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Nasrollahi TS, Shahrestani S, Borrelli M, Hopp ML, Wu AW, Tang DM, Yu JS. The Influence of Modifiable Risk Factors on Postoperative Outcomes in Patients Receiving Surgery for Resection for Acoustic Neuroma. EAR, NOSE & THROAT JOURNAL 2023:1455613231191020. [PMID: 37605484 DOI: 10.1177/01455613231191020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023] Open
Abstract
Acoustic neuromas are the most common tumor of the cerebellopontine angle that are associated with a number of symptoms that negatively impact a patient's quality of life. While the mainstay of treatment for these benign tumors remains microsurgical resection, there is limited research exploring how certain modifiable risk factors (MRFs) may affect the perioperative course. The purpose of this study was to investigate how MRFs including malnutrition, obesity, dyslipidemia, uncontrolled hypertension, and smoking may affect postoperative rates of readmission and nonroutine discharges. We utilized the 2016 and 2017 Healthcare Cost and Utilization Project Nationwide Readmissions Database. MRFs were queried using appropriate International Classification of Diseases, Tenth Revision (ICD-10) coding for categories including malnutrition, obesity, dyslipidemia, smoking, alcohol, and hypertension. The statistical analysis was done using RStudio (Version 1.3.959). Chi-squared tests were done to evaluate differences between categorical variables. The Mann-Whitney U-testing was utilized to evaluate for statistically significant differences in continuous data. The "Epitools" package was used to develop logistic regression models for postoperative complications and post hoc receiver operating characteristic curves were developed. Pertaining to nonroutine discharge, predictive models using malnutrition outperformed all other MRFs as well as those with no MRFs (P < .05). In the case of readmission, models using malnutrition outperformed those of obesity and smoking (P < .05). Again, an increase in predictive power is seen in models using dyslipidemia when compared to obesity, smoking, or uncontrolled hypertension. Lastly, models using no MRFs outperformed those of obesity, smoking, and uncontrolled hypertension (P < .05). This is the first study of its kind to evaluate the role of MRFs in those undergoing surgical resection of their acoustic neuroma. We concluded that certain MRFs may play a role in complicating a patient's perioperative surgical course.
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Affiliation(s)
- Tasha S Nasrollahi
- Division of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Sinus Center of Excellence, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Shane Shahrestani
- Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Michela Borrelli
- Division of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Sinus Center of Excellence, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Martin L Hopp
- Division of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Sinus Center of Excellence, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Arthur W Wu
- Division of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Sinus Center of Excellence, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Dennis M Tang
- Division of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Sinus Center of Excellence, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - John S Yu
- Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Guo X, Zhai Y, Song C, Mi Z, Peng J, Guo J, Teng X, Zhang D. Elevated postprandial triglyceride-rich lipoproteins in patients with diabetes and stable coronary artery disease correlated with early renal damage and systemic inflammation. Lipids Health Dis 2023; 22:58. [PMID: 37138333 PMCID: PMC10158000 DOI: 10.1186/s12944-023-01820-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/21/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Dyslipidaemia is key in the development of coronary heart disease (CHD) in patients with diabetes mellitus (DM). Accumulated evidence supports that diabetic nephropathy increases the mortality risk of patients with CHD, while the influence of diabetic dyslipidaemia on renal damage in patients with DM and CHD remains unknown. Moreover, recent data indicate that postprandial dyslipidaemia has predictive value in terms of CHD prognosis, especially in patients with DM. The study aimed to determine the relationship of triglyceride-rich lipoproteins (TRLs) after daily Chinese breakfast on systemic inflammation and early renal damage in Chinese patients with DM and SCAD. METHODS Patients with DM diagnosed with SCAD while in the Department of Cardiology of Shengjing Hospital from September 2016 to February 2017 were enrolled in this study. Fasting and 4-h postprandial blood lipids, fasting blood glucose, glycated haemoglobin, urinary albumin-to-creatinine ratio (UACR), serum interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) concentrations, and other parameters were measured. Fasting and postprandial blood lipid profiles and inflammatory cytokines were analysed using a paired t-test. The association between variables was analysed using Pearson or Spearman bivariate analysis. P < 0.05 was considered to be statistically significant. RESULTS The study enrolled 44 patients in total. Compared with fasting state, postprandial total cholesterol high-density lipoprotein-cholesterol (HDL-C),low-density lipoprotein-cholesterol (LDL-C) and non-high-density lipoprotein-cholesterol (non-HDL-C) all showed no significant change. Postprandial serum triglyceride (TG) concentration increased significantly compared with that at fasting (1.40 ± 0.40 vs. 2.10 ± 0.94 mmol/L, P < 0.001), as did serum remnant lipoprotein-cholesterol (RLP-C) (0.54 ± 0.18 mmol/L vs. 0.64 ± 0.25 mmol/L). Pearson analysis revealed that serum TG and RLP-C positively correlated before and after breakfast. Moreover, during fasting, positive correlations were observed between TG and serum IL-6, TNF-α, and UACR. Positive correlations were observed between RLP-C and IL-6, UACR under fasting condition, while both TG and RLP-C were positively correlated with postprandial serum IL-6, TNF-α, and UACR concentrations. Finally, positive correlations were observed between UACR and IL-6 and TNF-α concentration under both fasting and postprandial conditions. CONCLUSIONS An increase in postprandial TRLs was observed in Chinese patients with DM and SCAD after daily breakfast, and this increase may be related to early renal injury via the induction of systemic inflammation.
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Affiliation(s)
- Xu Guo
- Department of Cardiology, Shengjing Hospital of China Medical University, #36 Sanhao Street, Heping District, Shenyang City, Liaoning Province, 110004, People's Republic of China
- Department of Critical Care Medicine, Hainan General Hospital, Haikou, China
| | - Yujia Zhai
- Department of Cardiology, Shengjing Hospital of China Medical University, #36 Sanhao Street, Heping District, Shenyang City, Liaoning Province, 110004, People's Republic of China
| | - Chenliang Song
- Department of Cardiology, Shengjing Hospital of China Medical University, #36 Sanhao Street, Heping District, Shenyang City, Liaoning Province, 110004, People's Republic of China
| | - Zhen Mi
- Department of Cardiology, Shengjing Hospital of China Medical University, #36 Sanhao Street, Heping District, Shenyang City, Liaoning Province, 110004, People's Republic of China
| | - Jiya Peng
- Department of Cardiology, Shengjing Hospital of China Medical University, #36 Sanhao Street, Heping District, Shenyang City, Liaoning Province, 110004, People's Republic of China
| | - Jing Guo
- Department of Cardiology, Shengjing Hospital of China Medical University, #36 Sanhao Street, Heping District, Shenyang City, Liaoning Province, 110004, People's Republic of China
| | - Xianzhuo Teng
- Department of Cardiology, Shengjing Hospital of China Medical University, #36 Sanhao Street, Heping District, Shenyang City, Liaoning Province, 110004, People's Republic of China
| | - Daqing Zhang
- Department of Cardiology, Shengjing Hospital of China Medical University, #36 Sanhao Street, Heping District, Shenyang City, Liaoning Province, 110004, People's Republic of China.
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Picca A, Coelho-Junior HJ, Calvani R, Marzetti E, Vetrano DL. Biomarkers shared by frailty and sarcopenia in older adults: A systematic review and meta-analysis. Ageing Res Rev 2022; 73:101530. [PMID: 34839041 DOI: 10.1016/j.arr.2021.101530] [Citation(s) in RCA: 110] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/04/2021] [Accepted: 11/21/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Physical frailty and sarcopenia show extensive clinical similarities. Whether biomarkers exist that are shared by the two conditions is presently unclear. METHODS We conducted a systematic review and meta-analysis of cross-sectional and longitudinal studies that investigated the association of frailty and/or sarcopenia with biomarkers as a primary or secondary outcome in adults aged 60 years and older. Only studies published in English that defined frailty using a validated scale and/or questionnaire and diagnosed sarcopenia according to the presence of muscle atrophy plus dynapenia or low physical function were included. Studies were identified from a systematic search of MEDLINE and SCOPUS databases from inception through August 2020. The quality of reporting of each study was assessed by using the Quality Assessment Tool for Observational Cohort, Cross-Sectional and Case-Control studies of the National Institute of Health. A meta-analysis was conducted when at least three studies investigated the same biomarker in both frailty and sarcopenia. Pooled effect size was calculated based on standard mean differences and random-effect models. Sensitivity analysis was performed based on age and the setting where the study was conducted. RESULTS Eighty studies (58 on frailty and 22 on sarcopenia) met the inclusion criteria and were included in the qualitative analysis. Studies on frailty included 33,160 community-dwellers, hospitalized, or institutionalized older adults (60-88 years) from 21 countries. Studies on sarcopenia involved 4904 community-living and institutionalized older adults (68-87.6 years) from 9 countries. Several metabolic, inflammatory, and hematologic markers were found to be shared between the two conditions. Albumin and hemoglobin were negatively associated with both frailty and sarcopenia. Interleukin 6 was associated with frailty and sarcopenia only in people aged < 75. Community-dwelling older adults with frailty and sarcopenia had higher levels of tumor necrosis factor alpha compared with their robust and non-sarcopenic counterparts. CONCLUSIONS A set of metabolic, hematologic, and inflammatory biomarkers was found to be shared by frailty and sarcopenia. These findings fill a knowledge gap in the quest of biomarkers for these conditions and provide a rationale for biomarker selection in studies on frailty and sarcopenia.
