Introduction:The prevalence of metabolic syndrome (MetS) and MetS-related stroke is set to increase dramatically in coming decades.MetS is a complex disease that includes endothelial dysfunction, insulin resistance, diabetes, hypertension, ectopic obesity, and dyslipidaemia and an increased risk of cardiovascular events.This study aims to fill this gap of research by conducting a Bayesian network meta-analysis to compare major drugs to treat MetS. Methods and analysis:We will search the PubMed, EMBASE, Cochrane Library, Web of Science, Embase, google scholar, clinical trials registry (ClinicalTrials.gov) for unpublished or undergoing research listed in registry platforms.Randomized controlled trials (RCTs) on the drug therapy of MetS with outcome measures including diagnostic criteria of MetS will be included.The quality of included RTCs will be evaluated according to the Cochrane Collaboration's risk of bias tool.Traditional pairwise meta-analysis and Bayesian network meta-analysis will be conducted to compare the efficacies of antidiabetic drugs.Sensitivity analysis on the sample size of RCTs, meta-regression analysis on the follow-up periods, dosages and baselines of outcome measure, contradiction analysis between pairwise and network meta-analyses, and publication bias analysis, will be performed.Randomized controlled trials (RCTs) on the drug therapy of MetS with outcome measures criteria of MetS diagnostic will be included.The quality of included RTCs will be evaluated according to the Cochrane Collaboration's risk of bias tool.Traditional pairwise meta-analysis and Bayesian network meta-analysis will be conducted to compare the efficacies of drugs.Sensitivity analysis on the sample size of RCTs, meta-regression analysis on the follow-up periods, dosages and baselines of outcome measure, contradiction analysis between pairwise and network meta-analyses, and publication bias analysis, will be performed.
Abstract Objective: Postprandial hyperinsulinaemia plays a key role in the development of non-alcoholic fatty liver disease (NAFLD). Diet is a potential factor affecting serum insulin levels. This study aimed to examine the relations of dietary insulin index (DII) and dietary insulin load (DIL) to the risk of NAFLD. Design: This study was a cross-sectional study. DII and DIL were calculated using the dietary data obtained from the FFQ. Fatty liver index ≥ 60 and the confirmation of a gastroenterologist were required to diagnose NAFLD. Setting: Community-based study. Participants: A total of 3158 people (46·7 % male), aged 40·57 ± 8·25 years, participated in this study in Tehran, Iran from April 2016 to December 2019. Results: The prevalence of NAFLD was 29·9 % (21·59 % in males and 33·74 % in females). In the fully adjusted model controlled for sex, age, energy intake, BMI, smoking, physical activity and education, DII was significantly associated with the increased risk of NAFLD in males (OR: 2·74, 95 % CI = 1·75, 4·31; P -trend = ≤0·001) and females (OR: 2·26, 95 % CI = 1·39, 3·69; P -trend = 0·005). A significant relationship was also detected between DIL and NAFLD in females (OR: 2·90, 95 % CI = 1·70, 4·93; P -trend ≤0·001) but not in males (OR: 1·33, 95 % CI = 0·84, 2·10; P -trend = 0·13). Conclusions: Adherence to a diet with a high DII and DIL may be related to the increased risk of NAFLD. These results may be useful for healthcare providers to design appropriate preventive measures for people at risk of NAFLD.
Purpose of review: HDL-C is believed to retard the formation of atherosclerotic lesions by removing excess cholesterol from cells and preventing endothelial dysfunction.However, there are no systematic analyses or well-conducted meta-analyses to evaluate the relationship between very low HDL-Cand stroke.Patients with peripheral artery disease (PAD) have been found to suffer from diabetes, obesity, lipid abnormalities, including elevated levels of total and LDL-cholesterol as well as triglyceride levels.The aim of this study is to examine this association of very low HDL-Cwith stroke in different ages and sex. Recent findings:The update systematic review and meta-analysis will be conducted using published studies that will be identified from electronic databases (ie, PubMed, EMBASE, Web of Science, and Google Scholar.Studies that (1) examined the association between very low HDL-Cand stroke, (2) had a longitudinal or prospective cohort design, (3) will conducted among in adults aged 34 to 70 years.,(4) provided sufficient data for calculating odds ratios (ORs) or relative risk with a 95% CI, (5) were published as original articles written in English or other languages, and (6) have been published until January 2019 will be included.Study selection, data collection, quality assessment and statistical syntheses will be conducted based on discussions among investigators.