Maternal folic acid supplementation to prevent preeclampsia: a systematic review and meta-analysis.

OBJECTIVE: The purpose of this systematic review was to examine the association between folic acid supplementation during pregnancy and the risk of preeclampsia. METHODS: Relevant studies were included by searching Embase, PubMed, Scope, Web of science, Cochrane Library databases. Studies were reviewed according to prespecified inclusion and exclusion criteria. Study characteristics were summarized, and study quality was assessed. Risk ratios (RR) and 95% confidence intervals (CI) were used as indicators of effect to assess the relationship between folic acid supplementation and risk of preeclampsia. RESULTS: The protocol of this study was prospectively registered with the PROSPERO (registration No. CRD42022380636). A total of nine studies were included, divided into three groups according to the type of study, containing a total of 107 051 and 105 222 women who were supplemented and not supplemented with folic acid during pregnancy. The results showed that folic acid supplementation during pregnancy could not be proven to reduce the risk of preeclampsia. CONCLUSION: The results of the study suggest that folic acid supplementation alone is not associated with a decreased risk of pre-eclampsia,but the inferences are somewhat limited by the low methodological quality of the included literature, and therefore higher quality studies are needed to prove this point.

Prospective Nested Case-Control Study of Dietary and Microbiological-Associated Levels and Dynamics of 5-Aminovaleric Acid Betaine (5-AVAB) in Patients with Type 2 Diabetes.

Objective: This study aimed to evaluate the associations between dietary and microbiological factors, and the levels and dynamics of 5-amino valeric acid betaine (5-AVAB) in patients with type 2 diabetes (T2D) through a prospective nested case-control study. An added meta-analysis aimed to provide a comprehensive evaluation of the relationship between 5-AVAB levels and T2D risk. Methods: A total of 1200 T2D patients and 1200 age- and sex-matched controls were recruited for this study. Dietary information was collected through 24-hour dietary recall questionnaires, while fecal samples were analyzed for gut microbiota composition using 16S rRNA gene sequencing. 5-AVAB levels were measured in plasma samples using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Multivariate logistic regression and general linear models were applied to evaluate the associations between 5-AVAB levels, dietary factors, and gut microbiota composition. Results: The T2D patients exhibited significantly lower plasma 5-AVAB concentrations compared to the control group (P < .001). Lower 5-AVAB levels were associated with higher odds of T2D (adjusted OR = 2.89, 95% CI: 1.76-4.74). Higher intake of dietary factors, including fiber and polyunsaturated fatty acids (PUFAs), were positively associated with 5-AVAB levels. Furthermore, specific bacterial taxa were significantly associated with 5-AVAB levels. A meta-analysis of five studies corroborated the inverse association between 5-AVAB and T2D risk (pooled OR = 2.68, 95% CI: 1.61-4.46). Conclusion: Our findings suggest that lower 5-AVAB levels are associated with an increased risk of T2D. Dietary factors and gut microbiota composition appear to significantly influence 5-AVAB levels. The potential use of 5-AVAB as a therapeutic target in T2D management is an exciting area of research that requires further investigation. If successful, it could lead to new treatment options for T2D patients, ultimately improving their long-term health outcomes and quality of life.

Effects of Tai chi in knee osteoarthritis patients: An overview of systematic reviews and meta-analyses.

OBJECTIVE: Tai Chi (TC) is a complementary therapy for knee osteoarthritis (KOA). Although systematic reviews (SRs) and meta-analyses (Mas) of efficacy studies have been published, the results remain uncertain, and their quality has not yet been fully evaluated. Here, we summarize the existing SRs/Mas, evaluate their quality and level of evidence, and provide a reference for the effectiveness of TC. METHODS: SRs/Mas of TC therapy for KOA published before February 2023 were retrieved from eight databases in Chinese and English. The Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020, and the Risk of Bias in Systematic (ROBIS) scale were used to assess methodological quality, reporting quality, and risk of bias. RESULTS: Seven SRs/Mas were finally included. One was deemed high quality by AMASTAR-2, while the rest were of critically low quality. In the PRISMA2020 assessment, the response rate of "Yes" for Q7, Q15, Q22, Q24, and Q27 was less than 50%. In the ROBIS assessment, three reports in Phase 3 were high risk and four were low risk. In the efficacy assessment, TC has shown varying degrees of improvement in physical function, pain, stiffness, 6-minute walk test, mental quality of life, TUG, and balance in patients with KOA. CONCLUSION: TC effectively treats KOA-associated pain, stiffness, body function, and mental quality of life. However, the low methodological quality of the studies and the high risk of migration reduced their reliability. Therefore, these conclusions should be taken with caution. High-quality, large-sample research is needed to provide stronger and more scientific evidence.