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Affiliation(s)
- Anna Picca
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | | | - Riccardo Calvani
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Department of Geriatrics and Orthopedics, Rome, Italy
| | - Davide Liborio Vetrano
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Arigo D, Brown MM, Pasko K, Ainsworth MC, Travers L, Gupta A, Downs DS, Smyth JM. Rationale and Design of the Women's Health And Daily Experiences Project: Protocol for an Ecological Momentary Assessment Study to Identify Real-Time Predictors of Midlife Women's Physical Activity. JMIR Res Protoc 2020; 9:e19044. [PMID: 33055065 PMCID: PMC7596655 DOI: 10.2196/19044] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 07/14/2020] [Accepted: 07/27/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Midlife women are at an elevated risk for cardiovascular disease (CVD) and associated mortality. Those who have additional risk conditions such as obesity or hypertension report specific barriers to engaging in cardioprotective behaviors such as physical activity (PA). Considerable effort has been devoted to understanding PA determinants and designing interventions for midlife women, although with suboptimal success, as increasing PA could meaningfully attenuate CVD risk. An updated approach to understanding PA among midlife women could improve upon existing resources by focusing on novel psychosocial influences on PA in this population (ie, body satisfaction, social interactions, social comparisons, mood state) and within-person relations between these influences and PA in the natural environment. OBJECTIVE The overarching goal of Project WHADE (Women's Health And Daily Experiences) is to use an ecological momentary assessment (EMA) approach to capture ecologically valid relations between midlife women's psychosocial experiences and PA as they engage in their normal daily activities. The primary aim of the study is to identify within-person psychosocial predictors of variability in PA (ie, experiences associated with higher vs lower PA for a given individual). METHODS Midlife women (aged 40-60 years) with one or more additional risk markers for CVD (eg, hypertension) will be recruited from primary care clinics and the general community (target n=100). Eligible women will complete an initial survey and a face-to-face baseline session before engaging in a 10-day EMA protocol. Psychosocial experiences will be assessed using a brief self-report via a smartphone 5 times per day, and PA will be assessed throughout waking hours using a research-grade monitor. Participants will return for a brief exit interview at the end of 10 days. Multilevel models that address the nested structure of EMA data will be used to evaluate the study aims. RESULTS Recruitment and enrollment are ongoing, and a total of 75 women have completed the protocol to date. Data collection is expected to be completed in Fall 2020. CONCLUSIONS Project WHADE is designed to identify naturally occurring psychosocial experiences that predict short-term variability in midlife women's PA. As such, the results of this study should advance the current understanding of PA among midlife women by providing further insight into within-person psychosocial influences on PA in this group. In the future, this information could help inform the design of interventions for this population. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19044.
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Affiliation(s)
- Danielle Arigo
- Department of Psychology, Rowan University, Glassboro, NJ, United States
- Department of Family Medicine, Rowan School of Osteopathic Medicine, Stratford, NJ, United States
| | - Megan M Brown
- Department of Psychology, Rowan University, Glassboro, NJ, United States
| | - Kristen Pasko
- Department of Psychology, Rowan University, Glassboro, NJ, United States
| | | | - Laura Travers
- Department of Psychology, Rowan University, Glassboro, NJ, United States
| | - Adarsh Gupta
- Department of Family Medicine, Rowan School of Osteopathic Medicine, Stratford, NJ, United States
| | - Danielle Symons Downs
- Departments of Kinesiology and Obstetrics & Gynecology, Pennsylvania State University, University Park, PA, United States
| | - Joshua M Smyth
- Departments of Biobehavioral Health and Medicine, Pennsylvania State University, University Park, PA, United States
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Blumenfeld Kan S, Staun-Ram E, Golan D, Miller A. HDL-cholesterol elevation associated with fingolimod and dimethyl fumarate therapies in multiple sclerosis. Mult Scler J Exp Transl Clin 2019; 5:2055217319882720. [PMID: 31662882 PMCID: PMC6794658 DOI: 10.1177/2055217319882720] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 09/01/2019] [Accepted: 09/16/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Patients with Multiple Sclerosis (PwMS) display altered lipoproteins levels and function, which seem to affect disease risk and progress. Whether disease-modifying therapies affect the lipoprotein profile in PwMS has scarcely been studied. OBJECTIVE The study aims to assess whether fingolimod and dimethyl fumarate (DMF) affect lipoproteins in PwMS. METHODS We compared retrospectively the blood lipoprotein levels of 29 fingolimod-treated and 41 DMF-treated patients before and after 3 and 12 months of therapy. Patients treated with cholesterol-reducing medications were not included. Data on weight change and disease activity during 1-year follow-up were obtained. RESULTS HDL level, HDL/LDL ratio and HDL/total cholesterol ratio were increased in both treatment groups after 3 months' therapy and sustained, with no change in LDL or triglycerides. While at baseline only 26% of patients met the recommended minimum of HDL 60 mg/dl, after 3 months' therapy, 43% of fingolimod-treated and 47% of DMF-treated patients reached the recommended level. The majority of patients had no weight reduction. CONCLUSIONS Fingolimod and DMF therapies are associated with a specific increase in HDL in PwMS. Further studies are required to validate these findings and their potential implication as biomarker of reduced inflammatory state and/or reduced risk of neurodegeneration or cardiovascular comorbidity.
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Affiliation(s)
- S Blumenfeld Kan
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - E Staun-Ram
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Neuroimmunology Unit & Multiple Sclerosis Center, Department of Neurology, Carmel Medical Center, Haifa, Israel
| | - D Golan
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Neuroimmunology Unit & Multiple Sclerosis Center, Department of Neurology, Carmel Medical Center, Haifa, Israel
| | - A Miller
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Neuroimmunology Unit & Multiple Sclerosis Center, Department of Neurology, Carmel Medical Center, Haifa, Israel
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Inflammatory Dietary Pattern Predicts Dyslipidemia and Anemia in Middle-Aged and Older Taiwanese Adults with Declined Kidney Function: A Cross-Sectional Population Study from 2008 to 2010. Nutrients 2019; 11:nu11092052. [PMID: 31480674 PMCID: PMC6770658 DOI: 10.3390/nu11092052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 08/17/2019] [Accepted: 08/25/2019] [Indexed: 02/06/2023] Open
Abstract
Dyslipidemia, anemia, and inflammation are associated with declined kidney function. This study investigated the association of inflammatory dietary pattern with dyslipidemia, anemia, and kidney function biomarkers among middle-aged and older Taiwanese adults with declined kidney function. Biochemical data and food frequency questionnaire were obtained from 41,128 participants with estimated glomerular filtration rate (eGFR) <90 mL/min/1.73 m2 and positive urinary protein. Inflammatory dietary pattern was identified by reduced rank regression with C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (N/L) as response variables. Males had higher prevalence of dyslipidemia and higher inflammatory markers, but lower prevalence of anemia and lower eGFR levels compared to females. Inflammatory dietary pattern characterized with low intakes of seafood, grains, vegetables, and fruits but high intakes of meat, eggs, preserved/processed foods, and sugary drinks was associated with an increased risk of dyslipidemia by 21% in males and an increased risk of anemia by 28–47% in both genders. Furthermore, high consumption of inflammatory dietary pattern was associated with reduced eGFR (males β = −0.85, 95% CI −1.26 to −0.43, females β = −0.53, 95% CI −0.98 to −0.08) and increased N/L and/or CRP in both genders. In conclusion, inflammatory dietary pattern is positively associated with dyslipidemia, anemia, and decreased kidney function in middle-aged and older adults with declined kidney function.
