Nutrition and health

Objectives:
Despite growing evidence that type 2 diabetes is associated with dementia, the question of whether intensive glucose control can prevent or arrest cognitive decline remains unanswered. Therefore, this review articles (meta-analysis) has been conducted.

Does intensive glucose control slow down cognitive decline in persons with type 2 diabetes?

Study design:
This review article included 5 cohort studies with 16,584 participants.
The mean follow-up duration ranged from 3.5 to 10 years.
The mean age of participants in the studies included in the current meta-analysis was 65.6 years at the initiation of the studies and the proportion of women was 40.8%.
All quality assessment scores fell in the range of 8 or 9, indicating high quality.
There was no publication bias.

Results and conclusions:
The investigators found a significantly poorer decline in cognitive function in the intensive glucose control group [β = -0.03, 95% CI = -0.05 to -0.02] than in the conventional glucose control group.

The investigators found, subgroup analysis showed a significant difference in the change in cognitive performance in composite cognitive function [β = -0.03, 95% CI = -0.05 to -0.01] and memory [β = -0.13, 95% CI = -0.25 to -0.02].

The investigators concluded that intensive glucose control in persons with type 2 diabetes slows down cognitive decline, especially the decline in composite and memory function. The impact of intensive glucose control on the brain structural abnormalities and risk of dementia needs further rigorously designed studies to validate these findings. Also, replicating and validating these findings is warranted.

Original title:
Impact of Intensive Glucose Control on Brain Health: Meta-Analysis of Cumulative Data from 16,584 Patients with Type 2 Diabetes Mellitus by Tang X, Cardoso MA, […], Simó R.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7947088/

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Objectives:
There is much debate regarding the source/quality of dietary proteins in supporting indices of skeletal muscle anabolism. Therefore, this review article has been conducted.

What is the effect of protein source/quality on acute muscle protein synthesis (MPS) and changes in lean body mass (LBM) and strength, when combined with resistance exercise (RE)?  

Study design:
This review article included 27 studies that compared the effects of ≥2 dose-matched, predominantly isolated protein sources of varying "quality”, in young (18-35 y) and older (≥60 y) adults.

3 separate models were employed as follows: 1) protein feeding alone on muscle protein synthesis, 2) protein feeding combined with a bout of resistance exercise on muscle protein synthesis and 3) protein feeding combined with longer-term resistance exercise training (RET) on lean body mass and strength.  

The mean age for the young groups across all 3 models ranged between 20 and 29 y and the older groups were between 61 and 75 y.

Results and conclusions:
The investigators found analysis revealed an effect favoring higher-quality protein for postprandial muscle protein synthesis at rest [mean difference (MD) = 0.014%/h, 95% CI = 0.006 to 0.021, p 0.001] and following resistance exercise [MD = 0.022%/h, 95% CI = 0.014 to 0.030, p 0.00001] in young [model 1 = 0.016%/h, 95% CI = -0.004 to 0.036, p = 0.12. Model 2 = 0.030%/h, 95% CI = 0.015 to 0.045, p 0.0001] and older [model 1 = 0.012%/h, 95% CI = 0.006 to 0.018, p 0.001. Model 2 = 0.014%/h, 95% CI = 0.007 to 0.021, p 0.001] adults.  

The investigators found, however, although higher protein quality was significantly associated with superior strength gains with resistance exercise training [standardized mean difference (SMD) = 0.24 kg, 95% CI = 0.02 to 0.45, p = 0.03], no effect was observed on changes to lean body mass [SMD = 0.05 kg, 95% CI = -0.16 to 0.25, p = 0.65].

The investigators concluded that protein quality provides a small but significant impact on indices of muscle protein anabolism in young and older adults. However, further research is warranted to elucidate the importance of protein source/quality on musculoskeletal aging, particularly in situations of low protein intake.

Original title:
Protein Source and Quality for Skeletal Muscle Anabolism in Young and Older Adults: A Systematic Review and Meta-Analysis by Morgan PT, Harris DO, […], Breen L.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8245874/

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Objectives:
Which disease-modifying osteoarthritis drugs improve knee and hip osteoarthritis among adults?

Study design:
This review article included 28 randomized controlled trials (RCTs) with 11,890 patients.

Results and conclusions:
The investigators found glucosamine supplements significantly improved both structure [minimum joint width or cartilage volume: network results: SMD = 0.16, 95% CI = 0.04 to 0.28] and symptoms [pain = -0.15, 95% CI = -0.25 to -0.05 and function = -0.17, 95% CI = -0.28 to -0.07] of knee and hip osteoarthritis among adults.

The investigators found chondroitin supplements significantly improved both structure [minimum joint width or cartilage volume: network results: SMD = 0.21, 95% CI = 0.10 to 0.32] and symptoms [pain = -0.06, 95% CI = -0.15 to -0.03 and function = -0.15, 95% CI = -0.26 to -0.03] of knee and hip osteoarthritis among adults.

The investigators found strontium supplements significantly improved structure [minimum joint width or cartilage volume: SMD = 0.20, 95% CI = 0.20 to 0.38] of knee and hip osteoarthritis among adults.

The investigators found vitamin D supplements significantly improved symptoms [pain = -0.15, 95% CI = -0.27 to -0.03 and function = -0.18, 95% CI = -0.31 to -0.06] of knee and hip osteoarthritis among adults.  

The investigators found, although doxycycline also demonstrated a favorable efficacy ranking, its safety profile was poor [withdrawal: network relative risk = 1.69, 95% CI = 1.03 to 2.75].

The investigators concluded glucosamine and chondroitin supplements yield statistically significant but clinically questionable long-term benefit on structure and symptoms of knee and hip osteoarthritis among adults, though both have favorable safety profiles.
Strontium supplements improve structure and vitamin D supplements improve symptoms of knee and hip osteoarthritis among adults. Although doxycycline has a favorable efficacy ranking, its safety profile is poor.
None of the 12 classes of drugs appears to have long-term clinically significant benefit.

Original title:
The Efficacy and Safety of Disease-Modifying Osteoarthritis Drugs for Knee and Hip Osteoarthritis-a Systematic Review and Network Meta-Analysis by Yang W, Sun C, […], Zhuo Q.

Link:
https://pubmed.ncbi.nlm.nih.gov/33846938/

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Objectives:
Patients with kidney failure often present with reduced cardiovascular functional reserve and exercise tolerance. Previous studies on cardiorespiratory fitness examined with cardiopulmonary-exercise-testing (CPET) in kidney-transplant-recipients (KTR) had variable results. Therefore, this review article has been conducted.

