BackgroundLipids are ubiquitous metabolites with diverse functions. Excessive lipid accumulation can trigger lipid redistribution among metabolic organs such as adipose, liver and muscle, thus altering the lipid metabolism. It has been revealed that disturbed lipid metabolism would cause multiple disease complications and is highly correlated with human morbidity. Resveratrol (RSV), a phytoestrogen with antioxidant, can modulate insulin resistance and lipid profile. Recently, research on RSV supplementation to improve glucose and lipid metabolism has been controversial. A meta-analysis may provide a scientific reference for the relationship between lipid metabolism and RSV supplementation.Methods and AnalysisWe searched the PubMed, Cochrane Library, Web of Science, and Embase databases from inception to October 2021 using relevant keywords. A comprehensive search for randomized controlled trials (RCTs) was performed. For calculating pooled effects, continuous data were pooled by mean difference (MD) and 95% confidence interval (CI). Adopting the method of inverse-variance with a random-effect, all related statistical analyses were performed using the Rev Man V.5.3 and STATA V.15 software.ResultsA total of 25 articles were incorporated into the final meta-analysis after removal of duplicates by checking titles and abstracts and excluding non-relevant articles. The selected articles had a total of 1,171 participants, including 578 in the placebo group and 593 in the intervention group. According to the current meta-analysis, which demonstrated that there was a significant decrease in waist circumference (SMD = –0.36; 95% CI: –0.59, –0.14; P = 0.002; I2 = 88%), hemoglobin A1c (–0.48; –0.69, –0.27; P ≤ 0.001; I2 = 94%), total cholesterol (–0.15; –0.3, –0.01; P = 0.003; I2 = 94%), low density lipoprotein cholesterol (–0.42; –0.57, –0.27; P ≤ 0.001; I2 = 92%), high density lipoprotein cholesterol (0.16; –0.31, –0.02; P = 0.03; I2 = 81%) following resveratrol administration.ConclusionThese results suggest that RSV has a dramatic impact on regulating lipid and glucose metabolism, and the major clinical value of resveratrol intake is for obese and diabetic patients. We hope that this study could provide more options for clinicians using RSV. Furthermore, in the future, large-scale and well-designed trials will be warranted to confirm these results.Systematic Review RegistrationWebsite [https://www.crd.york.ac.uk/prospero/#recordDetails], identifier [CRD42021244904].
Background: Diabetic kidney disease (DKD) is a chronic progressive disorder which is a leading cause of chronic kidney disease (CKD). As an important pathogenesis of DKD, the overproduction of reactive oxygen species (ROS) and the inflammatory response have been considered central mediators in the progression of DKD. Herbal products are increasingly being applied as antioxidants and anti-inflammatory agents. Of those, the effect of hydroxyl safflower yellow A (HSYA) on oxidative stress and inflammatory reactions has gradually been investigated for DKD treatment, which may provide therapies for DKD with new insights and promote its application in clinical practice.Methods: We searched CNKI, the Chinese Biomedical Literature Database, the Wanfang Database, PubMed, and Embase from the establishment date of the database to 22 April 2022. The included literature in our study was randomized controlled trials (RCTs) using HSYA to treat DKD. We performed a meta-analysis by calculating the standard mean difference (SMD) with a 95% confidence interval (CI). The inverse-variance method with a random effect was used in our meta-analysis using Stata software and RevMan software.Results: A total of 31 articles with 31 groups containing a total of 2487 participants were included in this meta-analysis. The pooled results showed a statistical improvement in the following measurements: fasting blood glucose (FBG), postprandial blood glucose (PBG), blood urea nitrogen (BUN), urinary albumin excretion rates (UAER), serum creatinine (SCR), hypersensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), fasting insulin (FINS), total cholesterol (TC), triglycerides (TGs), hemoglobin A1c (HbA1C), homeostasis model assessment insulin resistance (HOMA-IR), and malondialdehyde (MDA).Conclusion: HSYA can effectively treat DKD by inhibiting inflammatory reactions and oxidative stress, decreasing blood glucose and blood lipids, and improving renal function indices. However, more RCTs are still needed in the future to further demonstrate the effect of HSYA on biomarkers of oxidative stress and inflammatory reactions in patients with DKD due to the low quality and small sample size of the literature included in this study.Systematic Review Registration: PROSPERO: CRD 42021235689