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Ramos RM, Coelho-Júnior HJ, do Prado RCR, da Silva RS, Asano RY, Prestes J, Medeiros AIA, Rodrigues B, Assumpção CDO. Moderate Aerobic Training Decreases Blood Pressure but No Other Cardiovascular Risk Factors in Hypertensive Overweight/Obese Elderly Patients. Gerontol Geriatr Med 2018; 4:2333721418808645. [PMID: 30450368 PMCID: PMC6236479 DOI: 10.1177/2333721418808645] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/31/2018] [Accepted: 09/28/2018] [Indexed: 01/19/2023] Open
Abstract
Hypertension and obesity are prevalent diseases in elderly people, and their combination can cause deleterious effects on physiological system. Moderate intensity aerobic training (MIAT) seems to be a beneficial approach to control and treat these diseases separately. However, few studies have investigated the impact of MIAT on cardiovascular risk factors associated with these conditions (i.e., elevated blood pressure values, blood markers, and body composition). Therefore, the present study was designed to investigate the effects of MIAT on blood pressure, blood markers, and body composition in hypertensive overweight/obese elderly patients. Twenty-four hypertensive overweight/obese elderly patients were randomized into control group (CG) and training group (TG), submitted to 12 weeks of MIAT of 50 min, 3 days per week, at 60% of maximal HR (heart rate). There was a decrease in diastolic blood pressure (-10.1 ± 3.3; p = .01; effect size = 1.29) and mean arterial pressure (MAP; -8.2 ± 3.7; p = .04; effect size = 0.94) following 12 weeks of training in the TG as compared with baseline. There was an increase in triacylglycerol levels in the TG (+0.1 ± 0.0; p = .02). There were no significant changes in body composition for both groups. The present study revealed that 12 weeks of MIAT can decrease blood pressure in hypertensive obese elderly patients, with no significant modifications in blood markers and body composition.
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Affiliation(s)
| | | | | | | | - Ricardo Yukio Asano
- Universidade de São Paulo, Brasil.,Universidade Ibirapuera, São Paulo, Brasil
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Pourmasoumi M, Hadi A, Rafie N, Najafgholizadeh A, Mohammadi H, Rouhani MH. The effect of ginger supplementation on lipid profile: A systematic review and meta-analysis of clinical trials. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2018; 43:28-36. [PMID: 29747751 DOI: 10.1016/j.phymed.2018.03.043] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 01/30/2018] [Accepted: 03/18/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Elevated levels of blood lipids are a major cause of atherosclerosis and consequently cardiovascular disease. Several studies used ginger as a lipid lowering agent. PURPOSE The aim of the present systematic review and meta-analysis was to clarify the effect of ginger supplementation on lipid parameters. METHODS PubMed, Scopus, Science Direct, ISI Web of Science and Google Scholar were systematically searched until May 2017 to find clinical trials which examined effect of ginger supplementation on level of lipid parameters in adult participants. Means for blood lipids and potential sources of heterogeneity were extracted. A subgroup analysis was applied to find out potential sources of inter-study heterogeneity. RESULTS A total of 12 trials (586 participants) were included in the meta-analysis. Pooled analysis suggested that ginger supplementation reduced triacylglycerol (TAG) (-17.59 mg/dl; 95% CI: -29.32 to -5.87) and low density lipoprotein cholesterol (LDL-C) (-4.90 mg/dl; 95% CI: -22.30 to -6.17). Ginger had no significant effect on total cholesterol (TC) (-5.13 mg/dl, 95% CI: -11.05 to 0.78; P = 0.089) and high density lipoprotein cholesterol (HDL-C) (2.18 mg/dl, 95% CI: -0.08 to 4.45; P = 0.059). As inter-study heterogeneity was high, studies were classified by ginger dosage. Stratified analysis showed a significant reduction in TC (-12.26 mg/dl; 95% CI: -22.37 to -2.16) and TAG (-38.42 mg/dl; 95% CI: -57.01 to -19.82) in studies which used ≤2 g/day of ginger. However, a similar significant effect was not observed in trials with >2 g/day of ginger. Neither studies which used ≤2 g/day nor trials which used >2 g/day of ginger showed significant changes in LDL-C or HDL-C. CONCLUSION The present systematic review and meta-analysis suggests that ginger had a favorable effect on TAG and LDL-C. Also, the result revealed that low dose of ginger (≤2 g/day) had greater lowering impact on TAG and TC. Further studies with large-scale and better design are needed to confirm this result.
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Affiliation(s)
- Makan Pourmasoumi
- Gastrointestinal & Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Amir Hadi
- Gastrointestinal & Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Rasht, Iran
| | - Nahid Rafie
- Gastrointestinal & Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences, Rasht, Iran
| | | | - Hamed Mohammadi
- Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hossein Rouhani
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Khachatoorian Y, Samara A. Differential effects of dietary restriction combined with exercise vs dietary restriction alone on visceral and subcutaneous adipose tissues: A systematic review. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.obmed.2017.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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One year changes in biochemical and redox markers in training menopausal women with adherence to Mediterranean diet. Sci Sports 2018. [DOI: 10.1016/j.scispo.2017.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Fraga AS, Ladeia AMT, Sá CKCD, Tenório MCC. EFEITO DO EXERCÍCIO SOBRE OS NÍVEIS DE HDL-C: UMA REVISÃO SISTEMÁTICA DE METANÁLISES. REV BRAS MED ESPORTE 2017. [DOI: 10.1590/1517-869220172306163603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO A elevação de 1% no HDL-C associa-se à redução de 3% nas taxas de mortalidade cardiovascular. Contudo, praticar exercícios a ponto de gerar alterações benéficas do HDL-C ainda é controverso. Portanto, o objetivo deste estudo foi avaliar se existe benefício do exercício físico sobre os níveis de HDL-C. Trata-se de uma revisão sistemática de metanálises, de artigos indexados ao PubMed/MEDLINE, SciELO e LILACS. Utilizaram-se os termos, Lipoproteins, Cholesterol, HDL, Exercise and Resistance Training. Critérios de inclusão: metanálises publicadas até 22 de janeiro de 2015, com o exercício como forma de intervenção e com desfecho no HDL-C. Critérios de exclusão: Não citação de efeitos de confusão, avaliação do HDL-C como desfecho secundário ou intervenção dietética. Com relação ao resultado do treinamento aeróbico, avaliamos oito estudos. Quatro foram significantes para aumento de HDL-C. Destes, a menor duração em semanas foi 21,8 ± 19,5 e a maior foi 35,3 ± 31,8; a menor frequência foi 3,5 ± 1,0 e a maior, 4,0 ± 1,1; a menor intensidade/%VO2máx foi 64,8% e a maior, 69,2 ± 10,1. Quatro estudos não foram significantes, sendo a menor duração em semanas 10,7 ± 3,2 e a maior, 23,19 ± 17,7; a menor frequência foi 3,7 ± 0,8 e a maior foi 4,75 ± 2,5; a menor intensidade/%VO2máx foi 64,2 ± 9,4 e a maior, 74,7 ± 11,8. Treinamento resistido: Nenhum dos três estudos foi significante. Treinamento combinado: Um único estudo apresentou aumento dos níveis de HDL-C (diferença média [IC 95%]: 0,08 (IC 95%, 0,05-0,12 mmol/l]). Concluímos que não é possível afirmar que o treinamento aeróbico, resistido ou combinado, proporcionam aumentos significantes nos níveis de HDL-C, o que limita sua prescrição como terapia eficiente para aumento de HDL-C.
