ObjectsThis study aims to systematically evaluate the effectiveness of nurse-led cares on cardiovascular risk factors among individuals with type 2 diabetes mellitus.DesignSystematic review and meta-analysis.MethodsThe electronic databases PubMed, EMBASE, CINAHL and Cochrane Library databases were searched for randomised controlled trials of nurse-led care for individuals with type 2 diabetes mellitus (T2DM) published in English from inception to 23 December 2021. Random effects models were used to calculate weighted mean differences (WMD) with 95%CI.Results13 articles were included in the meta-analysis, with a total of3757 participants. Considering baseline measurements, pooled analysis showed that nurse-led care significantly decreased the glycosylated haemoglobin (HbA1c) (WMD=−0.68 mmol/L; 95% CI −0.85 to –0.52; p<0.001), body mass index (BMI) (WMD=−0.54 kg/m2; 95% CI: −0.97 to –0.11; p=0.01) and systolic blood pressure (SBP) (WMD=−1.17 mmHg; 95% CI: −2.11 to –0.22; p=0.02) for patients with T2DM. But there was no difference in low-density lipoprotein cholesterol (LDL-c) (WMD=−2.50 mg/dL ; 95% CI: −5.07 to 0.08; p=0.06) between the nurse-led and control groups.ConclusionNurse-led care is an effective and accessible intervention that could improve HbA1c, SBP, BMI levels among individuals with T2DM.PROSPERO registration numberCRD42021248275.
Purpose: The aim of the study is to explore the independent association of free triodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) with hepatic steatosis and insulin resistance.Methods: A cross-sectional study of 88 overweight/obese adults who underwent anthropometric measurements (BMI, waist circumference (WC) and waist-to-height ratio (WHtR)), hepatic steatosis assessment (FibroScan) and thyroid-related hormones tests was conducted from 2018 to 2020 in Xiamen, China.Results: Subjects with increasing tertiles of FT3 showed significantly higher levels of controlled attenuation parameter (CAP) ((295.4±44.1, 290.1 ± 68.2 and 331.7 ± 43.6 (dB/m) for tertile 1-3, respectively, p=0.007) and fatty liver index (FLI) score (47.7 (33.9-60.8), 61.5 (45.1-88.9) and 90.5 (84.5-94.8), respectively, p<0.001). FT3 significantly and positively correlated with obesity index (BMI, WC, and WHtR), homeostatic model assessment of insulin resistance (HOMA-IR) and hepatic steatosis (CAP and FLI). Multivariable linear regression analyses with adjustment for potential confounding factors showed FT3 was independently associated with BMI (regression coefficient (β(95%CI): 0.024(0.004-0.043), p=0.020), HOMA-IR (β(95%CI): 0.091(0.007-0.174), p=0.034), CAP (β(95%CI): 25.45(2.59-48.31), p=0.030) and FLI (β(95%CI): 0.121(0.049-0.194), p=0.001). Neither FT4 nor TSH was significantly associated with any indicators of obesity, insulin resistance or hepatic steatosis.Conclusions: Increased FT3, but not FT4 or TSH, was independently associated with higher risks of hepatic steatosis and insulin resistance in euthyroid overweight/obese Chinese adults.Trial registration: Registration is not applicable for our study.
Objective: The current study aimed to explore the prevalence rate of hyperuricemia in women with polycystic ovary syndrome (PCOS) and investigate the relationship between Visceral adiposity index (VAI) and hyperuricemia in PCOS.Methods: In this cross-sectional study, 318 PCOS women were evaluated between November 2018 to September 2020. Of them, 256 subjects with complete anthropometric and the serum uric acid (SUA) level data were analyzed. Multivariable linear regression and logistic regression analyses were performed to determine the associations of VAI with the SUA level and hyperuricemia.Results: The prevalence rate of hyperuricemia was 56.3% in women with PCOS and was gradually increased across tertiles of VAI, which was 2.6%, 21.3%, 22.4%, respectively. Obese subjects had significantly higher levels of systolic blood pressure (SBP), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), body fat percentage (BFP), triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), VAI (P<0.001) and lower high-density lipoprotein cholesterol (HDL-c) (P<0.001). Pearson correlation analysis showed the SUA level was positively correlated with BMI, BFP, WHR, log (TG), log (LDL-c), SBP, and log (VAI) and negatively correlated with HDL-c. In addition, with adjustment for potential confounding factors, multivariable linear regression and logistic regression analyses showed that VAI significantly associated with the SUA level and hyperuricemia, with the coefficient (95% confidence interval (CI)) of 9.20 (2.85-15.56, P=0.005) and the adjusted odds ratio (95% CI) of 1.32 (1.05-1.65, P=0.018), respectively.Conclusion: The present study indicates that VAI was independently associated with hyperuricemia, even with adjustment for BMI and other potential confounding factors.
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