Whether the lipid profile in diabetic patients is associated with diabetic neuropathy (DN) development remains ambiguous, as does the predictive value of serum lipid levels in the risk of DN. Here, ...we performed the first meta-analysis designed to investigate the relationship between DN and the serum levels of triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL), and low-density lipoprotein cholesterol (LDL). Candidate studies were comprehensively identified by searching PubMed, Embase, Cochrane Library and Web of Science databases up to May 2020. Observational methodological meta-analysis was conducted to assess the relationships of TG, TC, HDL, and LDL levels with DN. Changes in blood lipids were used to estimate the effect size. The results were pooled using a random-effects or fixed-effects model. Potential sources of heterogeneity were explored by subgroup analysis. Various outcomes were included, and statistical analyses were performed using STATA (Version 12.0). Mean differences (MDs) and odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. The Newcastle-Ottawa Scale (NOS) was applied to assess the methodological quality. I2 statistics were calculated to evaluate statistical heterogeneity. Funnel plots were utilized to test for publication bias. A sensitivity analysis was performed by omitting each study one by one. Thirty-nine clinical trials containing 32,668 patients were included in the meta-analysis. The results demonstrated that DN patients showed higher TG and lower HDL levels (MD = 0.34, 95% CI: 0.20-0.48 for TG; MD = -0.05, 95% CI: -0.08--0.02, I
= 81.3% for HDL) than controls. Subgroup analysis showed that patients with type 1 diabetes mellitus (T1DM) neuropathy had elevated TG levels in their serum (MD = 0.25, 95% CI: 0.16-0.35,I
= 64.4% for T1DM). However, only patients with T1DM neuropathy had reduced serum HDL levels, and there was no significant difference in serum HDL levels between patients with T2DM neuropathy and controls (MD = -0.07, 95% CI: -0.10--0.03, I
= 12.4% for T1DM; MD = -0.02, 95% CI: -0.07-0.03, I
= 80.2% for T2DM). TC and LDL levels were not significantly different between DN patients and controls (MD = -0.03, 95% CI: -0.14-0.09, I
= 82.9% for TC; MD = -0.00, 95% CI: -0.08-0.08, I
= 78.9% for LDL). In addition, compared with mild or painless DN patients, those with moderate or severe pain DN pain had significantly reduced serum TC and LDL levels (MD = -0.31, 95% CI: -0.49--0.13, I
= 0% for TC; MD = -0.19, 95% CI: -0.32--0.08, I
= 0% for LDL). TG levels and HDL levels did not vary considerably between patients with mild or painless DN and those with moderate or severe DN pain patients (MD = 0.12, 95% CI: -0.28-0.51, I
= 83.2% for TG; MD = -0.07, 95% CI:-0.14-0.01, I
= 58.8% for HDL). Furthermore, people with higher TG and LDL levels had higher risk of DN (OR = 1.36, 95% CI: 1.20-1.54, I
= 86.1% for TG and OR = 1.10, 95% CI: 1.02-1.19, I
= 17.8% for LDL). Conversely, high serum HDL levels reduced the risk of DN (OR = 0.85, 95% CI: 0.75-0.96, I
= 72.6%), while TC levels made no significant difference with the risk of DN (OR = 1.02, 95% CI: 1.00-1.04, I
= 84.7%). This meta-analysis indicated that serum lipid profile changes are among the biological characteristics of DN. Lipid levels should be explored as routine laboratory markers for predicting the risk of DN, as they will help clinicians choose appropriate therapies, and thus optimize the use of available resources.
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Abstract
Background
The coronavirus disease 2019 (COVID-19) pandemic has led to global research to predict those who are at greatest risk of developing severe disease and mortality. The aim of this ...meta-analysis was to determine the associations between obesity and the severity of and mortality due to COVID-19.
Methods
We searched the PubMed, EMBASE, Cochrane Library and Web of Science databases for studies evaluating the associations of obesity with COVID-19.
Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random- or fixed-effects models. Meta-regression analyses were conducted to estimate regression coefficients.
Results
Forty-six studies involving 625,153 patients were included. Compared with nonobese patients, obese patients had a significantly increased risk of infection.
(OR 2.73, 95% CI 1.53–4.87;
I
2
= 96.8%), hospitalization (OR 1.72, 95% CI 1.55–1.92;
I
2
= 47.4%), clinically severe disease (OR 3.81, 95% CI 1.97–7.35;
I
2
= 57.4%), mechanical ventilation (OR 1.66, 95% CI 1.42–1.94;
I
2
= 41.3%), intensive care unit (ICU) admission (OR 2.25, 95% CI 1.55–3.27;
I
2
= 71.5%), and mortality (OR 1.61, 95% CI 1.29–2.01;
I
2
= 83.1%).
Conclusion
Patients with obesity may have a greater risk of infection, hospitalization, clinically severe disease, mechanical ventilation, ICU admission, and mortality due to COVID-19. Therefore, it is important to increase awareness of these associations with obesity in COVID-19 patients.
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The relationship between prepregnancy body mass index (BMI) and maternal micronutrient status is inconsistent and has not received sufficient attention. This meta-analysis aimed to evaluate the ...effect of prepregnancy BMI on micronutrient levels in pregnant women. PubMed, Embase, Web of Science, and the Cochrane Library were searched for articles that contained information on micronutrient levels and prepregnancy BMI. A random-effects model was used to determine the association between prepregnancy BMI and maternal micronutrient status. Sixty-one eligible articles were eventually included, with 83,554 participants. Vitamin B12, folate, vitamin D, iron and ferritin were the main micronutrients evaluated in our meta-analysis. Prepregnancy obesity and overweight may lead to an increased risk of micronutrient deficiency, including vitamin B12, folate and vitamin D deficiency, while prepregnancy obesity or overweight may have no significant association with ferritin deficiency. Additionally, the results of the dose-response analyses demonstrated a possible significant inverse correlation between prepregnancy BMI and levels of micronutrient, except for iron and ferritin. Compared with women with normal weight, women who were overweight or obese prepregnancy have lower micronutrient concentrations and are more likely to exhibit micronutrient deficiency during pregnancy, which is harmful to both mothers and neonates.
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In December 2019, a novel pneumonia associated with the 2019 coronavirus emerged unexpectedly. However, limited data exist on the effects of COVID-19 on ACTH and cortisol levels. To address this gap ...in knowledge, we conducted a meta-analysis of published studies on the relationship between COVID-19 patients and their ACTH and cortisol levels.
We conducted a thorough search of the PubMed, Embase, Cochrane Library, and Web of Science databases up until May 2023. We assessed the relevance of each study we found, specifically looking for studies that reported on ACTH and cortisol levels in COVID-19 patients. We calculated weighted mean differences (WMD) and 95% confidence intervals (CI) to investigate the relationship between ACTH and cortisol levels in COVID-19 patients. We evaluated the quality of each study using the Newcastle Ottawa scale (NOS), and we assessed publication bias using Begg's rank correlation test, Egger's test, and funnel plot. We conducted our meta-analysis using the Stata 12.0 (Stata Corporation, TX).
Our search yielded nine studies that met our inclusion criteria, which included a total of 440 COVID-19 patients and 474 controls, with data up to May 2023. Seven of these studies reported on ACTH levels, and six studies reported on cortisol levels. Our findings revealed that COVID-19 patients had significantly higher levels of cortisol compared to controls (WMD 3.46 (95% CI 2.29 to 4.62)). However, there was no significant difference in ACTH levels between COVID-19 patients and controls (WMD 1.58 (95% CI -5.79 to 8.94)).
This meta-analysis indicates a potential relationship between elevated cortisol levels and COVID-19 infection. However, more well-designed, adequately powered, randomized controlled trial will be needed to assess the use of cortisol in patients with COVID-19 infection.