Does cardiovascular functional reserve improve after kidney-transplantation?

Study design:
This review article included 8 studies with 461 participants.

Results and conclusions:
The investigators found kidney-transplant-recipients had significantly higher oxygen consumption at peak/max exercise (VO2 peak/VO2 max) compared to patients with kidney failure [SMD = 0.70, 95% CI = 0.31 to 1.10, I2 = 70%, p = 0.002]. 

The investigators found, in subgroup analyses, similar differences were evident among 7 studies comparing kidney-transplant-recipients and hemodialysis patients [SMD = 0.64, 95% CI = 0.16 to 1.12, I2 = 65%, p = 0.009] and 2 studies comparing kidney-transplant-recipients with peritoneal dialysis subjects [SMD = 1.14, 95% CI = 0.19 to 2.09, I2 = 50%, p = 0.16]. 

The investigators found across 4 studies with relevant data, oxygen consumption during peak/max exercise showed significant improvement after kidney-transplantation compared to pre-transplantation values [WMD = 2.43, 95% CI = 0.01 to 4.85, I2 = 68%, p = 0.02].

The investigators concluded kidney-transplant-recipients exhibit higher cardiovascular functional reserve during cardiopulmonary-exercise-testing compared to patients with kidney failure. Cardiovascular reserve is also improved after kidney-transplantation in relation to pre-surgery levels.

Original title:
Cardiorespiratory fitness in kidney transplant recipients compared to patients with kidney failure: a systematic review and meta-analysis by Theodorakopoulou MP, Boutou AK, […], Sarafidis P.

Link:
https://pubmed.ncbi.nlm.nih.gov/34170572/

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Cardiac reserve or cardiovascular reserve refers to the difference between the rate at which the heart pumps blood and its maximum capacity for pumping blood at any given time. A measurement of the cardiovascular reserve may be a health indicator for some medical conditions, like patients with kidney failure.

Objectives:
Does supplementation of thiamine (vitamin B1) combined vitamin C reduce mortality in patients with sepsis or septic shock?

Study design:
This review article included 7 randomized controlled trials (RCTs) with a total of 868 patients.

Results and conclusions:
The investigators found there was no statistical difference between the thiamine combined vitamin C intervention group and the control group for in-hospital mortality [OR = 1.11, 95% CI = 0.79 to 1.56, p = 0.55].
No statistical because OR of 1 was found in the 95% CI of 0.79 to 1.56. OR of 1 means no risk/association.

The investigators found significant improvements of sequential organ failure assessment (SOFA) score during the first 72 h after enrollment and duration of vasopressor use for the thiamine combined vitamin C intervention group.
However, no other significant associations were found.

The investigators concluded despite widespread enthusiasm for thiamine (vitamin B1) combined with vitamin C for sepsis and septic shock, this meta-analysis only shows an association with reduced sequential organ failure assessment (SOFA) score and time of vasopressor use. There is no association with in-hospital mortality in patients with sepsis or septic shock.

Original title:
Thiamine combined with vitamin C in sepsis or septic shock: a systematic review and meta-analysis by Ge Z, Huang J, [...], Li Y.

Link:
https://pubmed.ncbi.nlm.nih.gov/33709993/

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Vasopressors are a group of medicines that contract (tighten) blood vessels and raise blood pressure.
 

Objectives:
The association of meat consumption with mortality and morbidity for non-communicable diseases has been extensively studied. However, the relation of white meat consumption with health outcomes remains controversial. Therefore, this review article has been conducted.

Does consumption of white meat reduce mortality and morbidity rate?

Study design:
This review article included 22 prospective cohort studies with 3,132,149 subjects.
11 studies (14 data-sets) reported data on all-cause mortality, 10 studies (15 datasets) on cardiovascular mortality and 10 studies (11 datasets) on non-fatal cardiovascular events.
The evaluation of methodological quality of each study showed a median NOS score of 6.

Funnel plot examination suggested the absence of publication bias and of small-study effect, confirmed by the Egger’s test for all-cause mortality.

Results and conclusions:
The investigators found the analysis of the 11 studies (14 datasets) on all-cause mortality showed a statistically significant lower mortality rate of 6% for subjects in the highest vs. lowest unprocessed white meat consumption category [OR = 0.94, 95% CI = 0.90 to 0.97, p 0.001, I2 = 95.6%, p 0.001].

The investigators found an overall neutral association between high unprocessed white meat consumption and cardiovascular mortality and morbidity.

The investigators concluded that consumption of unprocessed white meat reduces all-cause mortality.

Original title:
White Meat Consumption, All-Cause Mortality, and Cardiovascular Events: A Meta-Analysis of Prospective Cohort Studies by Lupoli R, Vitale M, […], Vaccaro O.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7924043/

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Objectives:
Does spina bifida increase risk of neonatal and infant mortality?

Study design:
This review article included 20 population-based cohort studies conducted in high-income countries.
These studies included a total study population of over 30 million liveborn infants (median study sample size: 1,178,452 (251,699-14 million)) in which approximately 12,000 (median: 231 (27-3,903)) were affected by spina bifida.
All infants included were born at ≥20 weeks gestational age with a birthweight ≥500g.

Results and conclusions:
The investigators found significant declines in spina bifida associated infant and neonatal mortality rates [e.g. 4.76% decrease in IMR per 100, 000 live births per year] and case fatality [e.g. 2.70% decrease in infant case fatality per year] were consistently observed over time.

The investigators found preterm birth [RR = 4.45, 95% CI = 2.30 to 8.60] and low birthweight [RR = 4.77, 95% CI = 2.67 to 8.55] were the strongest risk factors associated with increased spina bifida infant case fatality.

The investigators concluded that a decline in spina bifida associated infant/neonatal mortality and case fatality are consistently observed, in which advances in medical and surgical treatment and mandatory folic acid food fortification likely to play an important role. Preterm birth and low birthweight are strongest risk factors associated with increased case fatality of infants with spina bifida, which warrant particular attention from clinicians caring for these vulnerable babies.

Original title:
Neonatal and infant mortality associated with spina bifida: A systematic review and meta-analysis by Ho P, Quigley M, […], Kurinczuk JJ.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8115829/

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Taking 400 micrograms (mcg) of folic acid before and during pregnancy can reduce the risk of certain birth defects. These include spina bifida, anencephaly and some heart defects. Birth defects occur within the first 3-4 weeks of pregnancy.
 

