Context
Elevated serum remnant cholesterol independently predicts risks of cardiovascular diseases. However, the association between remnant cholesterol and metabolic dysfunction-associated fatty liver disease (MAFLD) remains unclear.
Objectives
This study aimed to explore the association of remnant cholesterol with MAFLD and its long-term mortality.
Methods
We extracted data from the NHANES Ⅲ, 1988−1994 and the linked mortality data till December 31, 2015. The association between remnant cholesterol and MAFLD was analyzed by multivariate logistic regression. Cox proportional hazards regression was performed to assess whether elevated remnant cholesterol increased all-cause and cause-specific mortalities in MAFLD patients.
Results
At baseline, 28.6% (1474/5156) of participants had MAFLD. In multivariate logistic regression, the fourth quartile of remnant cholesterol was associated with an increased risk of MAFLD compared with the first quartile (OR: 1.714, 95% CI: 1.586–1.971; P <0.001). In participants with normal levels of triglyceride, LDL- and HDL-cholesterol, the relationship between remnant cholesterol and MAFLD risk remained significant (OR: 1.346, 95% CI: 1.248–1.761; P <0.001). During a median follow-up of 307 months, MAFLD patients with serum remnant cholesterol in the fourth quartile were associated with a higher risk of all-cause mortality (HR: 2.183, 95% CI: 1.825–2.407; P <0.001), as well as a higher risk of cardiovascular mortality (HR: 2.346, 95% CI: 2.046–2.885; P <0.001) and cancer-related mortality (HR: 2.366, 95% CI: 1.864–2.932; P <0.001) compared with MAFLD patients in the first quartile.
Conclusions
Remnant cholesterol was independently associated with the risk of MAFLD and predicted all-cause, cardiovascular, and cancer-related mortalities in MAFLD patients.
Background
Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder involving gut-brain interactions with limited effective treatment options. Vitamin D deficiency is commonly observed in patients with IBS, but whether vitamin D supplementation ameliorates IBS is controversial in randomized controlled trials. The present systematic review and meta-analysis explored the efficacy of vitamin D supplementation in patients with IBS.
Methods
We performed a systematic search of potentially relevant publications from PubMed, EMBASE, the Cochrane Central Register of Controlled Studies and the Web of Science up until January 2022. We assessed the weighted mean difference (WMD) and 95% confidence interval (95% CI) of the IBS severity scoring system (IBS-SSS), IBS quality of life (IBS-QoL) and IBS total score (IBS-TS) before and after vitamin D supplementation intervention.
Results
We included four randomized, placebo-controlled trials involving 335 participants. The differences in IBS-SSS score between participants in the intervention group and the placebo group increased after intervention (WMD: -55.55, 95% CI: -70.22 to -40.87, I2 = 53.7%, after intervention; WMD: -3.17, 95% CI: -18.15 to 11.81, I2 = 0.0%, before intervention). Participants receiving vitamin D supplementation showed greater improvement in IBS-SSS after intervention than participants receiving placebo treatment (WMD: -84.21, 95% CI: -111.38 to -57.05, I2 = 73.2%; WMD: -28.29, 95% CI: -49.95 to -6.62, I2 = 46.6%, respectively). Vitamin D supplementation was also superior to placebo in IBS-QoL improvement (WMD: 14.98, 95% CI: 12.06 to 17.90, I2 = 0.0%; WMD: 6.55, 95% CI: -2.23 to 15.33, I2 = 82.7%, respectively). Sensitivity analyses revealed an unstable pooled effect on IBS-TS in participants receiving vitamin D supplementation. Therefore, we did not evaluate the efficacy of vitamin D intervention in IBS-TS.
Conclusions
This systematic review and meta-analysis suggested that vitamin D supplementation was superior to placebo for IBS treatment.
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