Background: Cinnamon is a spice used in cooking and in large quantities as a medical complement with hypoglycemic and lipid-lowering properties. The potential pharmacological mechanisms underlying cinnamon’s anti-diabetic properties and its active ingredients have not been adequately determined. The current meta-analysis aims to systematically review the potential pharmacological mechanisms underlying the hypoglycemic and hypolipidemic efficacy of cinnamon administration and summarize clinical recommendations of cinnamon and its active ingredients.Method: Relevant randomized clinical trials (RCTs) were identified through a literature search that spanned the years January 2005 to April 2022. Retrieve electronic databases including Web of Science, PubMed, Embase, Medline, and the Cochrane Library. To obtain standardized mean differences (SMDs), continuous outcomes were pooled and 95 percent confidence intervals (CIs) were provided. Categorical outcomes were aggregated to calculate relative risks (RRs) and were accompanied by 95% CIs. Heterogeneity was measured using the Cochrane Q-test and I2 statistics, with a p < 0.05 considered as substantial heterogeneity. If I2 was less than 50%, a fixed effect model was employed; otherwise, a random effect model was used. Subgroup analyses and sensitivity analyses were performed to identify the origins of heterogeneity. Publication bias was retrieved by means of a funnel-plot analysis and Egger’s test. The data were analyzed using revman (V.5.3) and stata (V.15) software packages.Results: These 16 RCTs included a total of 1,020 patients who were followed for a duration ranging from 40 days to 4 months. According to the current meta-analysis results, glycolipid levels in diabetic individuals who received cinnamon were significantly improved as compared to those who got placebo (All p < 0.05). An adverse effect was only detected in one patient.Conclusion: These findings imply that cinnamon has a significant influence on lipid and glucose metabolism regulation. An even more pronounced effect was observed in patients with HbA1c of 8%. The results of this study suggested that cinnamon may be utilized as hypoglycemic and lipid-lowering supplement in clinical settings with a guaranteed safety profile.Systematic Review Registration: [PROSPERO], identifier [CRD42022322735].
BackgroundDiabetic kidney disease (DKD), defined broadly as persistent proteinuria with low estimated glomerular filtration rate in patients with diabetes, is a main cause of end-stage renal disease. Excessive production of reactive oxygen species is an important mechanism underlying the pathogenesis of DKD and many antioxidants have been investigated as therapeutic agents. Among them, Chinese medicine antioxidative stress therapies have been widely used to combat DKD, which may offer new insights into therapeutic development of DKD. There are several discrepancies among the efficacy of Western medicine (WM) and Chinese medicinal formula (CMF) action.MethodsWe searched PubMed, Cochrane Library, the Web of Science databases, Embase, and Scopus from inception to December 2021 using relevant keywords and a comprehensive search for randomized controlled trials (RCTs) was performed. Calculating the pooled weighted mean difference (MD) and 95% CI by the method of inverse-variance with a random-effect. All the related statistical analyses were performed using Stata version 15.1 software (Stata Corporation) and Rvman version 5.3 (Nordic Cochrane Center).ResultsA total of 8 articles with the 9 groups including 106 in the model group, 105 in the CMF group, and 99 in the WM group. Pooled data from 8 studies (9 groups) showed a statistical improvement in superoxide dismutase compared with the model group [standardized MD (SMD) = 1.57; 95 CI: 1.16–1.98; P < 0.05] and the WM group (SMD = 0.56; 95 CI: 0.19–0.92; P < 0.05). For glutathione peroxidase (GSH-Px), it was significantly improved in the CMF group vs. the model group and the WM group. For malondialdehyde (MDA), it was significantly reduced in the CMF group (CMF vs. model group: SMD = −1.52; 95 CI: −1.88 −1.17; P < 0.05; CMF vs. WM group: SMD = −0.64; 95 CI: −0.95 −0.33; P < 0.05).ConclusionThis systematic review and meta-analysis have demonstrated that the therapy of CMF had a notable curative effect on relieving oxidative stress in STZ-induced DKD rats and CMF was significantly more effective than the WM control group. For the clinical application, the results providing confidence and some theoretical reference for DKD via evaluating the efficacy of CMF to a certain extent.Systematic Review Registration[PROSPERO], identifier [CRD42022313737].
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