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The Impact of Cardiorespiratory Fitness Levels on the Risk of Developing Atherogenic Dyslipidemia. Am J Med 2016; 129:1060-6. [PMID: 27288861 PMCID: PMC5039056 DOI: 10.1016/j.amjmed.2016.05.017] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 05/25/2016] [Accepted: 05/25/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND Low cardiorespiratory fitness has been established as a risk factor for cardiovascular-related morbidity. However, research about the impact of fitness on lipid abnormalities, including atherogenic dyslipidemia, has produced mixed results. The purpose of this investigation is to examine the influence of baseline fitness and changes in fitness on the development of atherogenic dyslipidemia. METHODS All participants completed at least 3 comprehensive medical examinations performed by a physician that included a maximal treadmill test between 1976 and 2006 at the Cooper Clinic in Dallas, Texas. Atherogenic dyslipidemia was defined as a triad of lipid abnormalities: low high-density-lipoprotein cholesterol ([HDL-C] <40 mg/dL), high triglycerides ([TGs] ≥200 mg/dL), and high low-density-lipoprotein cholesterol ([LDL-C] ≥160 mg/dL). RESULTS A total of 193 participants developed atherogenic dyslipidemia during an average of 8.85 years of follow-up. High baseline fitness was protective against the development of atherogenic dyslipidemia in comparison with those with low fitness (odds ratio [OR] 0.57; 95% confidence interval [CI], 0.37-0.89); however, this relationship became nonsignificant after controlling for baseline HDL-C, LDL-C, and TG levels. Participants who maintained fitness over time had lower odds of developing atherogenic dyslipidemia than those with a reduction in fitness (OR 0.56; 95% CI, 0.34-0.91) after adjusting for baseline confounders and changes in known risk factors. CONCLUSIONS High fitness at baseline and maintenance of fitness over time are protective against the development of atherogenic dyslipidemia.
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Abstract
Glucose-control has a modest beneficial effect on cardiovascular outcomes in patients with type 2 diabetes mellitus. Thus, managing other atherogenic risk factors including hypertriglyceridemia, low HDL-cholesterol and moderately elevated LDL-cholesterol levels with increased small dense LDL-cholesterol fraction, is crucial. Insulin resistance is a key pathophysiologic factor in this population. Treatment starts with lifestyle modifications, but current best programmes have not translated into positive cardiovascular outcomes. Lowering LDL-cholesterol with statins is currently the main treatment strategy, but significant residual risk remains. Attempts to elevate HDL-cholesterol and to reduce triglycerides levels, with niacin or fibrates have not improved cardiovascular prognosis, but addition of ezetimibe, or fibrates in specific patients subgroups, have shown modest benefit. Some glucose-lowering medications and bariatric surgery may also improve diabetic dyslipidemia. Results of three major cardiovascular outcome trials evaluating the effect of lowering LDL-cholesterol with PCSK9 inhibitors in large cohorts that include thousands of diabetic patients are pending.
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Affiliation(s)
- Auryan Szalat
- Internal Medicine Ward, Endocrinology and Metabolism Service, Hadassah Hebrew University Medical Center, PO BOX 24035, 91240, Jerusalem, Israel.
| | - Ronen Durst
- Cardiology Department, Hadassah Hebrew University Medical Center, 91120, Jerusalem, Israel.
| | - Eran Leitersdorf
- Hadassah Hebrew University Medical Center, 91120, Jerusalem, Israel.
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Kang EB, Koo JH, Jang YC, Yang CH, Lee Y, Cosio-Lima LM, Cho JY. Neuroprotective Effects of Endurance Exercise Against High-Fat Diet-Induced Hippocampal Neuroinflammation. J Neuroendocrinol 2016; 28. [PMID: 26991447 DOI: 10.1111/jne.12385] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 03/01/2016] [Accepted: 03/09/2016] [Indexed: 12/11/2022]
Abstract
Obesity contributes to systemic inflammation, which is associated with the varied pathogenesis of neurodegenerative diseases. Growing evidence has demonstrated that endurance exercise (EE) mitigates obesity-induced brain inflammation. However, exercise-mediated anti-inflammatory mechanisms remain largely unknown. We investigated how treadmill exercise (TE) reverses obesity-induced brain inflammation, mainly focusing on toll-like receptor-4 (TLR-4)-dependent neuroinflammation in the obese rat brain after 20 weeks of a high-fat diet (HFD). TE in HFD-fed rats resulted in a significant lowering in the homeostasis model assessment of insulin resistance index, the area under the curve for glucose and abdominal visceral fat, and also improved working memory ability in a passive avoidance task relative to sedentary behaviour in HFD-fed rats, with the exception of body weight. More importantly, TE revoked the increase in HFD-induced proinflammatory cytokines (tumour necrosis factor α and interleukin-1β) and cyclooxygenase-2, which is in parallel with a reduction in TLR-4 and its downstream proteins, myeloid differentiation 88 and tumour necrosis factor receptor associated factor 6, and phosphorylation of transforming growth factor β-activated kinase 1, IkBα and nuclear factor-κB. Moreover, TE reduced an indicator of microglia activation, ionised calcium-binding adapter molecule-1, and also decreased glial fibrillary acidic protein, an indicator of gliosis formed by activated astrocytes in the cerebral cortex and the hippocampal dentate gyrus, compared to HFD-fed sedentary rats. Finally, EE up-regulated the expression of anti-apoptotic protein, Bcl-2, and suppressed the expression of pro-apoptotic protein, Bax, in the hippocampus compared to HFD-fed sedentary rats. Taken together, these data suggest that TE may exert neuroprotective effects as a result of mitigating the production of proinflammatory cytokines by inhibiting the TLR4 signalling pathways. The results of the present study suggest that the unique combination of the beneficial effects of TE on the restoration of the blood profile and the anti-inflammatory and anti-apoptotic effects on cognitive function should inspire further investigations into its therapeutic potential for metabolic disorders and neurodegenerative diseases.
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Affiliation(s)
- E-B Kang
- Exercise Biochemistry Laboratory, Korea National Sport University, Seoul, Korea
| | - J-H Koo
- Exercise Biochemistry Laboratory, Korea National Sport University, Seoul, Korea
| | - Y-C Jang
- Exercise Biochemistry Laboratory, Korea National Sport University, Seoul, Korea
| | - C-H Yang
- Department of Marine Sports, University of Han-Seo, Seosansi, Korea
| | - Y Lee
- Exercise Biochemistry Laboratory, University of West Florida, Pensacola, FL, USA
| | - L M Cosio-Lima
- Exercise Biochemistry Laboratory, University of West Florida, Pensacola, FL, USA
| | - J-Y Cho
- Exercise Biochemistry Laboratory, Korea National Sport University, Seoul, Korea
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Glueck CJ, Shah P, Goldenberg N, Prince M, Lee K, Jetty V, Kumar A, Goldenberg M, Wang P. Eligibility for PCSK9 treatment in 734 Hypercholesterolemic patients referred to a regional cholesterol treatment center with LDL cholesterol ≥ 70 mg/dl despite maximal tolerated cholesterol lowering therapy. Lipids Health Dis 2016; 15:55. [PMID: 26968977 PMCID: PMC4788934 DOI: 10.1186/s12944-016-0227-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 03/09/2016] [Indexed: 12/13/2022] Open
Abstract
Background LDL cholesterol (LDLC) lowering has been revolutionized by PCSK9 inhibitors, Alirocumab (Praluent) and Evolocumab (Repatha), approved as adjuncts to maximally tolerated cholesterol lowering therapy in heterozygous (HeFH) or homozygous (HoFH) familial hypercholesterolemia, and/or clinical atherosclerotic cardiovascular disease (CVD) where LDLC lowering is insufficient. Methods We applied FDA and insurance eligibility criteria for PCSK9 inhibitor use in 734 hypercholesterolemic patients serially referred over 3 years who then received ≥ 2 months maximally tolerated LDLC lowering therapy with follow up LDLC ≥ 70 mg/dl, and in 50 patients approved by insurance for PCSK9 inhibitors. We documented the percentage of patients with HeFH and/or CVD who met FDA and insurance criteria for PCSK9 inhibitor therapy using LDLC goal-based guidelines. Results Of 734 patients with LDLC ≥ 70 mg/dl after ≥ 2 months maximally tolerated LDLC lowering therapy, 220 (30 %) had HeFH and/or CVD with LDLC > 100 mg/dl, meeting FDA-insurance criteria for PCSK9 inhibitor therapy. Another 66 (9 %) patients were statin intolerant, without HeFH or CVD. Of the 50 patients whose PCSK9 inhibitor therapy was approved for insurance coverage, 45 (90 %) had LDLC > 100 mg/dl after ≥ 2 months on maximally tolerated LDLC lowering therapy. Seventeen of these 50 patients (34 %) had HeFH without CVD (LDLC on treatment 180 ± 50 mg/dl), 15 (30 %) had CVD without HeFH (LDLC on treatment 124 ± 26 mg/dl), 14 (28 %) had both HeFH and CVD (LDLC on treatment 190 ± 53 mg/dl), and 4 (8 %) had neither HeFH nor CVD (LCLC 142 ± 11 mg/dl). Conclusion Of 734 patients referred for LDLC reduction, with LDLC ≥ 70 mg/dl after ≥ 2 months on maximally tolerated therapy, 220 (30 %) had HeFH and/or CVD with LDLC > 100 mg/dl, meeting FDA-insurance criteria for PCSK9 inhibitor therapy as an adjunct to diet-maximally tolerated cholesterol lowering therapy in HeFH or CVD. If 30 % of patients with high LDLC and HeFH-CVD are eligible for PCSK9 inhibitors, then specialty pharmaceutical pricing models (~$14,300/year) will collide with tens of millions of HeFH-CVD patients. We speculate that if there was a 50 % reduction in CVD, then there would be savings of $245 billion, in the middle of the range of estimated PCSK9 inhibitor costs of $185-342 billion. Whether the health care savings arising from the anticipated reduction of CVD events by PCSK9 inhibitors justify their extraordinary costs in broad population use remains to be determined.
