Effect of Anthocyanin Supplementations on Lipid Profile and Inflammatory Markers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
ABSTRACT: Purpose:To assess combined data from seventeen randomized controlled trials studying effect of anthocyanin consumption on levels of various lipids and inflammatory markers with meta-analysis approach. Methods:Various databases, namely, PubMed, MEDLINE, EMBASE, and Cochrane Trial Register were used to identify randomized controlled trials (RCTs) investigating an association between anthocyanins and lipid profile and inflammatory markers. Heterogeneity was assessed using Q and I2 statistics and data was expressed using mean difference with 95% confidence interval. Results:Statistically significant reduction in triglyceride [mean difference (MD) = -9.16, 95% CI: -14.02 to -4.31?mg/dL, I2 = 33.54%, P = 0.149], low density lipoprotein [MD = -8.86, 95% CI: -11.17 to -20.02?mg/dL, I2 = 37.75%, P = 0.098], and apolipoprotein B [MD = -7.13, 95% CI: -8.66 to -5.59?mg/dL, I2 = 20.42%, P = 0.287] levels and increase in high-density lipoprotein [MD = 1.67, 95% CI: 0.8 to 2.54?mg/dL, I2 = 44.88%, P = 0.053] and apolipoprotein A-1 [MD = 6.1, 95% CI: 4.51 to 7.69?mg/dL, I2 = 6.95%, P = 0.358] levels were observed with anthocyanin supplementation. Levels of inflammatory markers were found to reduce [TNF-? - MD = -1.98, 95% CI: -2.40 to -1.55?pg/mL, I2 = 0%, P = 0.975; IL-6 - MD = 1.17, 95% CI: 0.8 to 1.53?pg/mL, I2 = 0%, P = 0.825; hs-CRP - MD = 0.164, 95% CI: -0.06 to 0.39?mg/dL, I2 = 0%, P = 0.569]. Though the effect on TC, IL-6, and hs-CRP was positive, it was nonsignificant in nature. Conclusion:Anthocyanin supplementation significantly improves lipid profile and inflammatory status. However, future trials with sufficient sample size are recommended to substantiate the findings especially for the parameters showing nonsignificant improvement.
Project description:<h4>Background</h4>Dyslipidemia was present in most of the patients with coronary heart disease. Epidemiological evidence suggests that anthocyanin has some effects on the serum lipid. However, these results are controversial. This study aimed at collecting current clinical evidence and evaluating the effects of anthocyanin supplementation on total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in dialysis patients.<h4>Methods</h4>The search included PubMed, Web of Science, MEDLINE, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database (up to July 2015) to identify randomized controlled trials (RCTs) on the association between anthocyanin and serum lipids. RevMan (version 5.2) was used for Meta-analysis. Meta-regression analysis, sensitivity analysis and Egger's weighted regression tests were performed by using STATA software (version 12.0; StatCorp, College Station, TX, USA).<h4>Results</h4>Six studies (seven arms) involving 586 subjects were included in this meta-analysis. The results showed that anthocyanin supplementation has significant effects on TC [MD = -24.06, 95% CI(-45.58 to -2.64) mg/dL, I2 = 93%], TG [MD = -26.14, 95%CI(-40.20 to -3.08) mg/dL, I2 = 66%1], LDL-C [MD = -22.10, 95% CI (-34.36 to -9.85) mg/dL, I2 = 61%], and HDL-C(MD = 5.58, 95% CI (1.02 to 10.14) mg/dL;I2 = 90%).<h4>Conclusion</h4>Anthocyanin supplementation significantly reduces serum TC, TG, and LDL-C levels in patients with dyslipidemia, and increases HDL-C. Further rigorously designed RCTs with larger sample sizes are needed to confirm the effectiveness of anthocyanin supplementation for dyslipidemia, especially hypo high density lipoprotein cholesterolemia.
