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The question of whether zinc supplementation may improve cardio-metabolic health in patients with type 2 diabetes mellitus (T2DM) remains controversial and require further evaluation. This study aimed to summarize the effectiveness of oral zinc supplementation in improving cardio-metabolic risk markers in people with T2DM. We searched PubMed, Scopus, and Web of Science from inception to April 2023, for randomized controlled trials (RCTs). RCTs of type 2 diabetic adults (aged ≥18 years) comparing zinc supplementation with placebo were included. We excluded studies if not randomized, involved co-supplementation, and were conducted in children or pregnant women. Glycemic indices, lipid profiles, blood pressure, anthropometric measure, c-reactive protein (CRP), creatinine, and serum zinc were extracted. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methods. We used a random-effect model to perform the dose-response analysis. Effect sizes were presented as mean difference (MD) and 95% confidence interval (CI). 22 studies (n = 1442 participants) were included. The certainty of the evidence was rated as moderate to high. Zinc supplementation significantly reduced glycemic indices: including two-hour postprandial glucose (2hpp) (mean difference (MD): −34.34 mg/dl; 95%CI: −51.61∼ −17.07), fast blood sugar (FBS) (MD: −23.32 mg/dl; 95% CI: −33.81∼ −12.83), and hemoglobin A1c (HbA1c) (MD: −0.47; 95% CI: −0.71∼ −0.23). Zinc had a favorable effect on lipid profiles low-density lipoprotein (LDL) (MD: −10.76 mg/dl; CI: −17.79∼−3.73), triglyceride (TG) (MD: −18.23 mg/dl; CI: −32.81∼−3.65), total cholesterol (TC) (MD: −12.74 mg/dl; CI: −21.68∼−3.80), VLDL (MD: −5.39 mg/dl; CI: −7.35∼−3.43) and high-density lipoprotein (HDL) (MD: 4.04 mg/dl; CI: 0.96 ∼ 7.12). Systolic blood pressure (SBP) (MD): −3.64 mmHg; 95% CI: −6.77∼ −0.52), weight (MD: 1.00 kg; 95% CI: 0.34∼1.66), CRP (MD: −3.37 mg/l, 95% CI: −4.05∼ −2.70), and serum zinc (MD: 15.38 µg/dl; 95% CI: 10.74∼ 20.02) changed to a statistically significant extent with zinc supplementation. There was also a linear association between additional 10 mg/d zinc treatment with FBS, HbA1c, HDL, LDL, TG, TC, and serum zinc. A non-linear dose-response gradient was seen for FBS, HDL, and SBP (p < 0.05). Egger's test showed no substantial publication bias. Our findings strongly suggest a potential beneficial effect of zinc supplementation on type 2 diabetic patients. Further high-quality research is needed to determine the optimal form, dosage, and duration of zinc supplementation for this population. [ABSTRACT FROM AUTHOR]

Context Nonalcoholic fatty liver disease (NAFLD) is prevalent in 25–30% of British and European populations, representing a potential global public health crisis. Marine omega-3 (n-3) polyunsaturated fatty acids offer well-evidenced benefits to NAFLD biomarkers; however, the effect of plant-based n-3 has not been evaluated with a systematic review and meta-analysis. Objective The review aimed to systematically evaluate the effect of plant-based n-3 supplementation on NAFLD surrogate biomarkers and parameters. Data Sources Medline (EBSCO), PubMed, CINAHL (EBSCO), Cochrane Central Register of Controlled Trials, the International Clinical Trials Registry Platform, and Google Scholar databases were searched to identify randomized controlled trials published between January 1970 and March 2022 evaluating the impact of plant-based n-3 interventions on diagnosed NAFLD. The review followed the PRISMA checklist and is PROSPERO registered (CRD42021251980). Data Extraction A random-effects model and generic inverse variance methods synthesized quantitative data, followed by a leave-one-out method for sensitivity analysis. We identified 986 articles; after the application of selection criteria, six studies remained with 362 patients with NAFLD. Results The meta-analysis showed that plant-based n-3 fatty acid supplementation significantly reduced alanine aminotransferase (ALT) (mean difference: 8.04 IU/L; 95% confidence interval: 14.70, 1.38; I2 = 48.61%) and plasma/serum triglycerides (44.51 mg/dL; 95% confidence interval: –76.93, –12.08; I2 = 69.93%), alongside body-composition markers in patients with NAFLD (P < 0.05). Conclusion Plant-based n-3 fatty acid supplementation improves ALT enzyme biomarkers, triglycerides, body mass index, waist circumference, and weight loss when combined with lifestyle interventions to increase physical activity and a calorie-controlled diet. Further research is needed to identify the most effective plant-based n-3 sources in larger numbers of patients with NAFLD over longer study durations. Systematic Review Registration PROSPERO registration no. CRD42021251980. [ABSTRACT FROM AUTHOR]