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Affiliation(s)
- Charles J Glueck
- From the Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, USA.
| | - Parth Shah
- From the Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, USA
| | - Naila Goldenberg
- From the Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, USA
| | - Marloe Prince
- From the Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, USA
| | - Kevin Lee
- From the Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, USA
| | - Vybhav Jetty
- From the Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, USA
| | - Ashwin Kumar
- From the Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, USA
| | - Michael Goldenberg
- From the Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, USA
| | - Ping Wang
- From the Cholesterol, Metabolism, and Thrombosis Center, Jewish Hospital of Cincinnati, Cincinnati, USA
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Krishnadath ISK, Nahar-van Venrooij LM, Jaddoe VWV, Toelsie JR. Ethnic differences in prediabetes and diabetes in the Suriname Health Study. BMJ Open Diabetes Res Care 2016; 4:e000186. [PMID: 27403324 PMCID: PMC4932318 DOI: 10.1136/bmjdrc-2015-000186] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 04/30/2016] [Accepted: 06/03/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Diabetes is increasing worldwide, and information on risk factors to develop targeted interventions is limited. Therefore, we analyzed data of the Suriname Health Study to estimate the prevalence of prediabetes and diabetes. We also explored whether ethnic differences in prediabetes or diabetes risk could be explained by biological, demographic, lifestyle, anthropometric, and metabolic risk factors. METHOD The study was designed according to the WHO Steps guidelines. Fasting blood glucose levels were measured in 3393 respondents, aged 15-65 years, from an Amerindian, Creole, Hindustani, Javanese, Maroon or Mixed ethnic background. Prediabetes was defined by fasting blood glucose levels between 6.1 and 7.0 mmol/L and diabetes by fasting blood glucose levels ≥7.0 mmol/L or 'self-reported diabetes medication use.' For all ethnicities, we analyzed sex, age, marital status, educational level, income status, employment, smoking status, residence, physical activity, body mass index, waist circumference, hypertension, and the levels of triglyceride, total cholesterol, high-density lipoprotein-cholesterol and low-density lipoprotein-cholesterol. RESULTS The prevalence of prediabetes was 7.4%, while that of diabetes was 13 0%. From these diabetes cases, 39.6% were not diagnosed previously. No ethnic differences were observed in the prevalence of prediabetes. For diabetes, Hindustanis (23.3%) had twice the prevalence compared to other ethnic groups (4.7-14.2%). The associations of the risk factors with prediabetes or diabetes varied among the ethnic groups. The differences in the associations of ethnic groups with prediabetes or diabetes were partly explained by these risk factors. CONCLUSIONS The prevalence of diabetes in Suriname is high and most elevated in Hindustanis. The observed variations in risk factors among ethnic groups might explain the ethnic differences between these groups, but follow-up studies are needed to explore this in more depth.
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Affiliation(s)
- Ingrid S K Krishnadath
- Department of Public Health, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname
| | - Lenny M Nahar-van Venrooij
- Department of Public Health, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname
| | - Vincent W V Jaddoe
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Jerry R Toelsie
- Department of Physiology, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname
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Liu XS. Sample Size and the Precision of the Confidence Interval in Meta-analyses. Ther Innov Regul Sci 2015; 49:593-598. [DOI: 10.1177/2168479015570332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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18
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The effect of exercise on lipid profiles and inflammatory markers in lean male adolescents: a prospective interventional study. J Investig Med 2015; 63:29-34. [PMID: 25415059 DOI: 10.1097/jim.0000000000000120] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Physical activity improves body composition and inflammatory markers in obese individuals, but little is known about the nonobese population. OBJECTIVE The aim of this study was to investigate associations between exercise and inflammatory cytokines in lean male adolescents in Taiwan. METHODS This interventional study enrolled a total of 79 normal body weight male adolescents [mean age, 16.8 (1.0) years] from the Army Academy of Taiwan. Body composition and inflammatory markers were measured at baseline and upon completion of a 12-week exercise intervention program. RESULTS Subjects' postintervention anthropometric measures, including waist circumference [74.6 (5.2)→72.6 (5.2) cm], hip circumference [92.3 (4.1)→89.9 (5.0) cm], body fat mass [10.2 (3.2)→8.2 (3.2) kg], and body fat percentage [15.8% (4.2)→12.6 (4.5)%] declined significantly compared to preintervention (all P<0.001), as did systolic blood pressure (P=0.002) and mean blood pressure (P = 0.020). Postintervention body height and free fat mass increased significantly (both P<0.001). Subjects' postintervention lipids including total cholesterol, low-density lipoprotein, high-density lipoprotein, and triglycerides increased significantly (all P<0.001). Inflammatory markers including adiponectin [14.32 (6.68)→31.31 (30.53) μg/mL, P<0.001], interleukin 6 [2.15 (4.81)→2.86 (6.37) pg/mL, P=0.005], and C-reactive protein [1.00 (2.57)→2.30 (4.17) μg/mL, P<0.001] increased significantly postintervention, but not leptin. CONCLUSIONS Exercise training significantly improves body composition and anti-inflammatory adiponectin levels in lean male adolescents.
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Huggins C, Charolidi N, Cockerill GW. Cholesteryl Ester Transfer Protein Inhibitors - Future Soon to be REVEALed. Eur Cardiol 2015; 10:64-67. [PMID: 30310426 DOI: 10.15420/ecr.2015.10.01.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Reduction of the remaining residual cardiovascular risk is a clinical unmet need currently being addressed through a combination of further reduction of plasma concentrations of low-density lipoproteins (LDLs) and increasing plasma concentrations of high-density lipoproteins (HDLs). This brief review sets out the so-called HDL hypothesis and summarises the clinical results of the family of drugs, which function to raise plasma HDL concentration through inhibition of cholesteryl ester transfer proteins (CEPT).
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Butryn ML, Arigo D, Raggio GA, Colasanti M, Forman EM. Enhancing physical activity promotion in midlife women with technology-based self-monitoring and social connectivity: A pilot study. J Health Psychol 2014; 21:1548-55. [PMID: 25488937 DOI: 10.1177/1359105314558895] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
This pilot study tested a novel program to promote adoption and maintenance of aerobic activity in midlife women. Lifestyle modification group sessions were held weekly for 3 months, followed by two booster sessions during the 3-month maintenance phase. During all 6 months of the program, participants used a physical activity sensor to automate self-monitoring and a web platform to facilitate social connectivity. Aerobic exercise increased from 63 to 132 minute/week from baseline to 3 months (p < .01), and activity was maintained at 6 months (135 minute/week). Technology enhancements have strong potential to promote maintenance of behavior change.