Project description:Background: Growing evidence shows that grape polyphenols can improve cardiovascular risk factors. Although there are clear data supporting a beneficial effect of grape supplementation on blood pressure and glucose metabolism, the effects of grape polyphenols on lipid metabolism are still controversial. Objective: We performed a meta-analysis of randomized controlled trials (RCTs) to assess the effect of grape products on lipid profile. Design: A systematic search was performed in the PubMed, Web of Science, Scopus, and EMBASE databases without any language or publication year restriction. The reference lists of all retrieved articles were manually reviewed. RCTs evaluating the impact of grape products/juice/extracts on lipid profile were included. Difference in total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), oxidized low-density lipoprotein cholesterol (oxLDL-C), apolipoprotein (apo) A, apo B before and after administration of grape products or placebo were expressed as mean differences (MD) with pertinent 95% confidence intervals (95% CI). The impact of clinical and demographic features on effect size was assessed by meta-regression. Results: The administration of grape products is associated with a significant improvement of lipid profile, as evidenced by changes in TC (MD: -7.6 mg/dL (-0.2 mmol/L); 95% CI: -10.8, -4.4; p < 0.001), HDL-C (MD: 1.4 mg/dL (0.04 mmol/L); 95% CI: 0.8, 1.9; p < 0.001, I2 = 74.7%, p < 0.001), LDL-C (-6.3 mg/dL (-0.16 mmol/L); 95% CI: -9.5, -3.0; p < 0.001), oxLDL-C (MD: -4.5 U/L; 95% CI: -7.5, -1.5; p = 0.003, I2 = 90.6%, p < 0.001), apo B (MD: -2.4 mg/dL (-0.05 µmol/L); 95% CI: -4.5, -0.3; p = 0.026), and TG (MD: -14.5 mg/dL (-0.16 mmol/L); 95% CI: -17.7, -11.2; p < 0.001) levels in subjects receiving grape products compared to placebo. With regard to the extent of the lipid-lowering effect, compared to baseline values, the highest reduction was reported for LDL-C (MD: -5.6 mg/dL (-0.14 mmol/L); 95% CI: -9.5, -1.7; p = 0.005) and for oxLDL-C (MD: -5.0 U/L; 95% CI: -8.8, -1.2; p = 0.010, I2 = 0%, p = 0.470). Conclusions: Grape polyphenols exert a favorable effect on lipid profile in humans by significantly reducing plasma levels of LDL-C and oxLDL-C.
Project description:Introduction:Psoriasis is a T cell-mediated inflammatory skin disease in which fatty acids may be a link between psoriasis and its comorbidity. Aim:The present meta-analysis aimed to evaluate lipid, lipoprotein, and apolipoprotein levels in the psoriatic patients compared with the control subjects. Material and methods:Four databases, including Web of Science, Scopus, PubMed, and Cochrane Library were searched until July 2017. All records analysed were case-control studies. The quality of the questionnaires was evaluated using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was done by Rev Man 5.3 using mean difference (MD) and 95% confidence intervals (CIs). Results:Out of 580 studies identified in four databases, 49 studies were included and analysed in this meta-analysis. The results showed that MD of total cholesterol, triglyceride, LDL, VLDL, HDL, Lp(a), Apo A1, and Apo B levels in the patients compared with the controls were (MD = 13.74 mg/dl; 95% CI: 7.72-19.75; p< 0.00001), (MD = 26.04 mg/dl; 95% CI: 20.77-31.31; p< 0.00001), (MD = 11.41 mg/dl; 95% CI: 6.26-16.57; p< 0.0001), (MD = 4.82 mg/dl; 95% CI: 3.63-6.00; p< 0.00001), (MD = -2.78 mg/dl; 95% CI: -4.53 - -1.03; p< 0.002), (MD = 8.51 mg/dl; 95% CI: 4.86-12.17; p< 0.0001), (MD = -6.60 mg/dl; 95% CI: -13.96 - 0.75; p< 0.08), and (MD = 9.70 mg/dl; 95% CI: 3.02-16.39; p< 0.004), respectively. Conclusions:This meta-analysis identified abnormality of serum lipid, lipoprotein, and apolipoproteinprofiles in psoriatic patients compared with the controls as well as possibly a greater risk of atherosclerosis and cardiovascular (CV) accidents in the patients.