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DPP-4 inhibitors are predicted to exert a protective effect on the progression of coronavirus disease 2019 (COVID-19). We conducted this meta-analysis to investigate this hypothesis.
Four databases, ...namely, PubMed, Web of Science, EMBASE and the Cochrane Library, were used to identify studies on DPP-4 and COVID-19. The outcome indicators were the mortality of COVID-19. Funnel plots, Begg's tests and Egger's tests were used to assess publication bias.
Four articles were included with a total of 1933 patients with COVID-19 and type 2 diabetes. The use of DPP-4 inhibitors was negatively associated with the risk of mortality (odds ratio (OR) = 0.58 95% confidence interval (CI), 0.34-0.99).
DPP-4 inhibitors may improve the mortality of patients with COVID-19 and type 2 diabetes. As few relevant studies are available, more large-scale studies need to be performed.
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Daytime napping, a habit widely adopted globally, has an unclear association with obesity. In this study, we executed a meta-analysis to explore the relationship between daytime napping and obesity. ...We conducted a comprehensive search of the PubMed, Embase, Cochrane Library, Scopus, PsycINFO, and Web of Science databases for pertinent articles published up to April 2023. Random-effects models were utilized to calculate odds ratios (ORs) with 95% confidence intervals (CIs), and we assessed the heterogeneity of the included studies using the I
statistic. To explore potential sources of heterogeneity, subgroup analyses were performed. The methodological quality of the studies was evaluated using the Newcastle-Ottawa Scale (NOS), and funnel plots were employed to detect any publication bias. Sensitivity analyses were conducted by sequentially omitting each study. We conducted a meta-analysis of twelve studies that included one each from the UK and Spain, five from the USA, and five from China, totalling 170,134 participants, to probe the association between napping and obesity. The pooled analysis suggested a higher risk of obesity in individuals who nap (OR: 1.22 1.10-1.35, p < 0.001, I
= 87%) compared to non-nappers. The meta-analysis results revealed variations in the summary ORs for studies conducted in China, Spain, the USA, and the UK. The ORs for China, Spain, the USA, and the UK were 1.05 (95% CI 0.90-1.23), 9.36 (95% CI 4.74-18.45), 1.27 (95% CI 1.10-1.47), and 1.39 (95% CI 1.32-1.47), respectively. A subgroup analysis based on age within the American population disclosed that napping in both adults and children heightened obesity incidence. A subgroup analysis based on nap duration found a significant rise in obesity occurrence when nap duration exceeded one hour, but no clear relationship emerged when nap duration was less than 1 h. In a subgroup analysis based on the definition of obesity, napping did not demonstrate a significant relationship with obesity when diagnostic criteria set obesity at a BMI of 25 or above. However, when the criteria were set at a BMI of 28 or 30 or more, napping significantly increased obesity risk. Our meta-analysis indicates a positive association between daytime napping and the risk of obesity. However, given the limited number of included studies, potential confounding factors might not have been fully addressed. Future well-designed prospective studies are required to further investigate this relationship. Large-scale studies are necessary to confirm our findings and elucidate the underlying mechanisms that drive these associations and causation.
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Aims
Coronavirus disease 2019 (COVID-19) is caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and within a few months of the first outbreak, it was declared a ...global pandemic by the WHO. The lethal virus SARS-CoV-2 is transmitted through respiratory droplets and enters host cells through angiotensin-converting enzyme 2 (ACE-2) receptors. ACE-2 receptors are highly expressed in many tissues, including testes. Therefore, the objective of this study was to summarize the available literature regarding the correlation between sex hormone levels and COVID-19.