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Fardet A, Boirie Y. Associations between food and beverage groups and major diet-related chronic diseases: an exhaustive review of pooled/meta-analyses and systematic reviews. Nutr Rev 2014; 72:741-62. [PMID: 25406801 DOI: 10.1111/nure.12153] [Citation(s) in RCA: 127] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Associations between food and beverage groups and the risk of diet-related chronic disease (DRCD) have been the subject of intensive research in preventive nutrition. Pooled/meta-analyses and systematic reviews (PMASRs) aim to better characterize these associations. To date, however, there has been no attempt to synthesize all PMASRs that have assessed the relationship between food and beverage groups and DRCDs. The objectives of this review were to aggregate PMASRs to obtain an overview of the associations between food and beverage groups (n = 17) and DRCDs (n = 10) and to establish new directions for future research needs. The present review of 304 PMASRs published between 1950 and 2013 confirmed that plant food groups are more protective than animal food groups against DRCDs. Within plant food groups, grain products are more protective than fruits and vegetables. Among animal food groups, dairy/milk products have a neutral effect on the risk of DRCDs, while red/processed meats tend to increase the risk. Among beverages, tea was the most protective and soft drinks the least protective against DRCDs. For two of the DRCDs examined, sarcopenia and kidney disease, no PMASR was found. Overweight/obesity, type 2 diabetes, and various types of cardiovascular disease and cancer accounted for 289 of the PMASRs. There is a crucial need to further study the associations between food and beverage groups and mental health, skeletal health, digestive diseases, liver diseases, kidney diseases, obesity, and type 2 diabetes.
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Affiliation(s)
- Anthony Fardet
- Unité de Nutrition Humaine, INRA de Theix & Université d'Auvergne, 63122, Saint-Genès-Champanelle, Auvergne, France
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Ruppar TM, Conn VS, Chase JAD, Phillips LJ. Lipid outcomes from supervised exercise interventions in healthy adults. Am J Health Behav 2014; 38:823-30. [PMID: 25207508 DOI: 10.5993/ajhb.38.6.4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To meta-analyze lipid outcomes from supervised exercise interventions among healthy adults. METHODS Comprehensive search strategies identified trials testing supervised exercise interventions in samples of healthy adults. Data were coded and analyzed using random effects meta-analysis methods. Moderator analyses explored whether design, sample, or intervention characteristics were linked with lipid outcomes. RESULTS Data were analyzed from 344 comparisons. The overall mean effect size for 2-group comparisons was 0.28, corresponding to reduced total cholesterol of 8.65 mg/dl. Study effect sizes were greater where participants were obese at baseline, and for interventions utilizing low-intensity exercise. CONCLUSIONS Supervised exercise interventions can improve lipid outcomes for healthy adults, with possible greater improvement for obese individuals, and through low-intensity exercise.
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Affiliation(s)
- Todd M Ruppar
- University of Missouri Sinclair School of Nursing, Columbia, MO, USA.
| | - Vicki S Conn
- University of Missouri Sinclair School of Nursing, Columbia, MO, USA
| | - Jo-Ana D Chase
- University of Missouri Sinclair School of Nursing, Columbia, MO, USA
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Kuhle CL, Steffen MW, Anderson PJ, Murad MH. Effect of exercise on anthropometric measures and serum lipids in older individuals: a systematic review and meta-analysis. BMJ Open 2014; 4:e005283. [PMID: 24928594 PMCID: PMC4067884 DOI: 10.1136/bmjopen-2014-005283] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 05/28/2014] [Accepted: 05/30/2014] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Overweight and obesity are increasing in individuals over age 60 years. This systematic review quantifies the effect of exercise on body mass index (BMI), waist circumference (WC) and lipids in overweight and obese individuals over the age of 60 years. SETTINGS Nine randomised controlled trials conducted in Brazil, Great Britain, Iceland, Japan and the USA compared aerobic and/or resistance exercise with a control group. PARTICIPANTS Final analysis reviewed 1166 participants over the age of 60 years for 3-9 months. PRIMARY OUTCOME MEASURES This study reviewed the effects of exercise on BMI, WC and low-density lipoprotein (LDL). RESULTS Exercise produced a significant reduction in BMI (-1.01 kg/m(2), 95% CI -2.00 to -0.01) and WC (-3.09 cm, 95% CI -4.14 to -2.04) but not LDL cholesterol (-0.31 mg/dL, 95% CI -0.81 to 0.19). Analyses revealed substantial heterogeneity likely due to the type and intensity of exercise. Data on adverse effects were minimal. The overall level of evidence is moderate due to imprecision and heterogeneity. CONCLUSIONS Exercise in overweight and obese older individuals improves anthropometric measures such as BMI and WC. The effect of exercise on serum lipids is unclear.
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Affiliation(s)
- Carol L Kuhle
- Division of Preventive Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Mark W Steffen
- Division of Preventive Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Paul J Anderson
- Division of Preventive Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Wu L, Ma D, Walton-Moss B, He Z. Effects of low-fat diet on serum lipids in premenopausal and postmenopausal women. Menopause 2014; 21:89-99. [DOI: 10.1097/gme.0b013e318291f5c2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Battaglia C, di Cagno A, Fiorilli G, Giombini A, Fagnani F, Borrione P, Marchetti M, Pigozzi F. Benefits of selected physical exercise programs in detention: a randomized controlled study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:5683-96. [PMID: 24185842 PMCID: PMC3863865 DOI: 10.3390/ijerph10115683] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Revised: 10/09/2013] [Accepted: 10/22/2013] [Indexed: 11/16/2022]
Abstract
The aim of the study was to determine which kind of physical activity could be useful to inmate populations to improve their health status and fitness levels. A repeated measure design was used to evaluate the effects of two different training protocols on subjects in a state of detention, tested pre- and post-experimental protocol.Seventy-five male subjects were enrolled in the studyand randomly allocated to three groups: the cardiovascular plus resistance training protocol group (CRT) (n = 25; mean age 30.9 ± 8.9 years),the high-intensity strength training protocol group (HIST) (n = 25; mean age 33.9 ± 6.8 years), and a control group (C) (n = 25; mean age 32.9 ± 8.9 years) receiving no treatment. All subjects underwent a clinical assessmentandfitness tests. MANOVA revealed significant multivariate effects on group (p < 0.01) and group-training interaction (p < 0.05). CRT protocol resulted the most effective protocol to reach the best outcome in fitness tests. Both CRT and HIST protocols produced significant gains in the functional capacity (cardio-respiratory capacity and cardiovascular disease risk decrease) of incarcerated males. The significant gains obtained in functional capacity reflect the great potential of supervised exercise interventions for improving the health status of incarcerated people.
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Affiliation(s)
- Claudia Battaglia
- Department of Health Sciences, Italian University of Sport and Movement of Rome “Foro Italico”, Piazza Lauro De Bosis 15, Rome 00196, Italy; E-Mails: (C.B.); (F.F.); (P.B.); (F.P.)
| | - Alessandra di Cagno
- Department of Health Sciences, Italian University of Sport and Movement of Rome “Foro Italico”, Piazza Lauro De Bosis 15, Rome 00196, Italy; E-Mails: (C.B.); (F.F.); (P.B.); (F.P.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +39-06-3673-3246; Fax: +39-33-8851-1016
| | - Giovanni Fiorilli
- Department of Health Sciences, University of Molise, V. De Sanctis 1, Campobasso 86100, Italy; E-Mails: (G.F.); (A.G.); (M.M.)
| | - Arrigo Giombini
- Department of Health Sciences, University of Molise, V. De Sanctis 1, Campobasso 86100, Italy; E-Mails: (G.F.); (A.G.); (M.M.)
| | - Federica Fagnani
- Department of Health Sciences, Italian University of Sport and Movement of Rome “Foro Italico”, Piazza Lauro De Bosis 15, Rome 00196, Italy; E-Mails: (C.B.); (F.F.); (P.B.); (F.P.)
| | - Paolo Borrione
- Department of Health Sciences, Italian University of Sport and Movement of Rome “Foro Italico”, Piazza Lauro De Bosis 15, Rome 00196, Italy; E-Mails: (C.B.); (F.F.); (P.B.); (F.P.)
| | - Marco Marchetti
- Department of Health Sciences, University of Molise, V. De Sanctis 1, Campobasso 86100, Italy; E-Mails: (G.F.); (A.G.); (M.M.)
| | - Fabio Pigozzi
- Department of Health Sciences, Italian University of Sport and Movement of Rome “Foro Italico”, Piazza Lauro De Bosis 15, Rome 00196, Italy; E-Mails: (C.B.); (F.F.); (P.B.); (F.P.)