Project description:The purpose of this study was to systematically determine the effect of dragon fruit on glycemic control in prediabetes and type 2 diabetes.Electronic databases including MEDLINE, CENTRAL, CINAHL, Scopus, ScienceDirect®, Proquest, Web of Science®, LILACS, NAPRALERT, SciFinder, Clinicalkey, Herbmed, NCCIH and Google Scholar were searched from their earliest inception up to March 2017 for relevant randomized controlled trials (RCTs) which compared dragon fruit with placebo or no treatment in prediabetes or type 2 diabetes. Clinicaltrials.gov, clinicaltrialresults.org, and ISRCTN registry were also searched. Personal contact with experts and historical search of related articles was undertaken. Outcome of interest were fasting plasma glucose (FPG) and 2 hours post-prandial glucose (2HPP). Study selection, data extraction and study quality assessment were performed independently by two investigators. Disagreements were resolved by a third reviewer. Treatment effect was estimated with mean difference (MD). Effect estimates were pooled using inverse-variance weighted method. Heterogeneity was assessed with the Q statistic and quantified with the I2 statistic. DerSimonian and Laird random-effects model was used when the Q-statistic was significant at the level of 0.1, otherwise a fixed-effects model was used.Among 401 studies identified from literature search, 4 RCTs involving 36 prediabetes subjects and 109 type 2 diabetes patients were included in the analysis. In prediabetes, FPG reduction was significant with MD of -15.1 mg/dL (95% CI: -23.8 to -6.5 mg/dL, P-value = 0.0006). Meta-analysis in type 2 diabetes showed no effect of dragon fruit on FPG (MD -26.5 mg/dL, 95% CI: -72.6 mg/dL to 19.6 mg/dL) and in 2HPP (MD -30.5 mg/dL, 95% CI: -80.9 mg/dL to 19.9 mg/dL).The available evidence in prediabetes is interesting. This will shed some light on diabetes prevention. The effect in T2DM was not significant. However, a trend towards greater blood glucose reduction with higher dose was observed.
Project description:Background:There is increasing evidence that the inflammatory indices of modified Glasgow prognostic score (mGPS) and high-sensitivity mGPS (HS-mGPS) play important roles in predicting the survival in many cancer; however, evidence supporting such an association in head and neck cancer (HNC) is scarce. Materials and Methods:We evaluated the impact of the mGPS and HS-mGPS on the overall survival (OS) in 129 patients with HNC treated at Aichi Cancer Center Central Hospital from 2012-2013. The mGPS was calculated as follows: mGPS of 0, C-reactive protein (CRP) ?1.0 mg/dl; 1, CRP >1.0 mg/dl; 2, CRP>1.0 mg/dl and albumin <3.5 mg/dl. Regarding the HS-mGPS, the CRP threshold level was set as 0.3 mg/dl. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated by Cox proportional hazard models after adjusting for potential confounders. Results:The prognosis of HNC worsened significantly as both the mGPS and HS-mGPS increased in a univariate analysis. After adjusting for covariates, the HS-mGPS was significantly associated with the OS (adjusted HR for HS-mGPS of 2 compared to an HS-mGPS of 0 [HRscore2-0] 3.14 [95% CI: 1.23-8.07], Ptrend < 0.001), while the mGPS was suggested to be associated with the survival (HRscore2-0 2.37 [95% CI:0.89-6.33], Ptrend = 0.145). Even after stratification by clinical covariates, these associations persisted. Conclusion:We conclude that the HS-mGPS is useful as an independent prognostic factor in HNC.
Project description:A meta-analysis was carried out to evaluate the efficacy of yoga in adults with type 2 diabetes mellitus.The PubMed, EMBASE and Cochrane databases were searched to obtain eligible randomized controlled trials. The primary outcome was fasting blood glucose, and the secondary outcomes included glycosylated hemoglobin A1c, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride and postprandial blood glucose. Weighted mean differences and 95% confidence intervals (CIs) were calculated. The I2 statistic represented heterogeneity.A total of 12 randomized controlled trials with a total of 864 patients met the inclusion criteria. The pooled weighted mean differences were -23.72 mg/dL (95% CI -37.78 to -9.65; P = 0.001; I2 = 82%) for fasting blood glucose and -0.47% (95% CI -0.87 to -0.07; P = 0.02; I2 = 82%) for hemoglobin A1c. The weighted mean differences were -17.38 mg/dL (95% CI -27.88 to -6.89; P = 0.001; I2 = 0%) for postprandial blood glucose, -18.50 mg/dL (95% CI -29.88 to -7.11; P = 0.001; I2 = 75%) for total cholesterol, 4.30 mg/dL (95% CI 3.25 to 5.36; P < 0.00001; I2 = 10%) for high-density lipoprotein cholesterol, -12.95 mg/dL (95% CI -18.84 to -7.06; P < 0.0001; I2 = 37%) for low-density lipoprotein cholesterol and -12.57 mg/dL (95% CI -29.91 to 4.76; P = 0.16; I2 = 48%) for triglycerides.The available evidence suggests that yoga benefits adult patients with type 2 diabetes mellitus. However, considering the limited methodology and the potential heterogeneity, further studies are necessary to support our findings and investigate the long-term effects of yoga in type 2 diabetes mellitus patients.