Methods
The PubMed, Web of Science, Embase, and Cochrane Library databases were reviewed systematically through August 2022 for studies comparing sex hormone levels between different patient groups: COVID-19 versus no COVID-19, more severe versus less severe COVID-19, and non-survivors versus survivors. Various types of clinical research reporting sex hormone levels, including free testosterone (FT), luteinizing hormone (LH), follicle-stimulating hormone (FSH), 17β-oestradiol (E
2
), the oestradiol-to-testosterone ratio (E
2
/T), prolactin (PRL), and sex hormone-binding globulin (SHBG), were included. Random- or fixed-effects models were used to calculate weighted mean differences (WMDs) and 95% confidence intervals (CIs). Heterogeneity among the studies was assessed by the
I
2
index, and data analyses were performed using meta-analysis with Stata version 12.0.
Results
Twenty-two articles that included 3369 patients were ultimately included in the meta-analysis. According to analysis of the included studies, patients with COVID-19 had significantly low T/LH, FSH/LH, and SHBG levels and high levels of LH, and E
2
/T, but their levels of FT, FSH, PRL, E
2
, and progesterone were not affected. Publication bias was not found according to funnel plots and Egger’s regression and Begg’s rank correlation tests.
Conclusion
Low T/LH, FSH/LH, and SHBG serum levels and high LH, and E
2
/T levels may increase the risk of COVID-19. Additionally, the greater is the clinical severity of COVID-19, the higher is the probability of increases in LH, and E
2
/T serum levels and decreases in T/LH, FSH/LH, and SHBG levels. COVID-19 may have unfavourable effects on gonadal functions, which should be taken seriously by clinicians. Routine monitoring of sex hormone levels might help clinicians to evaluate disease severity in patients with COVID-19.
Recently, insulin treatment has been found to be associated with increased mortality and other adverse outcomes in patients with coronavirus disease 2019 (COVID-19) and diabetes, but the results ...remain unclear and controversial, therefore, we conducted this meta-analysis.
Four databases, namely, PubMed, Web of Science, EMBASE and the Cochrane Library, were used to identify all studies concerning insulin treatment and the adverse effects of COVID-19, including mortality, incidence of severe/critical complications, in-hospital admission and hospitalization time. To assess publication bias, funnel plots, Begg's tests and Egger's tests were used. The odds ratios (ORs) with 95% confidence intervals (CIs) were used to access the effect of insulin therapy on mortality, severe/critical complications and in-hospital admission. The association between insulin treatment and hospitalization time was calculated by the standardized mean difference (SMD) with 95% CIs.
Eighteen articles, involving a total of 12277 patients with COVID-19 and diabetes were included. Insulin treatment was significantly associated with an increased risk of mortality (OR=2.10; 95% CI, 1.51-2.93) and incidence of severe/critical COVID-19 complications (OR=2.56; 95% CI, 1.18-5.55). Moreover, insulin therapy may increase in-hospital admission in patients with COVID-19 and diabetes (OR=1.31; 95% CI, 1.06-1.61). However, there was no significant difference in the hospitalization time according to insulin treatment (SMD=0.21 95% CI, -0.02-0.45).
Insulin treatment may increase mortality and severe/critical complications in patients with COVID-19 and diabetes, but more large-scale studies are needed to confirm and explore the exact mechanism.
Gap junctions mediate intercellular communications across cellular networks in the nervous and immune systems. Yet their roles in intestinal innate immunity are poorly understood. Here, we show that ...the gap junction/innexin subunit
acts in the
gonad to attenuate intestinal defenses to
PA14 infection through the PMK-1/p38 pathway. RNA-Seq analyses revealed that germline-specific
RNAi downregulated Notch/GLP-1 signaling, while lysosome and PMK-1/p38 pathways were upregulated. Consistently, disruption of
or
in the germline enhanced resistance to PA14 infection and upregulated lysosome and PMK-1/p38 activity. We show that lysosome signaling functions downstream of the INX-14/GLP-1 signaling axis and upstream of PMK-1/p38 pathway to facilitate intestinal defense. Our findings expand the understanding of the links between the reproductive system and intestinal defense, which may be evolutionarily conserved in higher organism.
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