Objectives:
Branched-chain amino acids (BCAAs; leucine, isoleucine and valine) are essential amino acids involved in immune responses and may have roles in protein malnutrition and sarcopenia (a type of muscle loss (muscle atrophy) that occurs with aging and/​or immobility). Furthermore, certain liver diseases have been associated with a decreased Fischer's ratio (BCAAs to aromatic amino acids; phenylalanine, tyrosine and tryptophan). However, a comprehensive synthesis of the evidence from human controlled studies on the supplemental use of BCAAs during the oncology peri-operative period has not been published. Therefore, this review article (meta-analysis) has been conducted.

Does branched-chain amino acids (BCAAs) supplementation during the oncological surgical period reduce post-operative morbidity from infections and ascites?

Study design:
This review article included 13 RCTs and 6 cohort studies with 2,019 participants.
Mean (or median) ages of the RCTs populations were from 53 to 67 years old and all of the RCTs had a predominantly male population.
9 RCTs (69%) evaluated oral intake of BCAAs and 4 (31%) administered (parenteral) BCAAs intravenously in hospital.
Duration of treatment use in the RCTs ranged from intra-operatively (single intravenous administration) up to a maximum duration of 13 months (oral administration).

Among 13 RCTs, 77% involved liver cancer. Methodological study quality scored substantial risk-of-bias across most RCTs.

Overall, 6 cohort studies were of low methodological quality.

Results and conclusions:
The investigators found meta-analysis of RCTs showed a 38% significantly decreased risk of post-operative infections in BCAAs group compared to controls [RR = 0.62, 95% CI = 0.44 to 0.87, p= 0.006, I2 = 0%, number of RCTs, k = 6, total sample size, n = 389].

The investigators found BCAAs supplementation was also beneficial for ascites [RR = 0.55, 95% CI = 0.35 to 0.86, p = 0.008, I2 = 0%, k = 4, n = 296], body weight [MD = 3.24 kg, 95% CI = 0.44 to 6.04, p = 0.02, I2 = 24%, k = 3, n = 196] and hospitalization length [MD = -2.07 days, 95% CI = -3.97 to -0.17, p = 0.03, I2 = 59%, k = 5, n = 362].

The investigators found no differences between BCAAs and controls for mortality, recurrence, other post-operative complications (liver failure, edema, pleural effusion), blood loss, quality of life, ammonia level and prothrombin time.

The investigators found no serious adverse events were related to BCAAs; however, serious adverse events were reported due to intravenous catheters. No safety concerns from observational studies were identified.

The investigators concluded that branched-chain amino acids (BCAAs) supplementation during the oncological surgical period may reduce important post-operative morbidity from infections and ascites compared to controls. May reduce because the included studies were of low methodological quality. Therefore, blinded, placebo-controlled confirmatory trials of higher methodological quality are warranted, especially using oral, short-term BCAAs-enriched supplements within the context of recent ERAS programs.

Original title:
Are Supplemental Branched-Chain Amino Acids Beneficial During the Oncological Peri-Operative Period: A Systematic Review and Meta-Analysis by Cogo E, Elsayed  M, […], Papadogianis P.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7930658/

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Ascites is the buildup of fluid in the space around the organs in the abdomen. When ascites is caused by cancer, it is called malignant ascites.
 

Objectives:
Excess body weight, including overweight and obesity, is one of the major factors influencing human health and plays an important role in the global burden of disease. Carotenoids serve as precursors of vitamin A-related retinoids and are considered to have potential effects on many diseases. However, the influence of carotenoids on people with excess body weight is unclear. Therefore, this review article has been conducted.

Does carotenoid supplementation reduce risk of overweight and obesity in overweight or obese subjects?

Study design:
This review article included 7 randomized controlled trials (RCTs) and 8 observational studies with 28,944 subjects and data on multiple carotenoid subgroups, including lycopene, astaxanthin, cryptoxanthin, α-carotene, and β-carotene.

In all included RCTs, the intervention duration was 20 days at the shortest and 16 weeks at the longest and the range of intervention doses was 1.2-60 mg/d.

Results and conclusions:
The investigators found that the insufficiency of serum carotenoids significantly increased risk of overweight and obesity with 73% [OR = 1.73, 95% CI = 1.57 to 1.91, p 0.001].

The investigators found, moreover, carotenoid supplementation was significantly associated with body weight reductions [SMD = -2.34 kg, 95% CI = -3.80 to -0.87 kg, p 0.001], body mass index decrease [SMD = -0.95 kg/cm², 95% CI = -1.88 to -0.01 kg/cm², p 0.001] and waist circumference losses [SMD = -1.84 cm, 95% CI = -3.14 to -0.54 cm, p 0.001].

The investigators concluded that 1.2-60 mg/d carotenoid supplementation reduces risk of overweight and obesity in overweight or obese subjects. Furthermore, an insufficiency of serum carotenoids is a risk factor for overweight and obesity. Additional data from large clinical trials are needed.

Original title:
The association between carotenoids and subjects with overweight or obesity: a systematic review and meta-analysis by Yao N, Yan S, […], Cui W.

Link:
https://pubmed.ncbi.nlm.nih.gov/33977977/

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Am I overweight?
 

Objectives:
The literature showed that grape products containing polyphenols (GPCP) had anti-oxidant activity. However, the effects of GPCP on different biomarkers of oxidative stress are still controversial. Therefore, this review article (meta-analysis) has been conducted.

Does supplementation of grape products containing polyphenols improve status of oxidative stress (like TAC, ORAC and SOD)?

Study design:
This review article included 17 eligible RCTs with a total of 633 participants.

Results and conclusions:
The investigators found supplementation of grape products containing polyphenols significantly increase total antioxidant capacity (TAC) [WMD = 1.524 mmol/L, 95% CI = 0.83 to 2.21].

The investigators found supplementation of grape products containing polyphenols significantly enhanced superoxide dismutase (SOD) [WMD = 0.450 mmol/L, 95% CI = 0.23 to 0.66], total antioxidant capacity (TAC) [WMD = 2.829 mmol/L, 95% CI = 0.13 to 5.52] and oxygen radical absorbance capacity (ORAC) [WMD = 0.524 μmol/L, 95% CI = 0.42 to 0.62] among healthy participants. 

The investigators found in subgroup analyses, that higher grape products containing polyphenols doses significantly increased SOD [WMD = 0.539 U/mgHb, 95% CI = 0.24 to 0.82] and ORAC [WMD = 0.377 μmol/L, 95% CI = 0.08 to 0.67], whereas longer intervention periods significantly enhanced ORAC [WMD = 0.543 μmol/L, 95% CI = 0.43 to 0.64].