Objectives This systematic review and meta-analysis aimed to investigate the prevalence of postmortem kidney histopathologic features of patients with coronavirus disease 2019 (COVID-19) in addition to the rate of renal tropism in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods We searched Web of Science, PubMed, Embase, and Scopus up to September 2022 to identify eligible studies. A random-effects model was used to estimate the pooled prevalence. Cochran Q test and Higgins I2 were used to assess evidence of heterogeneity. Results In total, 39 studies were included in the systematic review. The meta-analysis included 35 studies consisting of a total of 954 patients, with an average age of 67.1 years. The pooled prevalence of acute tubular injury (ATI)–related changes was the predominant finding (85% [95% confidence interval, 71%-95%]), followed by arteriosclerosis (80%), vascular congestion (66%), and glomerulosclerosis (40%). Endotheliitis (7%), fibrin microthrombi (12%), focal segmental glomerulosclerosis (1%), and calcium crystal deposits (1%) were seen in a smaller number of autopsies. The overall average rate of virus detection was 47.79% in the pooled data of 21 studies (272 samples). Conclusions The main finding—ATI—correlated to clinical COVID-19–associated acute kidney injury. The presence of SARS-CoV-2 in kidney samples in addition to vascular lesions in kidneys can be linked to direct kidney invasion by the virus. [ABSTRACT FROM AUTHOR]

This systematic review and meta-analysis aimed to investigate the effect of zinc supplementation on immune factors in randomized controlled trials. A comprehensive search was done in PubMed, Scopus, Web of Science, Embase, and Cochrane databases up to December 2020. We used standard and weighted mean differences and 95% confidence intervals for net changes in selected parameters of immune responses. Subgroup analysis was used to find heterogeneity. Overall, 35 RCTs comprising 1995 participants were eligible for this meta-analysis. There was a significant reduction of circulating CRP (WMD: −32.4; 95% CI: −44.45 to −19.62, p < 0.001), hs-CRP (WMD: −0.95; 95% CI: −1.01 to −0.89, p < 0.001), Neutrophil levels (SMD: −0.46; 95% CI: −0.90 to −0.01, p = 0.043), following zinc supplementation. CD4 level also increased significantly, (WMD: 1.79; 95% CI: 0.57 to 3, p = 0.004). Zinc supplementation had no significant effect on WBC (SMD: −0.66; 95% CI: −1.67 to 0.36, p = 0.204), lymphocyte (WMD: 1.86; 95% CI: −0.86 to 4.58, p = 0.181), monocyte levels (SMD: −0.16; 95% CI: −0.07 to 0.39, p = 0.167), CD3 (SMD: 0.37; 95% CI: −0.49 to 1.22, p = 0.399). Zinc supplementation decreased the CRP, hs-CRP and TNF-α, IL-6, neutrophil and increased CD3 and CD4 level significantly. [ABSTRACT FROM AUTHOR]

Background Increased protein intake is suggested as a strategy to slow or reverse the loss of muscle mass and strength observed in sarcopenia, but results from studies that directly tested this possibility have been inconsistent. Objectives We assessed the evidence on the effects of whole protein supplementation or higher-protein diets, without the use of amino acids or supplements known to stimulate hypertrophy, alone or in combination with resistance exercise (RE) interventions, on lean body mass (LBM) and strength in older adults. Methods A systematic search was conducted using PubMed, Medline, Web of Science, and Cochrane CENTRAL databases from January 1990 to July 2021. Randomized controlled trials that assessed the effects of protein supplementation and/or higher-protein dietary interventions in older adults (mean age ≥50 y) on total LBM, appendicular lean mass (ALM), and handgrip (HG) and knee extension (KE) strength were included. Results Twenty-eight studies were identified. In pooled analysis, compared with lower protein controls, protein supplementation did not have a significant positive effect on total LBM [weighted mean difference in change (WMD): 0.34; 95% CI: –0.21, 0.89; I 2 = 90.01%], ALM (WMD: 0.4; 95% CI: –0.01, 0.81; I 2 = 90.38%), HG strength (WMD: 0.69; 95% CI: –0.69, 2.06; I 2 = 94.52%), or KE strength (WMD: 1.88; 95% CI: –0.6, 4.35; I 2 = 95.35%). However, in interventions that used also RE, statistically significant positive effects of protein were observed for ALM (WMD: 0.54; 95% CI: 0.03, 1.05; I 2 = 89.76%) and HG (WMD: 1.71; 95% CI: 0.12, 3.30; I 2 = 88.71%). Meta-regression revealed no significant association between age, per-meal protein dose, duration, and baseline protein intake with change in any outcome. Subgroup analysis revealed the statistically significant effects on ALM occurred only in sarcopenic/frail populations (WMD: 0.88; 95% CI: 0.51, 1.25; I 2 = 79.0%). Most studies (n  = 22) had some risk of bias. Conclusions In older adults performing RE, increased protein intake leads to greater ALM and HG strength compared with lower protein controls. Without RE, protein has no additional benefit on changes in total LBM, ALM, or HG strength. [ABSTRACT FROM AUTHOR]

