Exposure to heavy metals and the risk of osteopenia or osteoporosis: a systematic review and meta-analysis

The relationship between heavy metal exposure and risk of osteopenia or osteoporosis has biological plausibility, yet it remains inconclusive; therefore, we conducted a systematic review and meta-analysis to evaluate the associations between exposure to heavy metals (i.e., cadmium, lead, and mercury) and the risk of osteopenia or osteoporosis. Databases of MEDLINE, Embase, Scopus, and Web of Science were searched through November 2019, to identify studies that evaluated the relationship between exposure to cadmium, lead, and mercury and risk of osteopenia or osteoporosis in adults. Fourteen eligible studies were included. Effect sizes expressed as pooled odds ratios (OR) and 95% confidence intervals (CI) were estimated using weighted random-effect models. Exposure to cadmium (OR = 1.35; 95% CI: 1.17 to 1.56; P ≤ 0.001) and lead (OR = 1.15; 95% CI: 1.00 to 1.32; P = 0.05) was associated with an increased risk of osteopenia or osteoporosis, unlike mercury. Subgroup analyses showed cadmium exposure increased the risk of osteopenia or osteoporosis in older (> 65 yrs.; OR = 1.43; 95%CI: 1.08 to 1.88, P = 0.01) compared with younger (18-65 yrs.; OR = 1.24; 95% CI: 1.02 to 1.52, P = 0.03) adults. Also, lead exposure increased the risk in men (OR = 1.55; 95% CI: 1.15 to 2.09, P = 0.007) unlike in women. By contrast to urinary levels, blood (OR = 1.26; 95% CI: 1.08 to 1.47, P = 0.003) and dietary (OR = 1.46; 95% CI: 1.28 to 1.67, P < 0.001) levels of cadmium were associated with an increased risk of osteopenia or osteoporosis. Exposure to cadmium and lead may be associated with an increased risk of osteopenia or osteoporosis, although high heterogeneity was detected.

Dietary Inflammatory Index and the Risk of Frailty Among Older Adults: A Systematic Review and Meta-Analysis

A systematic review and meta-analysis was conducted to comprehensively examine the association between Dietary Inflammatory Index (DII®) score and risk of frailty. Frailty risk were available from five studies comprising 13,908 older adults. Furthermore, frailty related parameters were extacted from two studies with 7,539 individuals. A pooled adjusted odds ratio analysis indicated that there was an association between DII® score and frailty risk (OR = 1.24, 95%CI: 1.6-1.33, P < 0.001, I² = 0.0%). The results of frailty related parameters demonstrated that DII® score was associated with weakness risk (OR = 1.12, 95%CI: 1.05-1.19, P = 0.014, I² = 0.0%), but not other frailty-related parameters including exhaustion, low BMI or low physical activity. The results of this meta-analysis suggest that older adults who exhibit higher DII® scores have an increased frailty risk. Further prospective cohort studies with longer follow-up periods, are needed to support this possible association between DII® score and frailty risk.

Effect of green tea extract on lipid profile in patients with type 2 diabetes mellitus: A systematic review and meta-analysis

BACKGROUND

Previous studies have indicated controversial results regarding the efficacy of green tea extract (GTE) in improving the lipid profile of type 2 diabetes mellitus (T2DM) patients. We aimed to conduct a systematic review and meta-analysis to pool data from randomized controlled trials (RCTs).

METHODS

A systematic search was performed in Web of Science, PubMed, and Scopus databases, without any language and time restriction until August 2019, to retrieve the RCTs which examined the effects of GTE on serum concentrations of high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG) or total cholesterol (TC) in T2DM patients. Meta-analyses were carried out using a random effects model. I2 index was used to evaluate the heterogeneity.

RESULTS

Initial search yielded 780 publications. Of these, seven studies were eligible. The supplementary intake of GTE improved lipid profile by reducing serum TG concentrations in patients with T2DM. Meanwhile, subgroup analyses based on duration of interventions (≤8 and > 8 weeks) and intervention dosage (≤800 and > 800 mg/day) showed that the GTE supplementation longer than 8 weeks and in doses >800 mg/day resulted in a significant decrease in serum TG concentrations. Furthermore, intervention longer than 8 weeks with doses lower than 800 mg/day resulted in a significant reduction in serum TC concentrations.

CONCLUSION

In conclusion, present systematic review and meta-analysis revealed that the supplementary intake of GTE may improve lipid profile by reducing serum concentrations of TG in patients with T2DM. Furthermore, the results of our stratified analyses suggested that long-term GTE intervention may reduce serum concentrations of TG and TC.

Effects of Cynara scolymus L. on glycemic indices:A systematic review and meta-analysis of randomized clinical trials

OBJECTIVES

Cynara scolymus L. (common artichoke) and its products have been considered as potential phytotherapeutic agents for various conditions, such as cardiovascular, hepatic and gastric diseases, among others. Until now, the effects of artichoke and artichoke products administration on glycemic indices have not been sufficiently appraised. The present study evaluated the effects of artichoke and artichoke products administration on the glycemic indices.

METHODS

Clinical trials were identified in the Cochrane Library, PubMed, Embase and Scopus databases; to infinity until 15 March 2020. Weighted mean differences (WMD) were pooled using a random-effects model. Heterogeneity, sensitivity analysis and publication bias were reported using standard methods.

RESULTS

Pooled analysis of nine Randomized controlled trials (RCTs), demonstrated that the administration of artichoke and artichoke products led to a significant reduced fasting blood sugar (FBS) (WMD: -5.28 mg/dl, 95 % CI: -8.95, -1.61; p = 0.005). However, other glycemic indeces including fasting insulin (WMD: -0.45 μIU/dL, 95 % CI: -1.14, 0.25; p = 0.20), HOMA-IR (MD: -0.25, 95 % CI: -0.57, 0.07; p = 0.12) or Hemoglobin A1c (HbA1c) (WMD: -0.09, 95 % CI: -0.20, 0.02; p = 0.09) did not alter after the administration of artichoke and artichoke products. A subgroup analysis comparing the kind of intervention, revealed that just the supplementation of artichoke and artichoke products, in a noco-supplementation form, was efficacy for the reduction of Homeostatic model assessment of insulin resistance (HOMA-IR) (WMD: -0.52, 95 % CI: -0.85, -0.19; p = 0.002).

CONCLUSIONS

The supplementation of artichoke and artichoke products can significantly reduce the FBS concentrations in humans. Moreover, these outcomes suggested that just the supplementation of artichoke and artichoke products is more effective in the reduction of HOMA-IR levels than the co-supplementation form. However, additional clinical trials with longer study periods are necessitated to obtain a robust conclusion for producing new guidelines as part of a healthy diet.

Greater child dental health inequality in England compared to Wales and Northern Ireland, despite lower average disease levels

INTRODUCTION

Dental caries and inequalities in dental health are major public health concerns.

AIM

To report variation in dental caries experience across deprivation quintiles and the magnitude of inequalities between countries.