The investigators concluded that supplementation of grape products containing polyphenols partly improves status of oxidative stress, but further well-designed trials are required to confirm these results.

Original title:
The effect of grape products containing polyphenols on oxidative stress: a systematic review and meta-analysis of randomized clinical trials by Sarkhosh-Khorasani S, Sangsefidi ZS, […], Hosseinzadeh M.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7971097/

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Polyphenols are divived into 2 general classes, one is flavonoids and other is phenolic acids. Flavonoids are divided into flavones, flavononse, flavonols, flavanols, isoflavones, while phenolic acids are generally classified into hydroxybenzoic and hydroxycinnamic acids.

Objectives:
Due to the rapid increase of primary liver cancer incidence and the poor prognosis, it is imperative to identify new modifiable factors such as diet and nutrition for the prevention of liver cancer. Diet high in saturated fatty acids (SFA) has been hypothesized to be associated with increased risk of cancers. However, the associations between dietary fatty acids and liver cancer are not consistent. Therefore, this review article has been conducted.

Does a diet high in saturated fatty acids or cholesterol increase risk of liver cancer?

Study design:
This review article included 14 prospective cohort studies with 15,890 liver cancer cases.

Results and conclusions:
The investigators found for the highest dietary saturated fat versus lowest intake, a significantly increased risk of 34% [RR = 1.34, 95% CI = 1.06 to 1.69, I2 = 16.9%, n = 5] for liver cancer.

The investigators found for every increase with 1 En% saturated fat, a significantly increased risk of 4% [RR = 1.04, 95% CI = 1.01 to 1.07, I2 = 16.8%, n = 5] for liver cancer.

The investigators found per 0.1-unit increase in ratio of monounsaturated fatty acids (MUFA): saturated fat (SFA), a significantly decreased risk of 9% [RR = 0.91, 95% CI = 0.86 to 0.95] for liver cancer.

The investigators found per 0.1-unit increase in ratio of unsaturated fatty acids (UFA):saturated fat (SFA), a significantly decreased risk of 6% [RR = 0.94, 95% CI = 0.90 to 0.97] for liver cancer.

The investigators found for every increase with 100 mg dietary cholesterol intake per day, a significantly increased risk of 16% [RR = 1.16, 95% CI = 1.01 to 1.07, I2 = 0%, n = 2] for liver cancer.

The investigators found for the highest serum total cholesterol levels versus lowest levels, a significantly decreased risk of 58% [RR = 0.42, 95% CI = 0.33 to 0.54, I2 = 90.7%, n = 7] for liver cancer.

The investigators found for the highest serum total cholesterol levels versus lowest levels, a significantly decreased risk of 61% [RR = 0.39, 95% CI = 0.27 to 0.57] for liver cancer among men. 

The investigators found for the highest serum total cholesterol levels versus lowest levels, a significantly decreased risk of 69% [RR = 0.31, 95% CI = 0.26 to 0.38] for liver cancer among women. 

The investigators found for every increase with 1 mmol/L in serum cholesterol level, a significantly decreased risk of 28% [RR = 0.72, 95% CI = 0.69 to 0.75, I2 = 75.3%, n = 7] for liver cancer.

The investigators found for every increase with 1 mmol/L in serum HDL cholesterol level, a significantly decreased risk of 58% [RR = 0.42, 95% CI = 0.27 to 0.64, I2 = 0%, n = 2] for liver cancer.

The investigators found these findings were generally robust and stable in sensitivity analyses.

The investigators concluded there is an increased risk for dietary saturated fat with liver cancer using both category and dose-response analyses. Higher ratios of monounsaturated fatty acids (MUFA):saturated fat (SFA) and unsaturated fatty acids (UFA):saturated fat (SFA) are associated with a lower risk of developing liver cancer. Higher serum total and HDL cholesterol are associated with a lower risk of liver cancer with high between-studies variability.

Original title:
Dietary Fats, Serum Cholesterol and Liver Cancer Risk: A Systematic Review and Meta-Analysis of Prospective Studies by Zhao L, Deng C, [...], Zhang X.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037522/

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A diet high in saturated fat (unhealthy fat) is a diet with more than 10 En% saturated fat.

The easiest way to follow a diet with more than 10 En% saturated fat is to choose only products/meals that also contain more than 10 En% saturated fat. Check here which products contain more than 10 En% saturated fat.

More than 10% saturated fat means that the total amounts of saturated fat make up more than 10% of the total kcal of the diet. So a 2000 kcal diet with more than 10 En% saturated fat contains more than 22 grams of saturated fat. 22 grams of saturated fat provides 22x9 kcal = 198 kcal. 198 kcal is 10% of 2000 kcal.

However, products with more than 10 En% saturated fat are unhealthy products.

Objectives:
Does vitamin B supplementation have positive effects on patients with mouth ulcers?

Study design:
This review article included 16 RCTs with 1,534 patients (767 in the treatment group and 767 in the control group).
Patients who did not receive treatment were taken as controls, while those who were treated with vitamin B alone or vitamin B combined with pantothenic acid were included in the treatment group.

Results and conclusions:
The investigators found, in comparison with the control group, the effective rate was higher [OR = 5.24, 95% CI = 3.72 to 7.37, p 0.001] while the recurrence rate was lower [OR = 0.194, 95% CI = 0.128 to 0.295, p 0.001] in the treatment group.
Sensitivity analysis revealed that the results did not change significantly after pooling, suggesting that the result was stable and less likely to be affected by heterogeneit

The investigators found, additionally, both the ulcer healing time [SMD = -2.15, 95% CI = -2.80 to -1.50, p 0.001] and treatment time [SMD = -2.31, 95% CI = -2.67 to -1.96, p 0.001] in the treatment group were shorter than those of the control group.  
Additionally, the low sensitivity was also supported by the above results and indicated the robustness of the above results.

The investigators concluded that vitamin B supplementation (both vitamin B alone or vitamin B combined with pantothenic acid) enables a higher effective rate and lower recurrence rate, accelerates ulcer healing and shortens the course of treatment. Collectively, vitamin B has a high clinical value in treating patients with mouth ulcers.

Original title:
Clinical efficacy of vitamin B in the treatment of mouth ulcer: a systematic review and meta-analysis by Shi J, Wang L, [...], Zhi D.

Link:
https://apm.amegroups.com/article/view/72221/html

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Objectives:
L-carnitine is an amino acid derivative that is thought to be helpful for treating renal anemia in hemodialysis patients. However, the mechanism remains to be fully elucidated. Therefore, this review article (meta-analysis) has been conducted.