Previous studies reported inconsistent findings regarding the effects of magnesium supplementation on obesity measures. This study was done to quantify the effect of magnesium supplementation on body weight, Body Mass Index (BMI), Waist Circumference (WC), Body Fat (BF) percentage and Waist to Hip Ratio (WHR). Four online databases (Scopus, PubMed, Google Scholar and Cochrane library) were searched until March 2020 using relevant keywords. Random-effects model was used to pool effect sizes; Cochran's Q-test and I2 index assessed heterogeneity. Sensitivity analysis and Egger test were used to check the robustness of findings and the possibility of publication bias, respectively. Thirty-two RCTs including different dosage of magnesium (48-450 mg/d), and duration (6-24 weeks) were entered to this study. Magnesium supplementation resulted in a great reduction in BMI [Weighted Mean Difference (WMD): -0.21 kg/m2, 95% CI: -0.41, -0.001, P = 0.048, I2 = 89.5%, n = 22], which was mainly driven by the effect among those with magnesium deficiency, insulin resistance related disorders, and obesity at baseline. No significant change was observed in bodyweight, WC, BF percentage and WHR as compared to controls. However, the change in body weight, and WC was significant in subgroups of participants with insulin resistance related disorders, hypertension, obesity, magnesium deficiency at baseline, and females. We found a significant reduction in BMI following magnesium supplementation. The change in body weight and WC were evident in certain subgroups. [ABSTRACT FROM AUTHOR]

Evidence suggests that garlic supplementation may have an effect on oxidative stress by augmenting the rate of enzymatic and non‐enzymatic antioxidants and diminishing pro‐oxidant enzymes. Given inconsistencies across studies, we aimed to systematically review the current literature and quantify the effects of garlic supplementation on oxidative stress. We conducted a systematic search with multiple databases (Scopus, PubMed, and Web of Science) to find relevant articles published prior to October 2020. Results were reported as bias‐corrected standardized mean difference (Hedges' g) with 95% confidence intervals (CI) using random‐effects models. Cochrane's Q and I squared (I2) tests were used to determine heterogeneity among the studies included. Twelve randomized controlled trials (RCTs) were included. Garlic doses ranged from 80 to 4,000 mg/day, and intervention duration varied between 2 and 24 weeks. Garlic supplementation increased serum level of total antioxidant capacity (TAC) (Hedges' g: 2.77, 95% CI: 1.37 to 4.17, p < 0.001) and superoxide dismutase (SOD) (Hedges' g: 13.76, 95% CI: 4.24 to 23.29, p = 0.004), while it reduced the malondialdehyde serum level (MDA) (Hedges' g: ‐1.94, 95% CI: −3.17 to −0.70, p = 0.002). Due to limited data available, glutathione (GSH) was not considered for the current meta‐analysis. The nonlinear dose‐response effect of garlic supplementation was not observed with regard to serum TAC and MDA levels (TAC: p‐nonlinearity = 0.398; MDA: p‐nonlinearity = 0.488). Garlic supplementation appears to improve serum levels of TAC, MDA, and SOD. Garlic supplementation may be useful to reduce oxidative stress and related diseases. Future studies with large sample sizes and longer duration are required to confirm these findings. [ABSTRACT FROM AUTHOR]