DESIGN

Secondary analyses of cross-sectional data from the 2013 Child Dental Health Survey (CDHS) in England, Wales, and Northern Ireland.

MATERIALS AND METHODS

Distribution of dental caries across deprivation quintiles were estimated using as proportions and means. The magnitude of inequalities was calculated using the Relative Index of Inequality (RII).

MAIN OUTCOMES

Dental caries experience as indicated by the prevalence (%dmft/DMFT>0) and severity (dmft/DMFT) of 'obvious' and 'clinical' decay experience in both primary and permanent dentitions.

RESULTS

Children from more deprived quintiles showed higher prevalence and severity of dental caries. RIIs for dental caries were greater in England than Wales or Northern Ireland, indicating greater relative inequalities despite lower average dental caries experience. The prevalence and severity of dental caries among the most deprived children in England were 1.7 to 3.7 times greater than those of the least deprived.

CONCLUSION

There is a deprivation gradient in child dental caries in all three countries, with England showing the greatest inequalities.

Effects of cinnamon on controlling metabolic parameters of polycystic ovary syndrome: A systematic review and meta-analysis

ETHNOPHARMACOLOGICAL RELEVANCE

Cinnamon as a traditional medicine has been widely used in various disorders such as headache, toothache, common cold, diarrhea, flatulence, fever, amenorrhea frigidity. However, the effect of cinnamon supplementation on metabolic parameters of polycystic ovary syndrome (PCOS) patients has not been fully assessed.

AIM OF THE STUDY

Clinical trials have shown contradictory effects of cinnamon supplementation on metabolic parameters of polycystic PCOS patients. Therefore, we evaluated the effect of cinnamon supplementation on metabolic parameters of PCOS patients through a systematic review and meta-analysis of clinical trials.

MATERIALS AND METHODS

PubMed, Embase, the Cochrane library, Scopus and Web of Science databases (until August 2019) were searched to identify potential clinical trials with information on cinnamon supplementation on metabolic parameters among PCOS patients. Weighted Mean Differences was pooled using a random-effects model. Standard methods were used for assessment of heterogeneity, publication bias and sensitivity analysis.

RESULTS

Pooling five clinical trials (five treatment arms) together did not show any significant effect on body weight (WMD: -0.74 kg, 95% CI: -3.17 to 1.69) and body mass index (BMI) (WMD: -1.47, 95% CI: -4.07 to 1.12). Our results illustrated that a significant decrease of fasting blood sugar (WMD: -5.32, mg/dL95% CI: -10.46 to -0.17), fasting insulin (WMD: -4.10, μIU/dL95% CI: -6.76 to -0.144) and HOMA-IR (WMD: -0.69 95% CI: -1.37 to -0.004) were observed after cinnamon treatment. Moreover, our findings demonstrated that oral cinnamon supplementation in PCOS patients led to significant reduction of serum level of LDL-C, total cholesterol, and triacylglycerol. Besides, an improvement of serum concentration of HDL-C was shown by cinnamon supplementation.

CONCLUSION

Generally, present study indicated that cinnamon supplementation may help PCOS patients to manage their metabolic parameters. Future prospective randomized clinical trials with longer intervention duration are warranted to obtain a precise conclusion.

Effect of green cardamom on lipoproteins, glycemic control and anthropometric parameters: A meta-analysis of randomized clinical trials

INTRODUCTION

The aim of this systematic review and meta-analysis was to summarize all the existing randomized controlled trials (RCTs) evidence and to evaluate the effects of green cardamom on lipoproteins, glycemic control and anthropometric parameters in healthy and/or with disease types compared with the control.

METHOD

Two independent authors systematically searched online databases including EMBASE, Scopus, PubMed, Cochrane Library, and Web of Science from inception until 30th July 2019. RCTs complying with the following criteria were included in this meta-analysis: human trials with either cross-over design or parallel design, trials with data on the effects of green cardamom on serum lipoproteins and glycemic control and anthropometric parameters with standard deviation and related 95% confidence interval for the both intervention and placebo groups. The heterogeneity among the included studies was assessed using Cochrane's Q test and I-square (I²) statistic. Data were pooled using a random-effects model and weighted mean difference (WMD) was considered as the overall effect size.

RESULT

Seven trials were included in this meta-analysis. Triglycerides were significantly reduced after cardamom supplementation when compared with the control group. Cardamom intake from 3 small studies resulted in a significant increase in BMI when compared with the control group. However, cardamom supplementation did not have any significant effect on total cholesterol, LDL-cholesterol, HDL-cholesterol, fasting plasma glucose and body weight when compared with the control group.

CONCLUSION

This meta-analysis demonstrated that green cardamom intake significantly reduced triglycerides levels which may have played an indirect role in improved clinical symptoms in diseases with metabolic disorders.

Association of dietary inflammatory potential with cardiometabolic risk factors and diseases: a systematic review and dose-response meta-analysis of observational studies

CONTEXT

The association of dietary inflammatory index (DII®), as an index of inflammatory quality of diet, with cardiometabolic diseases (CMDs) and risk factors (CMRFs) has been inconsistent in previous studies.

OBJECTIVE

The current systematic review and dose-response meta-analysis was performed to investigate the association of the DII score with CMDs and CMRFs.

DATA SOURCES

All published observational studies (cohort, case-control and cross-sectional) using PubMed/Medline, Scopus, ISI Web of Science, and Google Scholar databases were retrieved from inception through November 2019.

DATA EXTRACTION

Two reviewers independently extracted the data from included studies.

DATA ANALYSIS

Pooled hazard ratio (HR) or odds ratio (OR) were calculated by using a random-effects model.

RESULTS

Ten prospective cohort studies (total n = 291,968) with 31,069 CMDs-specific mortality, six prospective cohort studies (total n = 43,340) with 1311 CMDs-specific morbidity, two case-control studies with 2140 cases and 6246 controls and one cross-sectional study (total n = 15,613) with 1734 CMDs-specific morbidity were identified for CMDs. Meta-analyses of published observational studies demonstrated that the highest DII score category versus the lowest DII score category was associated with 29% increased risk of CMDs mortality (HR = 1.29; 95% confidence interval (CI) 1.18, 1.41). Moreover, there was a significant association between the DII score and risk of CMDs in cohort studies (HR = 1.35; 95% CI 1.13, 1.61) and non-cohort study (HR = 1.36; 95% CI 1.18, 1.57). We found a significant association between the DII score and metabolic syndrome (MetS) (OR: 1.13; 95% CI 1.03, 1.25), hyperglycemia and hypertension. None-linear dose response meta-analysis showed that there was a significant association between the DII score and risk of CMDs mortality (P_nonlinearity < 0.001). Moreover, evidence of none-linear association between the DII score and risk of CMDs was not observed (p-value = 0.1).

CONCLUSIONS

Adherence to pro-inflammatory diet was associated with increased risk of CMDs, mortality and MetS.