Does L-carnitine supplementation/therapy have positive effects on renal anemia in hemodialysis patients?

Study design:
This review article included 18 RCTs with 1,090 participants.

Results and conclusions:
The investigators found L-carnitine supplementation significantly increased plasma free L-carnitine levels [MD = 140.53, 95% CI = 102.22 to 178.85, p 0.00001]. 

The investigators found L-carnitine supplementation significantly decreased the erythropoietin responsiveness index (ERI) [MD = -2.72, 95% CI = -3.20 to -2.24, p 0.00001] and the required erythropoiesis-stimulating agent (ESA) doses [MD = -1.70, 95% CI = -2.04 to -1.36, p 0.00001].

The investigators found, however, the use of L-carnitine was not associated with a higher hemoglobin level [MD = 0.18, 95% CI = -0.20 to 0.55, p = 0.35] and hematocrit level [MD = 1.07, 95% CI = -0.73 to 2.87, p = 0.24].

The investigators found, in subgroup analyses, the effects of L-carnitine supplementation on renal anemia in patients on hemodialysis were independent of the treatment duration and intervention routes. 

The investigators concluded that L-carnitine supplementation/therapy increases plasma L-carnitine concentrations, improves the response to erythropoiesis-stimulating agent, decreases the required erythropoiesis-stimulating agent doses in patients receiving hemodialysis and maintains hemoglobin and hematocrit levels. L-carnitine supplementation should be supported in hemodialysis patients. However, the relationship between L-carnitine treatment and long-term outcomes is still unclear. Further high-quality RCTs are needed to verify these findings.

Original title:
Effect of L-carnitine supplementation on renal anemia in patients on hemodialysis: a meta-analysis by Zhu Y, Xue C, […], Deng J.

Link:
https://pubmed.ncbi.nlm.nih.gov/33713287/

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Erythropoietin responsiveness index (ERI) is defined as average weekly erythropoietin (EPO) dose per kg body weight (wt) per average hemoglobin (Hgb), over a 3-month period (ERI = (EPO/wt)/Hgb).

Epoetin alfa and darbepoetin alfa are erythropoiesis-stimulating agents (ESAs), approved for the treatment of anemia (low red blood cells) resulting from chronic kidney disease.
 

Objectives:
Does chromium supplementation improve lipid profile (serum levels of triglyceride and cholesterol) in patients with type 2 diabetes mellitus (T2DM)?

Study design:
This review article included  24 RCTs (with 28 effect sizes).

Results and conclusions:
The investigators found that chromium supplementation resulted in a significant decrease in serum levels of triglyceride (TG) in patients with type 2 diabetes mellitus [MD = -6.54 mg/dL, 95 % CI = -13.08 to -0.00, p = 0.050].
Significant means that there is an association with a 95% confidence.

The investigators found that chromium supplementation resulted in a significant decrease in serum levels of total cholesterol (TC) in patients with type 2 diabetes mellitus [WMD = -7.77 mg/dL, 95 % CI = -11.35 to -4.18, p 0.001].

The investigators found that chromium supplementation significantly increased high-density lipoprotein cholesterol (HDL cholesterol or good cholesterol) in patients with type 2 diabetes mellitus [WMD = 2.23 mg/dL, 95 % CI = 0.07 to 4.40, p = 0.043] level.

The investigators found, however, chromium supplementation did not have significant effects on low-density lipoprotein cholesterol (LDL cholesterol or bad cholesterol) in patients with type 2 diabetes mellitus [WMD = -8.54 mg/dL, 95 % CI = -19.58 to 2.49, p = 0.129] level.

The investigators concluded that chromium supplementation decreases serum levels of triglyceride (TG) and total cholesterol (TC) and increases HDL cholesterol (good cholesterol) levels in patients with type 2 diabetes mellitus. It should be noted that the lipid-lowering properties of chromium supplementation are small and may not reach clinical importance.

Original title:
Effects of chromium supplementation on lipid profile in patients with type 2 diabetes: A systematic review and dose-response meta-analysis of randomized controlled trials by Asbaghi O, Naeini F, […], Naeini AA.

Link:
https://pubmed.ncbi.nlm.nih.gov/33813266/

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Objectives:
Do rotavirus vaccines reduce risk of rotavirus gastroenteritis (RVGE) in children younger than 5 years?

Study design:
This review article included 20 RCTs and 38 case-control studies.

Results and conclusions:
The investigators found a meta-analysis of 20 RCTs and 38 case-control studies revealed that Rotarix (RV1) vaccines significantly reduced rotavirus gastroenteritis risk with 68.4% [RR = 0.316, 95% CI = 0.224 to 0.345] and rotavirus gastroenteritis hospitalization risk with 65.3% [OR = 0.347, 95% CI = 0.279 to 0.432] among children fully vaccinated.

The investigators found a meta-analysis of 20 RCTs and 38 case-control studies revealed that RotaTeq (RV5) vaccines significantly reduced rotavirus gastroenteritis risk with 65% [RR = 0.35, 95% CI = 0.275 to 0.445] and rotavirus gastroenteritis hospitalization risk with 72.8% [OR = 0.272, 95% CI = 0.197 to 0.376] among children fully vaccinated.

The investigators found rotavirus vaccines also demonstrated higher protection against severe rotavirus gastroenteritis.

The investigators found no significant differences in the protection of RV1 and RV5 against rotavirus disease were noted in adjusted indirect comparisons.

The investigators found moderate associations were seen between reduced rotavirus gastroenteritis risk and Rotavac [RR = 0.664, 95% CI = 0.548 to 0.804], Rotasiil [RR = 0.705, 95% CI = 0.605 to 0.821] and Lanzhou lamb rotavirus vaccine [RR = 0.407, 95% CI = 0.332 to 0.499].

The investigators found all rotavirus vaccines demonstrated no risk of serious adverse events.

The investigators found a positive correlation was also seen between immunogenicity and vaccine protection [e.g., association of rotavirus gastroenteritis with RV1: coefficient = -1.599, adjusted R2 = 99.7%].

The investigators concluded that the high protection and low risk of serious adverse events for rotavirus vaccines in children who were fully vaccinated emphasize the importance of worldwide introduction of rotavirus vaccination in children younger than 5 years. Similar protection provided by Rotarix and RotaTeq relieves the pressure of vaccines selection for health care authorities.

Original title:
Association of Rotavirus Vaccines With Reduction in Rotavirus Gastroenteritis in Children Younger Than 5 Years: A Systematic Review and Meta-analysis of Randomized Clinical Trials and Observational Studies by Sun ZW, Fu Y, […], Xu HG.