Background: The high chances of getting latent tuberculosis infection (LTBI) among health care workers (HCWs) will an enormous problem in low and upper-middle-income countries. Method: Search strategies were done through both national and international databases include SID, Barakat knowledge network system, Irandoc, Magiran, Iranian national library, web of science, Scopus, PubMed/MEDLINE, OVID, EMBASE, the Cochrane library, and Google Scholar search engine. The Persian and the English languages were used as the filter in national and international databases, respectively. Medical Subject Headings (MeSH) terms was used to controlling comprehensive vocabulary. The search terms were conducted without time limitation till January 01, 2019. Results: The prevalence of LTBI in Iranian’s HCWs, based on the PPD test was 27.13% [CI95%: 18.64–37.7]. The highest prevalence of LTBI in Iranian’s HCWs were estimated 41.4% [CI95%: 25.4–59.5] in the north, and 33.8% [CI95%: 21.1–49.3] in the west. The lowest prevalence of LTBI was evaluated 18.2% [CI95%: 3.4–58.2] in the south of Iran. The prevalence of LTBI in Iranian’s HCWs who had work-experience more than 20 years old were estimated 20.49% [CI95%: 11–34.97]. In the PPD test, the prevalence of LTBI in Iranian’s HCWs who had received the Bacille Calmette–Guérin (BCG) was estimated 15% [CI95%: 3.6–47.73]. While, in the QFT, the prevalence of LTBI in Iranian’s HCWs in non-vaccinated was estimated 25.71% [CI95%: 13.96–42.49]. Conclusions: This meta-analysis shows the highest prevalence of LTBI in Iranian’s HCWs in the north and the west probably due to neighboring countries like Azerbaijan and Iraq, respectively. It seems that Iranian’s HCWs have not received the necessary training to prevent of TB. We also found that BCG was not able to protect Iranian’s HCWs from TB infections, completely. [ABSTRACT FROM AUTHOR]

Objective: Accumulating evidence has been reported regarding the effect of dietary antioxidants on clinical variables in IBD patients, however, findings are controversial. This systematic review and meta-analysis aimed to investigate effect of dietary antioxidants on clinical variables in patients with IBD or its subtypes.Methods: We searched PubMed, Scopus, and ISI Web of Science from inception to January 2021 using relevant keywords. Data were pooled by using the random-effect model. All statistical analyses were done using STATA version 14.Results: Our meta-analysis was exclusively done on studies about the effect of curcumin on IBD patients, because limited studies were done on other antioxidants. Curcumin administration resulted in significant increment of clinical remission in patients with IBD (SMD: 0.86%, 95% CI: 0.16, 1.56, p = 0.016), significant remission in clinical symptoms (SMD: -0.96 score, 95% CI: -1.34, -0.57, p < 0.001), and significant increment in endoscopic remission in IBD patients (SMD: 0.51%, 95% CI: 0.16, 0.85, p = 0.004), comparing to control group. Curcumin supplementation also made better clinical response than control group (SMD: 0.74%, 95% CI: 0.22, 1.26, p = 0.005) and also resulted in significant improvement in quality of life of patients with IBD, as compared to control group (SMD: 1.23 score, 95% CI: 0.72, 1.74, p < 0.001).Conclusions: Our meta-analysis showed that curcumin significantly improved clinical and endoscopic remissions in IBD patients. This supplementation also caused significant reduction in clinical symptoms of IBD patients along with better clinical response and the increased quality of life. Further researches with larger sample size and longer period of intervention are required to evaluate efficacy of dietary antioxidants on clinical variables in patients with IBD. [ABSTRACT FROM AUTHOR]

We carefully read the meta -analysis by Hosseini et al. (1) on the effects of Zinc supplementation on inflammation and oxidative stress markers, which was recently published in Cytokine journal. The authors show that Zinc supplementation significantly decreased CRP, TNF, and MDA while having no significant effect on IL-6. Although respecting the authors' efforts, we are concerned about different aspects of the current review: the inadequate search strategy, the methodological flaws, the interpretation of data, and the reporting of the results that might lead to biased results. [ABSTRACT FROM AUTHOR]

Objective: Despite controversies, no study has systematically summarized findings from earlier studies on the effect of berberine and barberry on anthropometric measures. Therefore, the current systematic review and meta-analysis was conducted on the effect of berberine and barberry on body mass index (BMI), body weight (BW), waist circumference (WC) and waist-hip ratio (WHR) in adults.Methods: Relevant studies, published up to August 2019, were searched through PubMed/Medline, Scopus, ISI Web of Science, Embase and Google Scholar. All randomized clinical trials investigating the effect of berberine and barberry on the anthropometric measures including BMI, BW, WC or/and WHR were included.Results: Out of 252 citations, 12 trials that enrolled 849 subjects were included. Berberine and barberry resulted in no significant change in BMI (Weighted mean differences (WMD): -0.16 kg/m2; 95 % CI: -0.43 to 0.11, P = 0.247), BW (WMD: -0.11 kg; 95 % CI: -0.13 to 0.91, P = 0.830), and berberine resulted in not significant in WC (WMD: -0.58 cm; 95 % CI: -1.89 to 0.72, P = 0.379) and significant reduction in WHR (WMD: -0.03; 95 % CI: -0.04 to -0.01, P < 0.0001).Conclusion: We found a significant reduction in WHR following berberine consumption in adults. Further clinical trials with high quality according to challenges mentioned seem to be helpful to use berberine and barberry as a supplement for certain health conditions, efficiently. [ABSTRACT FROM AUTHOR]