Sleep duration and sarcopenia risk: a systematic review and dose-response meta-analysis

PURPOSE

Present systematic literature review and dose-response meta-analysis were carried out to evaluate the association between sleep duration and sarcopenia risk.

METHODS

Related studies were found by searching ISI Web of science databases, Scopus, and PubMed, up to May, 2019. Data were available from four studies. A total odds ratio of 17551 participants in these studies was pooled for the current study.

RESULTS

Pooled outcomes from random effects model demonstrated that lowest category of sleep duration (under 6 h) versus reference category (6-8 h) was significantly related with increased risk of sarcopenia (OR: 1.71 95% CI, 1.11, 2.64). Pooled OR also indicated that highest category (more than 8 h) of sleep duration versus reference category (6-8 h) was significantly associated with increased risk of sarcopenia (OR: 1.52 95% CI, 1.23, 1.88). Moreover, subgroup analysis by sex showed that women were affected by both short and long sleep while men were only affected by long sleep duration. The nonlinear dose-response meta-analysis revealed a U-shaped association between sleep duration and the risk of sarcopenia, with a nadir at 8 h per day. The linear dose-response meta-analysis illustrated that the risk of sarcopenia did not change significantly nor for a 0.5-h increment neither for 1-h increment in sleep duration per day.

CONCLUSION

The outcomes from this meta-analysis indicate that the public should be made aware of the negative consequences of long and short sleep for sarcopenia especially among women. Further studies should now be undertaken to establish possible links between risk of sarcopenia and sleep duration.

Effects of genistein on blood pressure: A systematic review and meta-analysis

Genistein (4',5,7-trihydroxyisoflavone) is a phytoestrogen with potential health benefits in the prevention of cardiovascular disease. However, the evidence regarding its effects on hypertension has not been conclusive. Therefore, we examined the impact of oral genistein supplementation on systolic blood pressure (SBP) and diastolic blood pressure (DBP) via a systematic review and meta-analysis of randomized controlled trials (RCTs). PubMed, ISI Web of Science, Scopus and the Cochrane library databases (until August 2019) were searched to identify potential RCTs with information on genistein supplementation and hypertension. Weighted Mean Difference (WMD) was pooled using a random-effects model. Pooling four RCTs (four treatment arms) together did not show any significant reduction of SBP (WMD: -5.32 mmHg, 95% CI: -14.59 to 3.96) and DBP (WMD: -2.06 mmHg, 95% CI: -6.41 to 2.28) compared to that of the placebo group. However, subgroup analysis by intervention duration suggested that more than 6 months genistein supplementation in metabolic syndrome patients can significantly decrease SBP (WMD: -13.73 mmHg, 95% CI: -18.10 to -9.37) and DBP (WMD: -5.18 mmHg, 95% CI: -6.62 to -3.74). Generally, present study indicated that genistein supplementation had no effect on hypertension, but it seems that longer intervention duration of more than 6 months especially among metabolic syndrome patients may lead to the effectiveness of genistein.

Clinical and psychological responses to synbiotic supplementation in obese or overweight adults: A randomized clinical trial

BACKGROUND

Obesity is highly prevalent worldwide. Emerging clinical studies suggest that pre- and pro- biotic formulations may be effective interventions for the management of obesity and associated metabolic complications. The current trial was conducted to assess the effect of synbiotic supplementation on anthropometric indices, glycemic and lipid profile, blood pressure, and psychological status of adults with overweight or obesity.

METHODS

This randomized double-blind, placebo-controlled trial was conducted on 60 adults with overweight or obesity. Participants were randomly assigned into two groups to receive either synbiotics (n = 30) in form of a 500 mg capsule (containing Lactobacillus acidophilus, Lactobacillus casei and Bifidobacterium bifidum plus inulin) or placebo (n = 30) for 8 weeks. The level of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FPG), insulin, body weight, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), stress, anxiety, and depression were measured at the baseline and end of the study.

RESULTS

In total, 59 subjects (39 men and 20 women) completed the present study. A significant between-group decrease in body weight (P = 0.03), TC (P = 0.01), TG (P = 0.02), LDL-C (P = 0.01), stress (P < 0.001), anxiety (P = 0.03), and depression (P = 0.03) was found in the synbiotic group compared to the placebo. However, synbiotics had no significant effect on HDL-C, SBP, DBP, FPG and fasting insulin concentrations, as well the BMI and WC (P < 0.05).

CONCLUSION

The present study showed that synbiotic supplementation can confer a number of health benefits including improvements in TG, TC, LDL-C, body weight, stress, anxiety, and depression to subjects that are overweight or obesity.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials IRCT20180201038585N3.

Effects of Spirulina supplementation on obesity: A systematic review and meta-analysis of randomized clinical trials

OBJECTIVE

Evidence has suggested that Spirulina supplementation may affect anthropometric indices. Therefore, a systematic review and meta-analysis was performed to summarize published randomized clinical trials which assess the effect of Spirulina supplementation on obesity.

SETTING

Pertinent studies were identified using Embase, Scopus, ISI Web of Science, PubMed and Cochrane library databases up to May 2019. Mean Differences (MD) were pooled using a random-effects model. Heterogeneity, sensitivity analysis and publication bias were reported using standard methods.

RESULTS

Results of 5 studies (7 treatment arms) showed a significant reduction in weight (MD: -1.56 Kg, 95% CI: -1.98 to -1.14) after Spirulina supplementation. Subgroup analysis based on health status revealed that weight change in obese subjects (MD: -2.06 Kg, 95% CI: -2.45 to -1.68) was greater than overweight participants (MD: -1.28 Kg, 95% CI: -1.62 to -0.93) following Spirulina supplementation. Also, pooled analysis showed that Spirulina supplementation led to a significant reduction in body fat percent (MD: -1.02, 95% CI: -1.49 to -0.54) and waist circumference (MD: -1.40, 95% CI: -1.40 to -1.39), but not in body mass index and waist to hip ratio.

CONCLUSION

Spirulina supplementation significantly reduces body weight, especially in obese individuals.

Effects of resveratrol supplementation on bone biomarkers: a systematic review and meta-analysis

The current study presents a comprehensive systematic review and meta-analysis of randomized controlled trials (RCTs) on resveratrol and bone health biomarkers. PubMed, Scopus, and Web of Science (until September 2018) were searched to identify the potential RCTs with information on resveratrol supplementation and bone metabolism biomarkers. Mean differences (MD) were analyzed using a random-effects model. Pooling six RCTs (eight treatment arms with 264 subjects) together identified no significant reduction of serum Ca, osteocalcin, C-terminal telopeptide of type I collagen, and procollagen I N-terminal propeptide values after resveratrol supplementation over placebo treatment. However, a significant increase in serum alkaline phosphatase (ALP) (MD: 5.69 mg/mL, 95% CI: 3.58-7.80, I²  = 95.7%, P < 0.001) and bone alkaline phosphatase (BAP) (MD: 10.57 mmHg, 95% CI: 5.36-15.78, I²  = 99.2%, P < 0.001) values was observed after resveratrol treatment relative to placebo. The findings of this study indicate that resveratrol supplementation increased some key bone biomarkers, such as ALP and BAP. Further precise clinical trials of the effects of resveratrol supplementation on bone health should be conducted.