Link:
https://pubmed.ncbi.nlm.nih.gov/33970192/

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Rotavirus gastroenteritis is the most common cause of severe diarrhoea in children under the age of 5. Rotavirus gastroenteritis is caused by rotavirus. It’s highly contagious and easily transmittable.

 

Objectives:
The evidence on the association between obesity and atrial fibrillation (AF) recurrence was equivocal. Therefore, this review article (meta-analysis) has been conducted.

Does obesity increase risk of atrial fibrillation recurrence in patients undergoing catheter ablation?

Study design:
This review article included 20 studies with 52,771 patients.

Results and conclusions:
The investigators found that obesity was significantly associated with higher atrial fibrillation recurrence [OR = 1.30, 95% C = 1.16 to 1.47, p 0.001, I2 = 72.7%] and similar rate of adverse events [OR = 1.21, 95% CI = 0.87 to 1.67, p = 0.264, I2 = 23.9%] in patients undergoing catheter ablation.

The investigators found meta-regression showed that the association varied by age [coefficient = -0.03, p = 0.024].

The investigators found meta-analysis of highest versus lowest BMI showed that the highest group had higher atrial fibrillation recurrence [OR = 1.37, 95% CI = 1.18 to 1.58, p 0.001, I2 = 64.9%] and adverse events [OR = 2.02, 95% CI = 1.08 to 3.76, p = 0.028, I2 = 49.5%] in patients undergoing catheter ablation.

The investigators found the dose-response relationship for BMI and atrial fibrillation recurrence was nonlinear [p nonlinearity 0.001], the curve became steeper at 30-35 kg/m².

The investigators found for adverse events, an increase of 1% for every 1 kg/m² increase in BMI [OR = 1.01, 95% CI = 1.00 to 1.02, p = 0.001], the relationship was nonlinear [p nonlinearity = 0.001].

The investigators concluded that obesity is associated with higher atrial fibrillation recurrence in patients undergoing catheter ablation. High BMI is associated with a higher risk for adverse events.

Original title:
BMI and atrial fibrillation recurrence post catheter ablation: A dose-response meta-analysis by Pranata R, Henrina J, […], Munawar M.

Link:
https://pubmed.ncbi.nlm.nih.gov/33544873/

Additional information of El Mondo:
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Catheter ablation is a procedure that uses radiofrequency energy (similar to microwave heat) to destroy a small area of heart tissue that is causing rapid and irregular heartbeats. Destroying this tissue helps restore your heart’s regular rhythm. Catheter ablation is also called radiofrequency ablation.

Am I overweight?
 

Objectives:
Does carotenoid (like astaxanthin, lutein/zeaxanthin, β-cryptoxanthin and lycopene) supplementation have protective effects on inflammatory biomarkers (like C-reactive protein and interleukin-6)?

Study design:
This review article included 26 RCTs with 35 effect sizes.

Results and conclusions:
The investigators found carotenoid supplementation significantly reduced C-reactive protein (CRP) [WMD = -0.54 mg/L, 95% CI = -0.71 to -0.37, p 0.001].
Significantly because the calculated p-value of 0.001 was less than the p-value of 0.05.

The investigators found carotenoid supplementation significantly reduced interleukin-6 (IL-6) [WMD = -0.54 pg/mL, 95% CI = -1.01 to -0.06, p = 0.025].
Significant means that there is an association with a 95% confidence.

The investigators found in subgroup analyses that astaxanthin supplementation significantly reduced C-reactive protein (CRP) [WMD = -0.30 mg/L, 95% CI = -0.51 to -0.09, p = 0.005].

The investigators found in subgroup analyses that lutein/zeaxanthin supplementation significantly reduced C-reactive protein (CRP) [WMD = -0.30 mg/L, 95% CI = -0.45 to -0.15, p 0.001].

The investigators found in subgroup analyses that β-cryptoxanthin supplementation significantly reduced C-reactive protein (CRP) [WMD = -0.35 mg/L, 95% CI = -0.54 to -0.15, p 0.001].

The investigators found in subgroup analyses that lycopene supplementation significantly reduced interleukin-6 (IL-6) [WMD = -1.08 pg/mL, 95% CI = -2.03 to -0.12, p = 0.027].

The investigators concluded that carotenoid supplementation (like astaxanthin, lutein/zeaxanthin, β-cryptoxanthin and lycopene) has protective effects on inflammatory biomarkers.

Original title:
Carotenoids supplementation and inflammation: a systematic review and meta-analysis of randomized clinical trials by Hajizadeh-Sharafabad F, Zahabi ES, […], Alizadeh M.

Link:
https://pubmed.ncbi.nlm.nih.gov/33998846/

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Objectives:
A few randomized controlled trials (RCTs) have assessed the effect of brown rice consumption on metabolic parameters (such as, weight, height, waist circumference, fasting glucose, LDL, HDL, total cholesterol, triglycerides and blood pressure) compared to white rice, with inconsistent findings. Therefore, this review article has been conducted.

Is the effect of brown rice on adiposity indices (such as, weight, height and waist circumference), lipid profile (such as, LDL, HDL, total cholesterol and triglycerides) and glycemic markers (such as, fasting blood glucose) higher compared to white rice in adult subjects?

Study design:
This review article included 13 RCTs.
In accordance with Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, the certainly of the included evidence was low and very low.

Results and conclusions:
The investigators found brown rice significantly reduced:
weight by -1.63 kg [95% CI = -2.15 to -1.11, I2 = 97%, n = 6];
body mass index (BMI) by -0.58 kg/m² [95% CI = -0.78 to -0.37, I2 = 96%, n = 6] and;
waist circumference by -2.56 cm [95% CI = -4.86 to -0.26, I2 = 88%, n = 5] compared with white rice.

The investigators found, moreover, brown rice had no significant effect on lipid profile and glycemic markers.

The investigators found pre-germinated brown rice significantly declined:
weight by -1.75 kg [95% CI = -2.70 to -0.81, I2 = 99%, n = 4];
total cholesterol by -24.22 mg/dL [95% CI = -33.03 to -15.41, I2 = 78%, n = 5];
triglyceride (TG) by -43.28 mg/dL [95% CI = -74.05 to -12.50, I2 = 90%, n = 5];
low-density lipoprotein (LDL or bad cholesterol) by -20.05 mg/dL [95% CI = -29.57 to -10.52, I2 = 71%, n = 5] and;
fasting blood glucose (FBG) by -15.83 mg/dL [95% CI = -25.20 to -6.46, I2 = 91%, n = 5] compared to white rice.