Project description:Background: Chinese patent medicine Tongxinluo capsule (TXL) is commonly used for cardio-cerebrovascular diseases. Previous research had demonstrated that TXL exhibited great clinical effects on the treatment of acute myocardial infarction (AMI), however there is a lack of systematic review. The purpose of this study was to evaluate the potential effectiveness and safety of TXL for secondary prevention in patients with AMI. Method: We searched 6 databases to identify relevant randomized controlled trials (RCTs) from inceptions to December 30, 2017. Two review authors independently assessed the methodological quality and analyzed data by the RevMan 5.3 software. The publication bias was assessed through funnel plot and Begg's test. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used for evaluating the quality of evidence. Results: We included 19 RCTs in this review and performed a meta-analysis based on 16 studies. There were statistical differences of TXL treatment group in reducing primary cardiovascular events (cardiac death [RR = 0.27, 95%CI: 0.08~0.95, I2 = 0%], recurrent myocardial reinfarction [RR = 0.38, 95%CI: 0.20~0.74, I2 = 0%], arrhythmia [RR = 0.44, 95%CI: 0.30~0.66, I2 = 0%], recurrent angina pectoris [RR = 0.34, 95%CI: 0.17~0.69, I2 = 0%]). TXL could improve cardiac function (LVEF [MD = 4.10, 95%CI: 3.95~4.25, I2 = 0%]), regulate blood lipid TC [MD = -0.66, 95%CI: -0.94 ~ -0.37, I2 = 74%], TG [MD = -0.38, 95%CI: -0.62 ~ -0.14, I2 = 70%], LDL-C[-0.40, 95%CI: -0.65 ~ -0.16, I2 = 88%), decrease the level of hs-CRP (4-week: MD = -0.78, 95%CI: -0.97 ~ -0.60, I2 = 20%; Over 4-week: MD = -1.36, 95%CI: -1.55 ~ -1.17, I2 = 20%). However, TXL has little effects on revascularization [RR = 0.45, 95%CI: 0.13~1.56, I2 = 0%], recurrent heart failure (RR = 0.83, 95%CI: 0.27~2.57, I2 = 0%), and HDL-C (MD = 0.14, 95%CI: 0.00 ~0.29, I2 = 73%). Furthermore, TXL treatment group was more prone to suffer gastrointestinal discomfort. Conclusion: Chinese patent medicine TXL seemed beneficial for secondary prevention after AMI. This potential benefit needs to be further assessed through more rigorous RCTs. Systematic review registration number in the PROSPERO register: CRD42017068417.
Project description:Chronic inflammation contributes to the onset and development of metabolic diseases. Clinical evidence has suggested that coenzyme Q10 (CoQ10) has some effects on inflammatory markers. However, these results are equivocal. The aim of this systematic review was to assess the effects of CoQ10 on serum levels of inflammatory markers in people with metabolic diseases.Electronic databases were searched up to February 2016 for randomized controlled trials (RCTs). The outcome parameters were related to inflammatory factors, including interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-?) and C reactive protein (CRP). RevMan software was used for meta-analysis. Meta-regression analysis, Egger line regression test and Begg rank correlation test were performed by STATA software.Nine trials involving 428 subjects were included in this meta-analysis. The results showed that compared with control group, CoQ10 supplementation has significantly improved the serum level of CoQ10 by 1.17?g/ml [MD = 1.17, 95% CI (0.47 to 1.87) ?g/ml, I2 = 94%]. Meanwhile, it has significantly decreased TNF-? by 0.45 pg/ml [MD = -0.45, 95% CI (-0.67 to -0.24) pg/ml, I2 = 0%]. No significant difference was observed between CoQ10 and placebo with regard to CRP [MD = -0.21, 95% CI (-0.60 to 0.17) mg/L, I2 = 21%] and IL-6 [MD = -0.89, 95% CI (-1.95 to 0.16) pg/ml, I2 = 84%].CoQ10 supplementation may partly improve the process of inflammatory state. The effects of CoQ10 on inflammation should be further investigated by conducting larger sample size and well-defined trials of long enough duration.