The effect of omega-3 and vitamin E on oxidative stress and inflammation: Systematic review and meta-analysis of randomized controlled trials

Background: Several studies have investigated the effect of omega-3 fatty acids and vitamin E on oxidative stress and inflammation, but their findings are inconsistent. The aim of this meta-analysis is to elucidate the overall effects of co-supplementation with omega-3 fatty acids and vitamin E on oxidative stress and inflammation. Methods: We searched titles, abstracts, and keywords of relevant articles indexed in PubMed, ISI, Scopus, and Google Scholar databases up to December 2018 to identify eligible RCT studies. Random effects model was used to estimate the pooled effect of co-supplementation with omega-3 fatty acids and vitamin E on oxidative stress and inflammation. Results: Overall, 7 RCTs with 504 participants were included in this meta-analysis. We found that co-supplementation with omega-3 fatty acids and vitamin E decreased hs-CRP (weighed mean difference (WMD) = -2.15 mg/L; 95% CI: -3.40, -0.91 mg/L; P < 0.001) concentrations and increased total antioxidant capacity (TAC) (WMD = 92.87 mmol/L; 95% CI: 31.97, 153.77 mmol/L; P = 0.03), and nitric oxide levels (NO) (WMD: 6.95 μmol/L; 95% CI: 3.86, 10.04, P < 0.001) compared with control group. Omega-3 fatty acids and vitamin E had no significant effect on malondialdehyde (MDA) (WMD: 1.54 mmol/L; 95% CI: -1.29, 4.36; P = 0.196), and glutathione (GSH) (WMD: 20.87 mmol/L; 95% CI: -20.04, 61.6, P = 0.31) levels. Conclusion: The present meta-analysis found that omega-3 fatty acids and vitamin E co-supplementation significantly decreased hs-CRP and increased NO and TAC, although it had no significant effect on MDA and GSH.

Association Between Neck Circumference and Blood Pressure: A Systematic Review and Meta-Analysis of Observational Studies

Neck circumference (NC) has been suggested as a predictor for blood pressure disorders. Therefore, we sought to conduct a systematic review and meta-analysis regarding the association between NC and blood pressure in adults. Pertinent studies were identified by searching PubMed and Scopus databases, up to March 2018. Studies which reported the correlation coefficient between NC, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were selected. Also, studies reported the odds ratio (OR) of hypertension or pre-hypertension included adults older than 18 years old were selected. Results were pooled using a random-effects model. Of 29 studies included in meta-analysis, 26 studies reported only correlation coefficient, 3 studies reported only odds ratio and 2 studies reported both correlation coefficient and odds ratio. Overall, NC was significantly correlated with SBP [ES (z)=0.20; 95% CI=0.18, 0.23] and DBP [ES (z)=0.20; 95% CI=0.16, 0.24]. Type of correlation coefficient was the sources of observed heterogeneity. Also, NC was directly associated with the risk of hypertension (OR=1.29; 95% CI: 1.06-1.56), but not pre-hypertension (OR=1.18; 95% CI: 0.92, 1.52). Furthermore, subgroup analysis based on the region indicated that the studies conducted in Western regions reported higher risk of HTN in association with NC (OR=1.27; 95% CI: 1.23-1.32), but not among those conducted in the Eastern regions (OR=1.11; 95% CI: 0.96-1.28). NC seems to be a new anthropometric measurement, which is probably a good predictor of elevated blood pressure, especially in the Western population.

A comparison of the effect of supplementation and sunlight exposure on serum vitamin D and parathyroid hormone: A systematic review and meta-analysis

Background: Supplementation and getting sunlight exposure are two treatments for vitamin D deficiency. However, studies reported conteroversial findings regarding the efficacy of these two methods.Objective: To compare the effect of oral vitamin D supplementation with sunlight exposure on serum vitamin D and parathyroid hormone (PTH).Methods: A computer-based literature search through PubMed, Scopus and Google scholar search engines was conducted until April 2019 to find clinical trials which compared the effect of oral vitamin D supplementation with sunlight exposure on serum vitamin D and PTH. Means for serum 25-hydroxy vitamin D3 (25(OH) D3) and PTH concentration were extracted. A subgroup analysis was used to detect potential sources of inter-study heterogeneity. Mean differences (MD) were analyzed using a random-effects model (the DerSimonian-Laird approach).Results: A total of seven papers were included in the meta-analysis. Pooled analysis showed that vitamin D supplementation significantly elevated levels of serum 25(OH) D3 in comparison with sunlight exposure (MD: 8.56nmol/l, 95%CI: 4.15, 12.97, T² = 40.32%, H² = 9.45%, P for heterogeneity p < 0.001). Also, the difference between the effect of vitamin D supplementation and sun exposure was lower in studies which used UVB radiation compared with studies which applied direct sunlight (MD: 11.65 nmol/l, 95%CI: 7.02, 16.28; P for between subgroup heterogeneity = 0.001).Conclusion: Vitamin D supplementation was more effective than sun exposure at increasing serum 25(OH) D3. The difference between efficacy of vitamin D supplementation and sun exposure was lower in studies which used long-term sun exposure or applied UVB treatment instead of direct sunlight.

Metabolically healthy status and BMI in relation to depression: A systematic review of observational studies

AIM

Findings of association between metabolically healthy status and BMI and risk of depression are controversial. This study aimed to assess the relation between metabolically healthy status and BMI and depression.

METHODS

All published studies up to 25 June 2018 were searched by using the databases of PubMed, ISI Web of Science, SCOPUS and Google Scholar and following key words were used: metabolically AND (healthy OR unhealthy OR benign) AND (overweight OR obes* OR "over weight") AND phenotype AND (depression OR depress* OR "depressive disorder").

RESULTS

After screening title and abstract and considering inclusion criteria, 5 studies were found to be included in our study. Metabolically unhealthy obesity was associated with 30%-83% increased risk of depression and metabolically unhealthy non-obesity was associated with 19%-60% increased risk of depression. Metabolically healthy obesity was not associated with the risk of depression in all studies.

CONCLUSIONS

In conclusion, metabolically health status and BMI are associated with risk of depression. Metabolically unhealthy situation increased risk of depression greater than metabolically healthy status.