The investigators concluded brown rice has anti-obesity effects in comparison with white rice. However, it has no beneficial effects on lipid profile and glycemic markers. Furthermore, pre-germinated brown rice has better functional effects on promoting lipid profile and fasting blood glucose compared to brown rice.

Original title:
The effect of brown rice compared to white rice on adiposity indices, lipid profile, and glycemic markers: a systematic review and meta-analysis of randomized controlled trials by Golzarand M, Toolabi K, […], Mirmiran P.

Link:
https://pubmed.ncbi.nlm.nih.gov/33905269

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Objectives:
Does coffee or tea consumption reduce the risk of glioma?

Study design:
This review article included 12 unique studies (cohort and case-control studies) comprising of 1,960,731 participants with 2,987 glioma cases.

Results and conclusions:
The investigators found in pooled analyses that higher tea consumption was significantly associated with a lower risk of 16% for glioma [RR = 0.84, 95% CI = 0.71 to 0.98, p = 0.030, I2 = 16.42%].

The investigators found in cohort studies that higher coffee consumption was significantly associated with a lower risk of 15% for glioma [RR = 0.85, 95% CI = 0.72 to 1.00, p = 0.046, I2 = 0%].

The investigators found in cohort studies that higher tea consumption was significantly associated with a lower risk of 19% for glioma [RR = 0.81, 95% CI = 0.70 to 0.93, p = 0.004, I2 = 0%].

The investigators found in dose-response meta-analysis that every one cup of coffee per day significantly decreased the risk of glioma by 3% [RR = 0.97, 95% CI = 0.94 to 0.99, p = 0.016, p non-linearity = 0.054]. 

The investigators found in dose-response meta-analysis that every one cup of tea per day significantly decreased the risk of glioma by 3% [RR = 0.97, 95% CI = 0.94 to 1.00, p = 0.048]. 

The investigators found meta-regression showed that the association between coffee and glioma was reduced by smoking [p = 0.029].

The investigators concluded both coffee (at least one cup of coffee per day) and tea consumption (at least one cup of tea per day) reduce the risk of glioma.

Original title:
Coffee and tea consumption and the risk of glioma: a systematic review and dose-response meta-analysis by Pranata R, Feraldho A, […], July J.

Link:
https://pubmed.ncbi.nlm.nih.gov/33750490/

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Glioma is a type of tumor that occurs in the brain and spinal cord. About 33 percent of all brain tumors are gliomas, which originate in the glial cells that surround and support neurons in the brain, including astrocytes, oligodendrocytes and ependymal cells.
Gliomas can affect all ages, but they are most often seen in adults. Gliomas are slightly more likely to occur in men than in women and more common in Caucasians than in African Americans.

Objectives:
Does mushroom dietary intake reduce risk of cancer at any site?

Study design:
This review article included 11 case-control studies and 6 cohort studies.

Results and conclusions:
The investigators found higher mushroom consumption significantly reduced total cancer with 34% [pooled RR for the highest compared with the lowest consumption groups = 0.66, 95% CI = 0.55 to 0.78, n = 17].

The investigators found higher mushroom consumption significantly reduced breast cancer with 35% [pooled RR for the highest compared with the lowest consumption groups = 0.65, 95% CI = 0.52 to 0.81, n = 10].

The investigators found higher mushroom consumption significantly reduced nonbreast cancer with 20% [pooled RR for the highest compared with the lowest consumption groups = 0.80, 95% CI = 0.66 to 0.97, n = 13].

The investigators found there was evidence of a significant nonlinear dose-response association between mushroom consumption and the risk of total cancer [p-nonlinearity = 0.001, n = 7].

The investigators concluded higher mushroom consumption reduces risk of cancer, particularly breast cancer.

Original title:
Higher Mushroom Consumption Is Associated with Lower Risk of Cancer: A Systematic Review and Meta-Analysis of Observational Studies by Ba DM, Ssentongo P, […], Richie JP.

Link:
https://pubmed.ncbi.nlm.nih.gov/33724299/

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Objectives:
The associations of alcohol consumption and venous thromboembolism (VTE) have been investigated widely, but the conclusions were inconsistent. Therefore, this review article has been conducted.

Does alcohol intake decrease risk of venous thromboembolism?

Study design:
This review article included 14 cohort studies and 4 case-control studies.

Results and conclusions:
The investigators found, compared with non-drinkers, the risk of venous thromboembolism was significantly decreased with 7% [RR = 0.93, 95% CI = 0.88 to 0.99] for alcohol drinkers.

The investigators found, compared with no alcohol intake, the risk of venous thromboembolism was significantly decreased with 9% [RR = 0.91, 95% CI = 0.84 to 0.99] for low to moderate alcohol intake (0.1-14.0 drinks/week).

The investigators concluded that low to moderate alcohol intake (0.1-14.0 drinks/week) decreases risk of venous thromboembolism. However, precautions are needed when providing personal drinking advice considering the potential harm of alcohol. Further studies are warranted to determine whether moderate alcohol consumption has a causal role in venous thromboembolism.

Original title:
Meta-analysis of alcohol consumption and venous thromboembolism by Zhang X, Chen X, [...], Li K.

Link:
https://pubmed.ncbi.nlm.nih.gov/33824981/

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Objectives:
Have enteral zinc supplementation positive effects on growth and neurodevelopmental outcomes of preterm infants?

Study design:
This review article included 8 RCTs with 742 infants.
7 studies reported growth anthropometrics at 3-6 months corrected age (CA) and 2 studies reported neurodevelopmental outcomes at 6-12 months CA.

Evidence was "moderate" certainty for weight and length and "very low" certainty for neurodevelopment.

Results and conclusions:
The investigators found enteral zinc supplementation was significantly associated with increased weight z-score [weighted mean difference (WMD) = 0.50, 95% CI = 0.23 to 0.76, I2 = 89.1%, p 0.01], length z-score [WMD = 1.12, 95% CI = 0.63 to 1.61, I2 = 96.0%, p 0.01] and motor developmental score [WMD = 9.54, 95% CI = 6.6 to 12.4, I2 = 0%, p = 0.52] in preterm infants.

The investigators found enteral zinc supplementation had no effect on head circumference and total developmental score in preterm infants.

The investigators concluded enteral zinc supplementation enhances weight gain and linear growth in preterm infants. There is a lack of data about relationship between zinc supplementation and neurodevelopment.