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Bhattacharjee S, Bhattacharya R, Kelley GA, Sambamoorthi U. Antidepressant use and new-onset diabetes: a systematic review and meta-analysis. Diabetes Metab Res Rev 2013; 29:273-84. [PMID: 23390036 PMCID: PMC4888867 DOI: 10.1002/dmrr.2393] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 12/16/2012] [Accepted: 01/11/2013] [Indexed: 11/06/2022]
Abstract
Antidepressant use has been linked to new-onset diabetes. However, the existing literature on this relationship has yielded inconsistent findings. The primary objective of this study was to systematically synthesize the literature on the relationship between antidepressant use and new-onset diabetes using meta-analysis. A systematic literature search was conducted to identify relevant studies in seven electronic databases. Two independent reviewers identified the final list of studies to be included in the meta-analysis using a priori selection criteria. Results for the primary outcome of interest, that is, odds and hazards of developing new-onset diabetes, were pooled using a random-effects model. Egger's regression test and the Trim and Fill method were utilized to detect the presence of any potential publication bias. Sensitivity analysis was conducted using the leave-one-out method as well as individual categories of antidepressant drugs. Eight studies met the inclusion criteria. Random effects models revealed that adults with any use of antidepressants were more likely to develop new-onset diabetes compared with those without any use of antidepressants [odd ratios = 1.50, 95% confidence interval (CI), 1.08-2.10; hazards ratio = 1.19, 95% CI, 1.08-1.32]. Sensitivity analyses revealed fair robustness; selective serotonin reuptake inhibitors and tricyclic antidepressants were more likely to be associated with the development of new-onset diabetes. Results from the Egger's regression test and Trim and Fill method revealed no evidence of publication bias. Among adults, antidepressant use was associated with higher chances of new-onset diabetes. However, because a cause-and-effect relationship cannot be established by observational studies, future randomized controlled studies are needed to confirm this association.
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Affiliation(s)
- Sandipan Bhattacharjee
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA.
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Venojärvi M, Wasenius N, Manderoos S, Heinonen OJ, Hernelahti M, Lindholm H, Surakka J, Lindström J, Aunola S, Atalay M, Eriksson JG. Nordic walking decreased circulating chemerin and leptin concentrations in middle-aged men with impaired glucose regulation. Ann Med 2013; 45:162-70. [PMID: 23110613 DOI: 10.3109/07853890.2012.727020] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Dysfunction of adipose tissue is one of the major factors leading to insulin resistance. Altered adipokine concentration is an early sign of adipose tissue dysfunction. The aim of this study was to assess the impact of exercise intervention on adipokine profile, glycemic control, and risk factors of the metabolic syndrome (MeS) in men with impaired glucose regulation (IGR). METHODS Overweight and obese men with IGR (n =144) aged 40-65 years were studied at baseline and at 12 weeks in a randomized controlled multicenter intervention study. BMI varied from 25.1 to 34.9. The subjects were randomized into one of three groups: 1) a control group (C; n =47), 2) a Nordic walking group (NW; n =48), or 3) a resistance training group (RT; n =49). RESULTS Leptin concentrations decreased in the NW group compared to both other groups. Both types of exercise intervention significantly decreased serum chemerin concentrations compared to the C group. In the NW group also body fat percentage, fatty liver index (FLI), and total and LDL cholesterol concentrations decreased compared to the RT group. CONCLUSIONS Nordic walking intervention seems to decrease chemerin and leptin levels, and subjects in this intervention group achieved the most beneficial effects on components of MeS.
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Mannu GS, Zaman MJS, Gupta A, Rehman HU, Myint PK. Evidence of lifestyle modification in the management of hypercholesterolemia. Curr Cardiol Rev 2013; 9:2-14. [PMID: 22998604 PMCID: PMC3584303 DOI: 10.2174/157340313805076313] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Revised: 08/26/2012] [Accepted: 10/13/2012] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Coronary heart disease (CHD) is the leading cause of morbidity and mortality worldwide. The growth of ageing populations in developing countries with progressively urbanized lifestyles are major contributors. The key risk factors for CHD such as hypercholesterolemia, diabetes mellitus, and obesity are likely to increase in the future. These risk factors are modifiable through lifestyle. OBJECTIVES To review current literature on the potential benefit of cholesterol lowering in CHD risk reduction with a particular focus on the evidence of non-pharmacological/lifestyle management of hypercholesterolemia. METHODS Medline/PubMed systematic search was conducted using a two-tier approach limited to all recent English language papers. Primary search was conducted using key words and phrases and all abstracts were subsequently screened and relevant papers were selected. The next tier of searching was conducted by (1) reviewing the citation lists of the selected papers and (2) by using PubMed weblink for related papers. Over 3600 reports were reviewed. RESULTS Target cholesterol levels set out in various guidelines could be achieved by lifestyle changes, including diet, weight reduction, and increased physical activity with the goal of reducing total cholesterol to <200 mg/dL and LDL-C<100 mg/dL. Various dietary constituents such as green tea, plant sterols, soy protein have important influences on total cholesterol. Medical intervention should be reserved for those patients who have not reached this goal after 3 months of non-pharmacological approach. CONCLUSION CHD remains as a leading cause of death worldwide and hypercholesterolemia is an important cause of CHD. Non-pharmacological methods provide initial as well as long-term measures to address this issue.
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Affiliation(s)
- G S Mannu
- Medicine and Biochemistry, C/o Level 2, MFE Offices, Norfolk and Norwich University Hospital, Norwich, NR4 7UY, UK.
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Aguiar e Silva MA, Vechetti-Junior IJ, Nascimento AFD, Furtado KS, Azevedo L, Ribeiro DA, Barbisan LF. Effects of swim training on liver carcinogenesis in male Wistar rats fed a low-fat or high-fat diet. Appl Physiol Nutr Metab 2012; 37:1101-9. [DOI: 10.1139/h2012-129] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The present study aimed to investigate the beneficial effects of swim training on the promotion–progression stages of rat liver carcinogenesis. Male Wistar rats were submitted to chemically induced liver carcinogenesis and allocated into 4 major groups, according their dietary regimen (16 weeks) and swim training of 5 days per week (8 weeks): 2 groups were fed low-fat diet (LFD, 6% fat) and trained or not trained and 2 groups were fed high-fat diet (HFD, 21% fat) and trained or not trained. At week 20, the animals were killed and liver samples were processed for histological analyses; immunohistochemical detection of persistent or remodeling preneoplastic lesions (pPNL and rPNL) expressing placental glutathione S-transferase (GST-P) enzyme; or proliferating cell nuclear antigen (PCNA), cleaved caspase-3, and bcl-2 protein levels by Western blotting or malonaldehyde (MDA) and total glutathione detection by HPLC. Overall analysis indicated that swim training reduced the body weight and body fat in both LFD and HFD groups, normalized total cholesterol levels in the HFD group while decreased the MDA levels, increased glutathione levels and both number of GST-P-positive pPNL and hepatocellular adenomas in LFD group. Also, a favorable balance in PCNA, cleaved caspase-3, and bcl-2 levels was detected in the liver from the LFD-trained group in relation to LFD-untrained group. The findings of this study indicate that the swim training protocol as a result of exercise postconditioning may attenuate liver carcinogenesis under an adequate dietary regimen with lowered fat intake.