Effects of Melatonin Supplementation On Blood Pressure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Melatonin is a physiological indoleamine secreted from the pineal gland into the bloodstream. This hormone has antioxidant effects in cardiovascular disease, but the evidence regarding its effects on blood pressure (BP) has not been conclusive. Therefore, we assessed the impact of melatonin supplementation on systolic BP (SBP) and diastolic BP (DBP) through a systematic review and meta-analysis of available randomized controlled trials (RCTs). Medline, Scopus, Web of Science, Cochrane library, and Google scholar (until May 2018) were searched to identify potential RCTs with information on melatonin supplementation and BP. Mean Differences (MD) were pooled using a random-effects model. Standard methods were used for assessment of heterogeneity, sensitivity analysis, and publication bias. Pooling 5 RCTs (6 treatment arms) together identified significant reduction for SBP (MD: -3.43 mmHg, 95% confidence interval (CI): -5.76 to -1.09, p=0.004) and DBP (MD: -3.33 mmHg, 95% CI: -4.57 to -2.08, p<0.001) after supplementation with melatonin compared with control treatment. The sensitivity analysis indicated that the results were robust. We did not observe any evidence regarding publication bias. The findings of this meta-analysis support the overall favorable effect of melatonin supplementation on BP regulation.

The association between diet and mood: A systematic review of current literature

A number of studies have examined the association between diet and mood state, but the findings have been inconclusive. Herein, we conducted a systematic review to assess the association between different diet and mood state. PubMed, Cochrane's library, Science direct, Scopus, Google scholar and ISI web of science databases were searched for all available literature until December 2017 for studies assessing the association between diet and mood state. The Newcastle-Ottawa Scale and Jadad scale for reporting randomized clinical trials were used to assess study quality. A total of 18 studies out of 2857 met our inclusion criteria and included in our systematic review. Although there are not consistent findings between studies, it seems that DASH, vegetable-based, glycemic load-based, ketogenic and Paleo diets could improve mood more than the others. Further studies are needed to assess such relationship in a longer period to draw a firm link between diet and mood.

Neck circumference in relation to glycemic parameters: a systematic review and meta-analysis of observational studies

BACKGROUND

Recent studies have suggested that neck circumference (NC) is a supplemental screening measure for diagnosing metabolic complications and might be associated with glycemic parameters. The aim of the present study was to to evaluate the association between NC and glycemic parameters.

METHODS

We systematically searched the electronic databases (including MEDLINE, Scopus, EMBASE, and Google scholar) up to April 2018. Observational studies that reported correlation coefficient between NC and glycemic parameters were included in the analysis. A random effects model was used to estimate overall Fisher's Z and 95% confidence interval of glycemic parameters including fasting plasma glucose (FBG), serum fasting insulin level, homeostasis model assessment-estimated insulin resistance (HOMA-IR) and glycated hemoglobin (HbA1c).

RESULTS

A total of 21 studies (44,031 participants) were eligible for including in the systematic review and meta-analysis. Significant correlations were found between NC and FBG (Fisher's Z = 0.18; 95% CI 0.16, 0.21), serum fasting insulin level (Fisher's Z = 0.34; 95% CI 0.26, 0.41), HOMA-IR (Fisher's Z = 0.36; 95% CI 0.29, 0.43) and HbA1c (Fisher's Z = 0.14; 95% CI 0.09, 0.20). Meta-regression analysis showed that NC were marginally associated with FBG in a linear manner (β = 0.008, P = 0.09); but not related to serum fasting insulin level, HOMA-IR, and HbA1c.

CONCLUSIONS

This meta-analysis of cross-sectional studies showed that NC was positively correlated with glycemic parameters including FBG, serum fasting insulin level, HOMA-IR, and HbA1c. Further investigations with prospective design are required to confirm these findings.

Effects of grape products on blood lipids: a systematic review and dose–response meta-analysis of randomized controlled trials

Grape products through several plausible mechanisms-of-action are reported to improve lipid profile. The present systematic review revealed that grape product supplementation might have a positive effect on achieving a lipid profile target.

Food insecurity and the risk of undernutrition complications among children and adolescents: A systematic review and meta-analysis

OBJECTIVES

This systematic review and meta-analysis was performed to examine the association between household food insecurity and the risk of being underweight, stunting, and wasting in children and adolescents.

METHODS

Pertinent studies were identified by searching PubMed, Web of Science, and Scopus databases up to June 2018. A total of 21 studies met the inclusion criteria to be included in the pooled analysis. The risk ratio of 55 173 individuals from 12 different countries were pooled in these studies for our meta-analysis.

RESULTS

It was found that food insecurity increased the risk of stunting (odds ratio [OR] = 1.17; 95% confidence interval [CI]: 1.09-1.25) and underweight (OR = 1.17; 95% CI: 1.01-1.36) but not of wasting (OR = 1.04; 95% CI: 0.96-1.12). Subgroup analysis by age indicated that food insecurity increased the risk of stunting (OR = 1.20; 95% CI: 1.02-1.39) and underweight (OR = 1.34; 95% CI: 1.02-1.77) in children older than 5 y. This association was significant just for stunting risk (OR = 1.14; 95% CI: 1.05-1.23) in children younger than 5 y. Furthermore, among children and adolescents, risk of stunting or being underweight increased by the intensification of the level of food insecurity in food-insecure households. Furthermore, subgroup analysis by country development levels showed that children and adolescents living in developing countries had higher risk of stunting (OR = 1.16; 95% CI: 1.05-1.27).

CONCLUSIONS

Household food insecurity appears to be associated with higher risk of stunting and being underweight among children and adolescents. In addition, the intensification of the level of food insecurity and the increased age of children may increase the risk of stunting or being underweight in food-insecure households. Also, the level of economic development is an important factor in the effects of food insecurity on risk of stunting.

Food insecurity and adult weight abnormality risk: a systematic review and meta-analysis

PURPOSE

Research into the relationship between food insecurity and weight abnormality has yielded varied and contradictory results. Therefore, a systematic review and meta-analysis were carried out to examine the association between food insecurity and weight abnormality in adults.

METHODS

Pertinent studies were identified by searching PubMed and Scopus databases, up to February 2018. Data were available from 31 studies. These studies were conducted in 14 different countries. The odds ratio of 115,993 individuals in these studies was pooled for the meta-analysis.

RESULTS

The present meta-analysis showed that adults in food-insecure households are more at risk of obesity (OR 1.15, 95% CI 1.06-1.23). Subgroup analysis by gender also revealed that women had a higher risk of obesity compared to men in food-insecure households (OR 1.26, 95% CI 1.05-1.46). Furthermore, subgroup analysis by food insecurity level implied that a severe level of household food insecurity may be associated with a higher risk of underweight (49%) than overweight (37%) or obesity (29%) among adults. In addition, subgroup analysis revealed that with lower levels of national economic development, the risk of weight abnormality shifted from obesity to underweight.

CONCLUSION

It seems that adults in food-insecure households, especially women, are at higher risk of obesity. The weight abnormality risk may increase with the intensification of the level of food insecurity. Also, the level of economic development is an important factor in the effects of food insecurity on weight status. However, due to the high heterogeneity among studies, the results should be interpreted with caution.

The associations between dietary patterns and bone health, according to the TGF-β1 T869→C polymorphism, in postmenopausal Iranian women

BACKGROUND/OBJECTIVE

Recent studies have shown that dietary variants and genetic variants play a decisive role in the risk of developing osteoporosis. Therefore, the objective of the present study was to examine associations between dietary pattern and bone health, according to the TGF-β1 T869→C polymorphism, in postmenopausal Iranian women.

