclear. Therefore, we sought to conduct an accurate estimate of the efficacy of CTBT for menopausal symptoms. METHODS: We conducted searches of Cochrane Library, EMBASE, PsycINFO, PubMed, and Web of Science databases for studies from 1 January 1977 to 1 November 2021. Randomized controlled trials (RCTs) comparing intervention groups to control groups for menopausal symptoms were included. Hedge's g was used as the standardized between-group effect size with a random-effects model. RESULTS: We included 14 RCTs comprising 1618 patients with a mean sample size of 116. CTBT significantly outperformed control groups in terms of reducing hot flushes [g = 0.39, 95% confidence interval (CI) 0.23-0.55, I2 = 45], night sweats, depression (g = 0.50, 95% CI 0.34-0.66, I2 = 51), anxiety (g = 0.38, 95% CI 0.23-0.54, I2 = 49), fatigue, and quality of life. Egger's test indicated no publication bias. CONCLUSIONS: CTBT is an effective psychological treatment for menopausal symptoms, with predominantly small to moderate effects. The efficacy is sustained long-term, although it declines somewhat over time. The efficacy was stronger for natural menopause symptoms, such as vasomotor symptoms, than for treatment-induced menopause symptoms. These findings provide support for treatment guidelines recommending CTBT as a treatment option for menopausal symptoms.

A meta-analysis of the efficacy of cognitive behavior therapy on quality of life and psychological health of breast cancer survivors and patients.

OBJECTIVE: The aim of this study was to examine the effect of cognitive behavior therapy (CBT) on quality of life (QOL) and psychological health of breast cancer survivors and patients. METHODS: A total of 1289 references were examined from an overall literature search in PubMed, Embase, CINAHL, and the Cochrane Database of Systematic Reviews. Randomized controlled trials assessing the efficacy of CBT compared with a range of comparators in cancer survivors. We assessed the effect of CBT by using the standardized mean difference as effect size. RESULTS: Among 1289 abstracts and 292 full-text articles reviewed, 10 studies were included. At the posttreatment period, the pooled effect size for CBT on QOL was 0.57 (95% CI, 0.44 to 0.69; P < .001), on depression was -1.11 (95% CI, -1.28 to -0.94; P < .001), on stress was -0.40 (95% CI, -0.53 to -0.26; P < .001), on anxiety was -1.10 (95% CI, -1.27 to -0.93; P < .001), and on hyperarousal cluster of symptoms was -0.18 (95% CI, -0.30 to -0.05; P < .001). The QOL was considered statistically medium effect sizes. The depression and anxiety were considered statistically large effect sizes. CONCLUSIONS: Cognitive behavior therapy is an effective therapy for psychological symptoms of cancer survivors and patients, with meaningfully clinical effect sizes. These findings suggested that CBT should be used as the intervention for breast cancer survivors and patients when possible.