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Affiliation(s)
- Marco Aurélio Aguiar e Silva
- Post-Graduation Program in General and Applied Biology, Institute of Biosciences, UNESP, Sao Paulo State University, Botucatu 18618-970, SP, Brazil
| | - Ivan José Vechetti-Junior
- Post-Graduation Program in General and Applied Biology, Institute of Biosciences, UNESP, Sao Paulo State University, Botucatu 18618-970, SP, Brazil
| | - André Ferreira do Nascimento
- Department of Clinical Medicine, School of Medicine, UNESP, Sao Paulo State University, 18618-970 Botucatu, SP, Brazil
| | - Kelly Silva Furtado
- School of Medicine, Department of Pathology, UNESP, Sao Paulo State University, 18618-970 Botucatu, SP, Brazil
| | - Luciana Azevedo
- Faculty of Nutrition, UNIFAL, Federal University of Alfenas, 37130-000, Alfenas, MG, Brazil
| | - Daniel Araki Ribeiro
- Department of Biosciences, UNIFESP, Federal University of Sao Paulo, 11060-001, Santos, SP, Brazil
| | - Luis Fernando Barbisan
- Department of Morphology, Institute of Biosciences, UNESP, Sao Paulo State University, 18618-970 Botucatu, SP, Brazil
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Assenza A, Tosto F, Piccione G, Fazio F, Nery J, Valle E, Bergero D. Lipid Utilization Pathways Induced by Early Training in Standardbred Trotters and Thoroughbreds. J Equine Vet Sci 2012. [DOI: 10.1016/j.jevs.2012.02.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Statistical models for meta-analysis: A brief tutorial. World J Methodol 2012; 2:27-32. [PMID: 25237614 PMCID: PMC4145560 DOI: 10.5662/wjm.v2.i4.27] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2011] [Revised: 03/19/2011] [Accepted: 07/04/2012] [Indexed: 02/06/2023] Open
Abstract
Aggregate data meta-analysis is currently the most commonly used method for combining the results from different studies on the same outcome of interest. In this paper, we provide a brief introduction to meta-analysis, including a description of aggregate and individual participant data meta-analysis. We then focus the rest of the tutorial on aggregate data meta-analysis. We start by first describing the difference between fixed and random-effects meta-analysis, with particular attention devoted to the latter. This is followed by an example using the random-effects, method of moments approach and includes an intercept-only model as well as a model with one predictor. We then describe alternative random-effects approaches such as maximum likelihood, restricted maximum likelihood and profile likelihood as well as a non-parametric approach. A brief description of selected statistical programs available to conduct random-effects aggregate data meta-analysis, limited to those that allow both an intercept-only as well as at least one predictor in the model, is given. These descriptions include those found in an existing general statistics software package as well as one developed specifically for an aggregate data meta-analysis. Following this, some of the disadvantages of random-effects meta-analysis are described. We then describe recently proposed alternative models for conducting aggregate data meta-analysis, including the varying coefficient model. We conclude the paper with some recommendations and directions for future research. These recommendations include the continued use of the more commonly used random-effects models until newer models are more thoroughly tested as well as the timely integration of new and well-tested models into traditional as well as meta-analytic-specific software packages.
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Sandvei M, Jeppesen PB, Støen L, Litleskare S, Johansen E, Stensrud T, Enoksen E, Hautala A, Martinmäki K, Kinnunen H, Tulppo M, Jensen J. Sprint interval running increases insulin sensitivity in young healthy subjects. Arch Physiol Biochem 2012; 118:139-47. [PMID: 22540332 DOI: 10.3109/13813455.2012.677454] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
High intensity cycling training increases oxidative capacity in skeletal muscles and improves insulin sensitivity. The present study compared the effect of eight weeks of sprint interval running (SIT) and continuous running at moderate intensity (CT) on insulin sensitivity and cholesterol profile in young healthy subjects (age 25.2 ± 0.7; VO(2max) 49.3 ± 1.2 ml·kg(-1)·min(-1)). SIT and CT increased maximal oxygen uptake by 5.3 ± 1.8 and 3.8 ± 1.6%, respectively (p < 0.05 for both). Oral glucose tolerance test (OGTT) was performed before and 60 h after the last training session. SIT, but not CT, reduced glucose area under curve and improved HOMA β-cell index (p < 0.05). Insulin area under curve did not decrease significantly in any group. SIT, but not CT, reduced LDL and total cholesterol. In conclusion, sprint interval running improves insulin sensitivity and cholesterol profile in healthy subjects, and sprint interval running may be more effective to improve insulin sensitivity than continuous running at moderate intensity.
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Affiliation(s)
- Marit Sandvei
- Department of Physical Performance, Norwegian School of Sport Science, PO Box 4014 Ullevål Stadion, N-0806 Oslo, Norway
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Stradling C, Chen YF, Russell T, Connock M, Thomas GN, Taheri S. The effects of dietary intervention on HIV dyslipidaemia: a systematic review and meta-analysis. PLoS One 2012; 7:e38121. [PMID: 22701607 PMCID: PMC3372478 DOI: 10.1371/journal.pone.0038121] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Accepted: 05/01/2012] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Efficacy of dietary intervention for treatment and prevention of HIV-related lipid disturbances has not been well established. METHODS We conducted a systematic search of electronic databases supplemented with manual searches and conference abstracts, without language restriction. All randomised controlled trials (RCTs) with blood lipid outcomes, involving dietary intervention or supplementation for the treatment or prevention of adult HIV dyslipidaemia, versus no or other intervention were included. Two authors using predefined data fields, including study quality indicators, extracted data independently. RESULTS Eighteen studies (n = 873) met our inclusion criteria. Seven RCTs for omega-3 supplementation (n = 372), and four RCTs for dietary intervention (n = 201) were meta-analysed using random-effects models. Mild statistical heterogeneity was observed. Dietary intervention reduced triglyceride levels by -0·46 mmol/l (95%CI: -0·85 to -0·07 mmol/l) compared to control. Omega-3 supplementation reduced triglyceride levels by -1.12 mmol/l, (95%CI: -1·57 to -0·67 mmol/l) and total cholesterol, -0·36 mmol/l (95%CI: -0·67 to -0·05 mmol/l) compared to placebo/control. CONCLUSIONS Both omega-3 supplementation and dietary intervention reduced triglyceride level, with the latter possibly to a smaller extent. While dietary interventions are beneficial, more stringent dietary approaches may be necessary to fully address lipid disturbances in HIV patients. TRIAL REGISTRATION PROSPERO 2011:CRD42011001329.
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Affiliation(s)
- Clare Stradling
- HIV Metabolic Clinic, Heart of England NHS Foundation Trust, Birmingham, United Kingdom
- Birmingham and Black Country NIHR CLAHRC, University of Birmingham, Birmingham, United Kingdom
| | - Yen-Fu Chen
- Birmingham and Black Country NIHR CLAHRC, University of Birmingham, Birmingham, United Kingdom
| | - Tracy Russell
- Dietetic Department, Western General Hospital, Edinburgh, United Kingdom
| | - Martin Connock
- Warwick Evidence, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - G. Neil Thomas
- School of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, United Kingdom
| | - Shahrad Taheri
- HIV Metabolic Clinic, Heart of England NHS Foundation Trust, Birmingham, United Kingdom
- Birmingham and Black Country NIHR CLAHRC, University of Birmingham, Birmingham, United Kingdom
- School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, United Kingdom
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Current world literature. Curr Opin Cardiol 2012; 27:441-54. [PMID: 22678411 DOI: 10.1097/hco.0b013e3283558773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Exercise intervention and inflammatory markers in coronary artery disease: a meta-analysis. Am Heart J 2012; 163:666-76.e1-3. [PMID: 22520533 DOI: 10.1016/j.ahj.2011.12.017] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 12/21/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND Inflammatory activity plays a role in the development and progression of coronary artery disease (CAD), and exercise confers survival benefit. We performed a meta-analysis of changes in inflammatory biomarkers over the course of exercise interventions in patients with CAD. METHODS We searched MEDLINE, Embase, the Cochrane Collaboration, AMED, and CINAHL for studies reporting peripheral inflammatory biomarker concentrations before and after exercise interventions of ≥ 2 weeks in patients with CAD. Data were summarized using standard mean differences (SMD) and 95% CIs. RESULTS Twenty-three studies were included. Concentrations of C-reactive protein (CRP; SMD -0.345, 95% CI -0.444 to -0.246, n = 1,466, P < .001), interleukin 6 (SMD -0.546, 95% CI -0.739 to -0.353, n = 280, P < .001), fibrinogen (SMD -0.638, 95% CI -0.953 to -0.323, n = 247, P < .001), and vascular cell adhesion molecule 1 (SMD -0.413, 95% CI -0.778 to -0.048, n = 187, P = .027) were lower postintervention. Higher total cholesterol (B = -0.328, 95% CI -0.612 to -0.043, P = .026) and higher total/high-density lipoprotein cholesterol ratios (B = -0.250, 95% CI -0.425 to -0.076, P = .008) at baseline were associated with greater reductions in CRP. In controlled studies, follow-up concentrations of CRP (SMD -0.500, 95% CI -0.844 to -0.157, n(exercise/control) = 485/284, P = .004), and fibrinogen (SMD -0.544, 95% CI -1.058 to -0.030, n(exercise/control) = 148/100, P = .038) were lower in subjects who exercised compared with controls. CONCLUSION Exercise training is associated with reduced inflammatory activity in patients with CAD. C-reactive protein and fibrinogen have provided the strongest evidence. Higher baseline CRP and adverse baseline lipid profiles predicted greater reductions in CRP.
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