MATERIALS AND METHODS

In this study, 264 postmenopausal women aged from 46 to 78 years were examined. Body composition was measured by a body composition analyzer and physical activity by the short-form physical activity questionnaire. Bone mineral density was measured by the DEXA method. Dietary patterns were determined using factor analysis on 27 foods groups, employing a valid, reliable 147-item semi-quantitative food frequency questionnaire. The dietary patterns were analyzed by the factor analysis method. Blood samples were taken for measuring blood parameters. DNA samples from participants were genotyped using the RFLP-PCR method.

RESULTS

Three dietary patterns were identified, namely: mediterranean diet, traditional diet, and unhealthy diet-one of which was associated with bone health. Postmenopausal women following a Mediterranean diet had lower weight and central obesity (0.05 > P). Higher adherence to a Mediterranean pattern was positively associated with Z-score L2_L4 lumbar spine (0.05 > P). TGF-β1 T869→C genotypes, after adjustment, were not directly correlated with bone mineral density and body composition (0.05 < P). Moreover, these findings demonstrated that in participants adhering to a Traditional dietary pattern, the C allele carrier group (TC and CC genotypes) had a lower L2_L4 Z-score (P = 0.05).

CONCLUSION

It seems that the mediterranean diet can be a beneficial dietary pattern in the prevention of osteoporosis and obesity in postmenopausal women. Furthermore (probably in the C allele carrier group), lower vitamin D intake, coupled with adherence to a traditional dietary pattern, reduces the deposition of TGF-beta and increases the risk of lumbar spine osteoporosis.

Associations between dietary inflammatory index and incidence of breast and prostate cancer: a systematic review and meta-analysis

OBJECTIVES

Dietary inflammatory index (DII) scores have been inconsistently linked to cancer risks. Therefore, a systematic review and meta-analysis was performed to examine the associations between the DII and the risks of breast and prostate cancer among men and women.

METHODS

Relevant studies were identified by searching PubMed and EMBASE databases up to March 2018. Data were available from 13 studies; of these, four studies used a prospective cohort design and nine studies were case-control studies. A total of 231 947 individuals from nine countries were included in these studies for the meta-analysis. The results were pooled using a random-effects model.

RESULTS

A pooled, adjusted odds ratio (OR) analysis indicated that there was a direct relationship between the highest versus lowest DII scores and prostate cancer risk in men (OR: 1.31; 95% CI: 1.04-1.57) but not the breast cancer risk (BCR) in women (OR: 1.65; 95% CI: 0.96-2.33). In the subgroup analyses, a more significant association between DII score and increased BCR was noted in premenopausal (OR: 2.03; 95% CI: 1.06-3.00) than in postmenopausal women (OR: 1.52; 95% CI: 0.89-2.16). When the results were stratified by body mass index, a positive association was observed between DII score and increased BCR in women (OR: 1.83; 95% CI: 1.48-2.18). Furthermore, there was no significant association between the highest versus lowest DII score and BCR among women who received hormone therapy (OR: 1.29; 95% CI: 0.93-1.64).

CONCLUSIONS

Men and premenopausal women who exhibit higher DII scores have increased prostate and breast cancer incidence risks, respectively. Moreover, body mass index had positive associations with the relationship between DII score and BCR in women. Further prospective cohort studies with longer follow-up periods are needed to support this possible association between DII score and cancer incidence.

Variants in the PPARGC1A Gene may Influence the Effect of Fat Intake on Resting Metabolic Rate in Obese Women

Recent studies have shown that dietary intake and genetic variants play a decisive role in the risk of obesity. Therefore, this study was designed to examine the interaction between dietary fat and PPARGC1A polymorphisms on the level of resting metabolic rate (RMR). We enrolled 288 Iranian overweight and obese women in this cross-sectional study. We sequenced the 648 b.p. DNA in Exon 8 of PPARGC1A gene. We analyzed the two single-nucleotide polymorphisms, namely rs11290186 and rs2970847, in this region. All participants were assessed for RMR, dietary intake, and body composition. This study demonstrated that total cholesterol and insulin levels were positively associated with T allele carriers of rs2970847. Moreover, the A-deletion allele carrier of the rs11290186 genotype had higher triacylglycerol and insulin concentrations. The current study revealed that, after adjustment for energy intake, the AA genotype of PPARGC1A (rs11290186) had a direct association with polyunsaturated fatty acids and linoleic acid intakes. Another important finding in our study was that there was an interaction seen between fat and saturated fatty acids intake with the PPARGC1A genotypes. Women with fat intakes of more than 30% of calorie intake per day and the A-deletion genotype had a lower RMR and RMR/fat free mass (FFM). It seems that the PPARGC1A polymorphisms lead to the downregulation of insulin signaling and subsequently insulin resistance. In addition, the interactions between the PPARGC1A polymorphisms (rs11290186) and the level of dietary fat intake probably can have an effect on RMR and RMR/FFM in obese women.

Role of components of microRNA machinery in carcinogenesis

MicroRNAs (miRNAs) are a broad class of non-coding RNAs nearly 21 nucleotides length, which play crucial functions in post-transcriptional gene regulation. These molecules are associated with many developmental and cellular processes in eukaryotic organisms. Current investigation has reported major factors contributing to miRNA biogenesis and has constituted basic principles of miRNA function. More recently, it was confirmed that various miRNAs are clearly implicated in human malignancies, such as lung, breast, ovarian, bladder, colon cancer and other kinds of carcinoma. In addition, dysregulation in the miRNA machinery elements such as Dicer, Drosha, DGCR8, Argonaut, and TRBP could be involved in the progress of many tumor types. The purpose of the current review was to compile growing information besides how miRNA biogenesis and gene silencing are modified to develop cancer.

Protective effects of hydro-alcoholic extract of Quercus brantii against lead-induced oxidative stress in the reproductive system of male mice

OBJECTIVE

Exposure to heavy metals such as lead (Pb) results in oxidative stress induction in the male reproductive system. Herbal medicine can be utilized as antioxidant agents against oxidative stress. Quercus brantii (QB) has shown antioxidant activity in previous studies. The aim of the present study was to evaluate effects of QB hydro-alcoholic extract against Pb-induced oxidative stress in the male mice reproductive system.

MATERIALS AND METHODS

Forty-two NMRI adult male mice were randomly divided into 7 groups of 6 animals each. Group I was the control group that received no treatment. Group II was the sham group and received 0.2 ml distilled water. Groups III and IV received QB hydro-alcoholic extract 500 and 1000 mg/kg bw, respectively. Group V received Pb 1000 ppm/kg bw. Group VI and VII received Pb 1000 ppm/kg bw and QB extract 500 and 1000 mg/kg bw, respectively. All groups received treatment via oral gavage. After 35 days, sperm parameters (i.e. sperm motility, count and morphology) were evaluated. Levels of sex hormones including LH, FSH, and testosterone, total antioxidant capacity (TAC), superoxide dismutase (SOD) and malondialdehyde (MDA) were measured in animals' serum.

