Effect of celery extract on thyroid function; is herbal therapy safe in obesity?

Celery (Apium graveolens) is a popular medicinal herb that used conventionally for the treatment of different diseases. This report aimed to demonstrate celery would induce hyperthyroidism after oral celery extract consumption for weight loss. A 36-year-old female patient came to our clinic with blurred vision, palpitation, and nausea. Dietary history showed that she used 8 g/day of celery extract in powder form for weight reduction. Weight loss during 78 days of celery extract consumption was 26 kg. Thyroid function test showed that serum level of thyroid-stimulating hormone (TSH) and T4 were 0.001 mIU/L and 23 ng/dl, respectively). Grave�s and thyrotoxicosis ruled out by other laboratory evaluations. Methimazole 10 mg/day was prescribed. Serum level of TSH was evaluated. The celery extraction intake was discontinued when started treatment with methimazole. Not found any thyroid stimulator (thyroxin and other) in celery extraction. We concluded that observed hyperthyroidism and allergic reaction may be induced by celery extract consumption. Therefore, it is possible that hyperthyroidism may be a side effect of frequent celery extract consumption. © 2019 International Journal of Preventive Medicine | Published by Wolters Kluwer - Medknow

Relationship between dietary patterns and mild cognitive impairment (MCI) in elderly women

Context: Mild cognitive impairment (MCI) is a transitional stage in cognitive performance between changes seen in normal aging and those observed in dementia. Early diagnosis and intervention during the initial stages of mild cognitive impairment can delay or prevent the onset of dementia. Preventive behavioral interventions, for instance changes in dietary patterns, can play a major role in reducing the burden of this disease. Aim: The aim of this study was to determine the association between dietary patterns and MCI in the elderly. Methods and material: The present case-control study was performed on 82 cases and 163 controls constituted by 60 year-old or older women. We conducted interviews and completed a general questionnaire, IPAQ, FFQ, and MMSE. We used factor analysis and principal component analysis to derive dietary patterns and the chi-square test, independent t-test, and logistic regression to analyze the data. Results: There were significant differences between the two groups in terms of educational level (P = 0.033), employment (p = 0.001), and the number of minutes of study (P =0.020). We identified three dietary patterns including unhealthy, Western, and healthy dietary patterns. There was a statistically significant difference between the two groups only in terms of the healthy dietary pattern (P = 0.004). The odds ratio of developing MCI in people who were in the highest tertile of the healthy dietary pattern was 50 lower than those in the first tertile (OR=0.496, 95CI: 0.261, 0.943). Conclusion: Our present study demonstrated that only the healthy dietary pattern was significantly associated with MCI and reduced the risk of the disease. It is recommended that further prospective studies be conducted to find more robust relationships. © Mattioli 1885

Elevated liver enzymes and cardiovascular mortality: A systematic review and dose-response meta-analysis of more than one million participants

Gamma glutamyl transferase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) are commonly used liver function markers. We performed a dose-response meta-analysis to investigate the association between liver enzymes and cardiovascular disease (CVD) mortality in prospective cohort studies. We conducted a systematic search up to April 2018 in Medline/PubMed, Scopus, Cochrane, and Embase databases. Combined hazard ratios (HRs) with 95 confidence intervals (CIs) were estimated using a random-effects model as described by DerSimonian and Laird. Dose-response analysis was also carried out. Twenty-three studies with 1 067 922 participants reported association between GGT and CVD mortality and were included in our analysis. Pooled results showed a significant association between GGT and risk of CVD mortality (HR: 1.62; 95 CI: 1.47-1.78, P=0.001, P-heterogeneity=0.001) and it was HR: 0.87; 95 CI: 0.73-1.07; P=0.221, P-heterogeneity=0.028, for ALT. There was a direct association between baseline levels of ALP and AST/ALT ratio with CVD mortality (HR: 1.45; 95 CI: 1.11-1.89; P=0.005, P-heterogeneity=0.026, and HR: 2.20; 95 CI: 1.60-3.04; P=0.001, P-heterogeneity=0.540, respectively). Pooled results did not show any significant association between AST and the risk of CVD mortality (HR: 1.20; 95 CI: 0.83-1.73; P=0.313, P-heterogeneity=0.024). Moreover, there was a significant nonlinear association between GGT and ALP levels and the risk of CVD mortality (P=0.008 and 0.016, respectively). Our dose-response meta-analysis revealed a direct relationship between GGT and ALP levels and the risk of CVD mortality. High levels of GGT, ALP and AST/ALT were associated with an increased CVD mortality rate. © 2019 Wolters Kluwer Health, Inc. All rights reserved