Project description:BACKGROUND: The induction of heat shock protein (HSP) 72 by mild electrical stimulation with heat shock (MES + HS), which improves visceral adiposity and insulin resistance in mice, may be beneficial in treating metabolic syndrome (MS) or type 2 diabetes mellitus (T2DM). METHODS: Using open-label crossover trials, 40 subjects with MS or T2DM were randomly assigned using computer-generated random numbers to 12 weeks of therapeutic MES + HS followed by 12 weeks of no treatment, or vice versa. During the intervention period, physical and biochemical markers were measured. FINDINGS: Compared to no treatment, MES + HS treatment was associated with a significant decrease in visceral adiposity (- 7.54 cm(2) (- 8.61%), 95% CI - 8.55 to - 6.53 (p = 0.037) in MS, - 19.73 cm(2) (- 10.89%), 95% CI - 20.97 to - 18.49 (p = 0.003) in T2DM). Fasting plasma glucose levels were decreased by 3.74 mg/dL (- 5.28%: 95% CI - 4.37 to - 3.09 mg/dL, p = 0.029) in MS and by 14.97 mg/dL (10.40%: 95% CI - 15.79 to 14.15 mg/dL, p < 0.001) in T2DM, and insulin levels were also reduced by 10.39% and 25.93%, respectively. HbA1c levels showed a trend toward reduction (- 0.06%) in MS, and was significantly declined by - 0.43% (95% CI - 0.55 to - 0.31%, p = 0.009) in T2DM. HbA1c level of less than 7.0% was achieved in 52.5% of the MES + HS-treated T2DM patients in contrast to 15% of the non-treated period. Several insulin resistance indices, inflammatory cytokines or adipokines, including C-reactive protein, adiponectin, and tumor necrosis factor-?, were all improved in both groups. In isolated monocytes, HSP72 expression was increased and cytokine expression was reduced following MES + HS treatment. Glucose excursions on meal tolerance test were lower after using MES + HS in T2DM. INTERPRETATION: This combination therapy has beneficial impacts on body composition, metabolic abnormalities, and inflammation in subjects with MS or T2DM. Activation of the heat shock response by MES + HS may provide a novel approach for the treatment of lifestyle-related diseases. FUNDING: Funding for this research was provided by MEXT KAKENHI (Grants-in-Aid for Scientific Research from Ministry of Education, Culture, Sports, Science and Technology, Japan).
Project description:BACKGROUND:There are current trials investigating the effect of resveratrol supplementation on lipid profiles and liver enzymes among patients with metabolic syndrome (MetS) and related disorders; however, their findings are controversial. This systematic review and meta-analysis were aimed to determine the effects of resveratrol supplementation on lipid profiles and liver enzymes among patients with MetS and related disorders. METHODS:We performed a comprehensive search of the following online databases up to November 2018: Cochrane Library, PubMed, Embase, and Web of Science. The relevant articles were assessed for quality of studies using the Cochrane risk of bias tool. RESULTS:Out of 2459 citations, 31 articles were appropriate for including to the current meta-analysis. The pooled results indicated that resveratrol use significantly decreased total cholesterol [weighted mean difference (WMD) =?-?7.65?mg/dL; 95% CI, -?12.93, -?2.37; P <?0.01; I2: 83.4%] and increased gamma-glutamyl transferase (GGT) concentrations (WMD?=?1.76?U/l; 95% CI, 0.58, 2.94; P <?0.01; I2: 20.1%). We found no significant effect of resveratrol supplementation on triglycerides (WMD?=?-?5.84?mg/dL; 95% CI, -?12.68, 1.00; P =?0.09; I2: 66.8%), LDL- (WMD?=?-2.90?mg/dL; 95% CI, -?10.88, 5.09; P =?0.47; I2: 96.0%), HDL-cholesterol (WMD?=?0.49?mg/dL; 95% CI, -?0.80, 1.78; P =?0.45; I2: 74.0%), alanine aminotransferase (ALT) (WMD?=?-0.14?U/l; 95% CI, -?3.69, 3.41; P =?0.93; I2: 79.6%), and aspartate aminotransferase (AST) (WMD?=?-0.34?U/l; 95% CI, -?2.94, 2.27; P =?0.80; I2: 88.0%) concentrations. CONCLUSIONS:This meta-analysis demonstrated that resveratrol supplementation among patients with MetS and related disorders significantly reduced total cholesterol and increased GGT concentrations, but did not affect triglycerides, LDL-, HDL-cholesterol, ALT, and AST concentrations. This data suggests that resveratrol may have a potential cardio-protective effect in patients with MetS and related disorders.