RESULTS

Exposure to Pb negatively affected sperm parameters (i.e. sperm motility, count and morphology), decreased serum concentrations of sex hormones (i.e. LH, FSH, and testosterone), TAC and SOD activity but increased MDA levels. However, co-administration of 500 and 1000 mg/kg bw QB hydro-alcoholic extract and Pb considerably improved sperm parameters (i.e. sperm motility, count and morphology), increased sex hormones (i.e.LH, FSH, and testosterone), TAC, and SOD activity while decreased MDA levels in animals' serum.

CONCLUSION

Administration of QB extracts (Low dose and high dose) is able to protect the male reproductive system of mice against Pb-induced oxidative stress.

Association between serum 25(OH) vitamin D and metabolic disturbances in polycystic ovary syndrome

BACKGROUND

To assess the relationship between serum 25(OH) vitamin D levels and metabolic parameters together with androgenic hormone levels in women with polycystic ovary syndrome (PCOS).

METHODS

This is a single-centre study from the Endocrinology Institute at Firouzgar Hospital in Iran. Seventy-three women aged 15-45 years were recruited from May 2013 to December 2013. Serum 25(OH) vitamin D level, other laboratory biomarkers and anthropometric indexes were measured. Data were analysed with statistical software SPSS version 16.0 for windows and we used specific analytical tests to assess data.

RESULTS

Serum 25(OH) vitamin D levels were < 20 ng/ml in 64 patients (79%). Nine patients (12.3%) were diagnosed with metabolic syndrome. A significant difference was found between the women with and without severe vitamin D deficiency with regard to waist circumference, fasting insulin level and HOMA-IR, and abnormal systolic and diastolic blood pressures. The serum 25(OH) vitamin D levels had a reverse but weak correlation with systolic and diastolic blood pressures.

CONCLUSION

This study showed an association between serum 25(OH) vitamin D levels and some metabolic parameters; however, there was no significant linear correlation between serum 25(OH) vitamin D levels and metabolic variables, except for systolic and diastolic blood pressure.

Adipokines may mediate the relationship between resting metabolic rates and bone mineral densities in obese women

The researchers sought to test the possible link between resting metabolic rate and bone mineral density through four adipokines. Participants with lower resting metabolic rate (RMR) per kilogram demonstrated higher total bone mineral density (BMD), total T-score, and total Z-score. Omentin-1 had a mediatory effect on the relationship between RMR/kg of body weight and bone parameters.

INTRODUCTION

The previous results of studies regarding the links between obesity and bone health are controversial. For this reason, the researchers sought to test the possible link between RMR and BMD through the following four adipokines: vaspin, retinol binding protein 4, angiopoietin-like 6 (ANGPL6), and omentin-1.

METHODS

We enrolled 312 obese Iranian women (30 ≤ body mass index <40) in this cross-sectional study. In order to examine the association of serum adipokine levels with RMR and BMD, the participants were grouped based on RMR per body weight. Body composition, dietary intake, bone mineral density, and resting metabolic rate were assessed in all participants. Serum adipokine levels were quantified by the enzyme-linked immunosorbent assay (ELISA) method.

RESULTS

Low levels of RMR/kg were strongly associated with higher weight, body mass index, fat mass, and visceral fat levels. In fact, participants with an RMR/kg of body weight <20 kcal/24 h/kg were more obese (p < 0.05). Another noteworthy finding was that participants with lower RMR/kg demonstrated higher total BMD, total T-score, and total Z-score. Our results showed that omentin-1 had a mediatory effect on the relationship between RMR per kilogram of body weight and bone parameters (p < 0.05). Nevertheless, other adipokines such as vaspin, retinol-binding protein 4 (RBP4), and ANGPL6 did not affect the relationship between RMR and BMD (p > 0.05).

CONCLUSIONS

The inhibitory effect of omentin-1 on TNF-alpha seems to be able to reduce the amount of circulating leptin as adipokine, affecting energy expenditure and improving bone loss induced by estrogen deficiency and controlled effect of RMR on BMD.

Association between sleep duration and osteoporosis risk in middle-aged and elderly women: A systematic review and meta-analysis of observational studies

OBJECTIVE

Increasing evidence has suggested an association between sleep duration and osteoporosis risk, although the results of previous studies have been inconsistent. To our knowledge, this is the first meta-analysis of the literature and quantitative estimates of the association between sleep duration and risk of osteoporosis in population-based studies of middle aged and elderly women.

METHODS

Pertinent studies were identified by searching PubMed and EMBASE databases up to February 2016. Five out of six included studies were cross-sectional and one was a prospective cohort study. They included 72,326 participants from three different countries. We extracted 31,625 individuals in these studies for our meta-analysis.

RESULTS

A pooled odds ratio analysis in women between 40 to 86years indicated that there is an inverse relationship between sleep duration and osteoporosis (overall OR =1.07 95% CI: 1.00-1.15). The negative association of long sleep duration (8h or more per day) with osteoporosis risk was observed in middle aged and elderly women (OR =1.22, 95% CI: 1.06-1.38) but not in women with short sleep duration (7h or less per day) (OR =0.98, 95% CI: 0.90-1.05).

CONCLUSION

This meta-analysis suggests that long sleep duration (8h or more per day) may be associated with a higher risk of osteoporosis in middle-aged and elderly. Further prospective cohort studies with longer follow-up periods, valid instruments for measurement of sleep duration and dynamic sleep quality are warranted to support the possible relationship between sleep duration and osteoporosis risk in women.

C667T and A1298C polymorphisms of methylenetetrahydrofolate reductase gene and susceptibility to myocardial infarction: A systematic review and meta-analysis

MTHFR C677T and A1298C polymorphisms have been reported to be associated with the risk of myocardial infarction (MI), although the results of previous studies have been inconsistent. The aim of this study was to explore whether these polymorphisms play a role in the genetic susceptibility to MI. A comprehensive search of MEDLINE and EMBASE databases was conducted for studies evaluating the association between the C667T and A1298C polymorphisms and MI risk. Odds ratios (OR) with 95% confidence intervals (CIs) were calculated to assess the strength of association in the dominant model, recessive model, allelic model, and genotypes contrast. A total of 47 studies were finally included in this meta-analysis. Overall, the results showed no statistically significant association between C667T and A1298C polymorphisms and MI risk. However, in subgroup analysis by ethnicity, the T allele of C677T polymorphism was associated with a 63% increased risk of MI compared with the C allele (T vs. C, OR=1. 63, 95%CI=1.15-2.10, fixed effects) in African populations, while compared to wild homozygote genotype, CT genotype was associated with a decreased risk of MI in North American populations (CT vs. CC, OR=0.81, 95%CI=0.64-0.98, fixed effects). Moreover, C677T polymorphism had a protective effect against MI risk under the dominant model (OR=0.93, 945%CI=0.87-0.99, fixed effects) in elderly (≥50) population. The A1298C polymorphism was not significantly associated with MI risk. Unlike A1298C polymorphism, C677T polymorphism was associated with risk of MI in African, North American, and elderly populations.