Original title:
Effect of enteral zinc supplementation on growth and neurodevelopment of preterm infants: a systematic review and meta-analysis by Alshaikh B, Zeed MA, […], Fenton T.

Link:
https://pubmed.ncbi.nlm.nih.gov/34006967/

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Enteral administration involves the esophagus, stomach and small and large intestines (i.e., the gastrointestinal tract).

Objectives:
Do high maternal or neonatal DHA and/or EPA levels increase offspring birth weight and weight in childhood?

Study design:
This review article included 27 RCTs with 6,408 infants and 14 observational studies.

Results and conclusions:
The investigators found in RCTs that >650 mg/day DHA and/or EPA supplementation significantly increased birth weight [MD = 87.5g, 95% CI = 52.3 to 122.6, n = 3,831 participants, moderate quality].

The investigators found in RCTs that >650 mg/day DHA and/or EPA supplementation significantly increased combined BMI and BMI z score at 5-10 years [SMD = 0.11, 95% CI = 0.04 to 0.18, n = 3,220 participant, moderate quality].

The investigators found results from the observational studies were generally inconsistent. High trans fatty acids levels during pregnancy seemed to be associated with lower birth weight.

The investigators concluded this review and meta-analysis support a relationship between high maternal or neonatal DHA and/or EPA levels and higher offspring birth weight and weight in childhood. More high-quality long-term studies are still needed.

Original title:
Systematic Literature Review and Meta-Analysis of the Relationship Between Polyunsaturated and Trans Fatty Acids During Pregnancy and Offspring Weight Development by Ren X, Vilhjálmsdóttir BL, […], Specht  IO.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8027310/

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Objectives:
Magnesium supplementation is often purported to improve sleep; however, as both an over-the-counter sleep aid and a complementary and alternative medicine, there is limited evidence to support this assertion. Therefore, this review article (meta-analysis) has been conducted.

Does magnesium supplementation improve sleep in older adults with insomnia?

Study design:
This review article included 3 randomized control trials (RCTs), comparing oral magnesium to placebo in 151 older adults in 3 countries.

All 3 RCTs were at moderate-to-high risk of bias and outcomes were supported by low to very low quality of evidence.

Daily elemental magnesium intake ranged from 320 mg to 729 mg taken 2 to 3 times per day using 2 formulations (magnesium oxide and magnesium citrate tablets).
Duration of follow-up for outcome assessment ranged from 20 days to 8 weeks.

Results and conclusions:
The investigators found pooled analysis showed that post-intervention sleep onset latency time was significantly 17.36 min less [95% CI = -27.27 to -7.44, p = 0.0006] after magnesium supplementation compared to placebo.
Significantly because the calculated p-value of = 0.0006 was less than the p-value of 0.05.

The investigators found pooled analysis showed that total sleep time improved by 16.06 min in the magnesium supplementation group but was statistically insignificant [95% CI = - 5.99 to 38.12, p = 0.15].
Insignificant because the calculated p-value of 0.15 was larger than the p-value of 0.05.

The investigators concluded that RCT evidence may support oral magnesium supplements (less than 1 g quantities given up to 3 times a day) for insomnia symptoms in older adults. May support because all 3 RCTs are at moderate-to-high risk of bias and outcomes are supported by low to very low quality of evidence.

Original title:
Oral magnesium supplementation for insomnia in older adults: a Systematic Review & Meta-Analysis by Mah J and Pitre T.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8053283/

Additional information of El Mondo:
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Magnesium oxide contains 60% elemental magnesium and magnesium citrate contains 16% elemental magnesium.
So if you want to get 320 mg elemental magnesium from magnesium supplements, you have to take 534 mg magnesium oxide supplements or 2000 mg magnesium citrate.

Objectives:
Over the past decade, the phenomenon of high urine iodine (HUI) and high water iodine (HWI) has become more common. But the risk of goiter caused by different levels of HUI and HWI remains unclear. Therefore, this review article has been conducted.

Does higher concentration of urinary iodine or water iodine increase the risk of goiter among school children?

Study design:
This review article included 10 cross-sectional studies with 104,645 subjects (49,244 subjects from the urinary iodine concentration (UIC)  ≥ 300 μg/L group and 55,401 subjects from the 100-300 μg/L group/reference group).

The result of the Begg’s test and Egger’s test were p = 0.163 > 0.1, indicating that there was no significant publication bias.

Results and conclusions:
The investigators found that a UIC ≥ 300 μg/L was significantly associated with an increased risk of 74% [OR = 1.74, 95% CI = 1.50 to 2.01, p  0.001] for developing a goiter compared to a UIC from 100-300 μg/L.

The investigators found in subgroup analyses, a UIC 300-500 μg/L was significantly associated with an increased risk of 67% [OR = 1.67, 95% CI = 1.42 to 1.97, p  0.001] for developing a goiter compared to a UIC from 100-300 μg/L.

The investigators found in subgroup analyses, a UIC 500-800 μg/L was significantly associated with an increased risk of 78% [OR = 1.78, 95% CI = 1.57 to 2.00, p  0.001] for developing a goiter compared to a UIC from 100-300 μg/L.

The investigators found in subgroup analyses, a UIC 800-1000 μg/L was significantly associated with an increased risk of 113% [OR = 2.13, 95% CI = 1.56 to 2.91, p  0.001] for developing a goiter compared to a UIC from 100-300 μg/L.

The investigators found in subgroup analyses, a UIC ≥ 1000 μg/L was significantly associated with an increased risk of 111% [OR = 2.11, 95% CI = 1.40 to 3.18, p  0.001] for developing a goiter compared to a UIC from 100-300 μg/L.

The investigators found in subgroup analyses the overall risk of high iodine causing goiter development was OR = 1.84 [95% CI = 1.63 to 2.07, p  0.001].

The investigators found, if the water iodine concentration (WIC) was greater than 100 μg/L, the OR between goiter development and WIC was 4.74 [95% CI = 1.15 to 19.46, p = 0.001].

The investigators found the linear trend analysis of high urinary iodine (HUI) and goiter showed that the prevalence of goiter increased with the increase of UIC [χ2 = 734.605, p 0.001].

The investigators concluded when the urinary iodine concentration ≥ 300 μg/L or the water iodine concentration ≥ 100 μg/L, the risk of goiter development among school children will increase. The higher the urinary iodine concentration, the greater the risk of goiter development. Further researches needed to be done to explore the relationship between high iodine levels and goiter development in newborns, pregnant women and the elderly.

Original title:
The relationship of different levels of high iodine and goiter in school children: a meta-analysis by Xu T, Ren Z, [...], Zhang W.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8094504/

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