Is Stress Hyperglycemia a Predicting Factor of Developing Diabetes in Future?

OBJECTIVE

Stress hyperglycemia is a transient increase in blood glucose during an acute physiological stress in the absence of diabetes. Stress hyperglycemia can be occurred in certain clinical conditions such as trauma, burns, sepsis and strokes in adults. In this study we aimed to evaluate the incidence of stress hyperglycemia among patients admitted to the Firouzgar hospital.

METHOD

In this analytical cross sectional study, all patients who referred to emergency department of Firouzgar hospital due to one of the causes of trauma, myocardial infarction (MI), subarachnoid hemorrhage (SAH), head trauma, sepsis, CVA, and abdominal surgery and had stress hyperglycemia during 2012-2014 were evaluated. Blood glucose test including random blood sugar (BS) and glycosylated hemoglobin (HbA1C) was performed for patients at admission. Patients with BS>180 mgmg/dl and no previous history of diabetes were enrolled in this study. Patients were referred to endocrinology clinic after 3 months of the first test and were re-evaluated for diabetes mellitus. Fasting Blood Sugar (FBS), HbA1C and 2 h post glucose load test blood sugar were measured. Diabetes was confirmed if FBS was above 126 mg/dl or 2 h post glucose load BS was over 200 mg/dl.

RESULT

A total of 98 (67 males & 31 women) patients enrolled in the study. No significant statistical relation found between mean of HBA1C at 3 months after admission and the background event (P=0.138). No statistical relation found between BMI and developing diabetes (P=0.352). 26 and 8 percent of the participants developed diabetes, and 25.8% were in pre-diabetic state. There was a statistical relation between gender and developing diabetes (P=0.027) and men developed diabetes more than women. Based on logistic regression the Odds Ratio (OR) was 1.017.

CONCLUSION

Our study demonstrates a significant relationship between stress hyperglycemia and development of diabetes. Stress hyperglycemia could be a predicting factor of development of diabetes.

Magnetite/dextran-functionalized graphene oxide nanosheets for in vivo positive contrast magnetic resonance imaging

In vivo positive contrast MRI by magnetite/dextran-functionalized graphene oxide (SPIO-Dex-FGO) as compared to Magnevist® (the right rat).

Master file size and apical transportation in severely curved root canals

OBJECTIVES

A curvature leads to asymmetrical removal of root dentine, which results in an increase in the incidence of canal transportation. The aim of this study was to evaluate the effect of master apical file (MAF) size on the apical transportation (AT) of teeth with severe canal curvatures.

METHODS

Thirty-six mesial roots of human mandibular first molars were included. Inclusion criteria consisted of mature roots with closed apices, absence of carious lesions and resorptions, and root canal curvatures (CC) of 45 degrees < CC < 60 degrees. The root canals were prepared using a crown-down pressureless technique. The samples were equally divided into groups A, B, and C based on MAF size: group A: MAF size equivalent to #20; group B: MAF size equivalent to #25, and group C: MAF size equivalent to #30. Cone beam computed tomography was used to evaluate the AT.

RESULTS

There were no statistically significant differences in the AT between the canals with different curvature angles up to MAF size #30 (P = 0.55).

CONCLUSION

Using flexible hand files for canal preparation, an increase in MAF size up to #30 does not significantly influence AT in severely curved canals.

Differential expression of RFamide-related peptide, a mammalian gonadotrophin-inhibitory hormone orthologue, and kisspeptin in the hypothalamus of Abadeh ecotype does during breeding and anoestrous seasons

Gonadotrophin-inhibitory hormone (GnIH) is a novel hypothalamic neuropeptide that was discovered in birds as an inhibitory factor for gonadotrophin release. RFamide-related peptide (RFRP) is a mammalian GnIH orthologue that inhibits gonadotrophin synthesis and release in mammals through actions on gonadotrophin-releasing hormone (GnRH) neurones and gonadotrophs, mediated via the GnIH receptor (GnIH-R), GPR147. On the other hand, hypothalamic kisspeptin provokes the release of GnRH from the hypothalamus. The present study aimed to compare the expression of RFRP in the dorsomedial hypothalamus and paraventricular nucleus (DMH/PVN) and that of kisspeptin in the arcuate nucleus (ARC) of the female goat hypothalamus during anoestrous and breeding seasons. Mature female Abadeh does were used during anoestrus, as well as the follicular and luteal phases of the cycle. The number of RFRP-immunoreactive (-IR) neurones in the follicular phase was lower than in the luteal and anoestrous stages. Irrespective of the ovarian stage, the number of RFRP-IR neurones in the rostral and middle regions of the DMH/PVN was higher than in the caudal region. By contrast, the number of kisspeptin-IR neurones in the follicular stage was greater than in the luteal stage and during the anoestrous stage. Irrespective of the stage of the ovarian cycle, the number of kisspeptin-IR neurones in the caudal region of the ARC was greater than in the middle and rostral regions. In conclusion, RFRP-IR cells were more abundant in the rostral region of the DMH/PVN nuclei of the hypothalamus, with a greater number being found during the luteal and anoestrous stages compared to the follicular stage. On the other hand, kisspeptin-IR neurones were more abundant in the caudal part of the ARC, with a greater number recorded in the follicular stage compared to the luteal and anoestrous stages.

The effects of aqueous extract of Boswellia Serrata on hippocampal region CA1 and learning deficit in kindled rats

Temporal lobe epilepsy (TLE) is a disorder of the central nervous system in which hippocampus is mostly involved and causes memory impairment. Kindling is a model of inducing epilepsy which is created through pentylenetetrazol (PTZ) administration. This study examines the role of the aqueous extract of Boswellia on the learning and development of brain (formation of dendritic branches and axons) of the PTZ-induced kindled rats. The study is conducted on sixty-four male rats divided into 8 groups. Kindling seizures are induced by three injections of 25 mg/kg of PTZ every 15 min. The aqueous extracts (0, 0.1, 0.5, 1 g/kg, i.p) are administrated to all animals for three consecutive days. Passive avoidance learning of animals is examined using shuttle box apparatus and step-through latency (STL) method. Rats are anesthetized and their brains are fixed by transcardial perfusion method and are analyzed by morphometric methods after applying Golgi and Cresyl violet staining methods. PTZ-induced kindling indicates a significant decrease in the number of pyramidal neurons and dendritic spines in hippocampal region cornu ammonis (CA1). The STL of the kindled rats is significantly reduced compared with control ones. Also, Boswellia extract dramatically increased the number of neuronal processes in CA1 region and improves passive-avoidance learning ability in both control and PTZ-kindled animals in 1 g/kg dose administration of Boswellia extract, especially at high doses can eliminate adverse effects of seizures on cognitive function in hippocampal area CA1 in rats.