The effects of vitamin D supplementation on indices of glycemic control in Iranian diabetics: A systematic review and meta-analysis

Background and purpose: This systematic review and meta-analysis aimed to assess the effects of vitamin D supplements on indices of glycemic control [homeostatic model assessment-insulin resistance (HOMA-IR), hemoglobin A1C (HbA1C), fasting blood glucose (FBG), and quantitative insulin-sensitivity check index (QUICKI) and lipid profile in diabetic patients. Methods: Eight databases were searched, for randomized controlled trials (RCTs) or cross-sectional and cohort studies that have been published up to December 2017. We used the comprehensive meta-analysis (CMA) software for all statistical analysis and used the I2 index for assessing heterogeneity. A p value of <0.05 was considered as statistically significant. Results: We found 621 articles, and after the exclusion of ineligible publications, 82 studies remained to be assessed of which 37 were used for meta-analysis. Vitamin D supplementation was associated with a significant improvement in FBG (p = 0.001 and 95% CI: −0.526 to −0.136) and HbA1C (p = 0.003 and 95% CI: 1.719 to −0.361) in individuals with type 2 diabetes mellitus (T2DM); while in women with gestational diabetes mellitus (GDM) the reduction in FBG (p = 0.071 and 95% CI: −0.873 to −0.035) and HbA1C (p = 0.199 and 95% CI: 3.270 to 0.681) failed to reach statistical significance. Treatment with vitamin D supplements was associated with an improvement in HOMA-IR in pregnant diabetic women (p = 0.028 and 95% CI: 0.924 to −0.053) and for individuals with diabetes mellitus (p = 0.005 and 95% CI: 1.772 to −0.319). The pooled result of the cross-sectional meta-analysis indicated that serum vitamin D concentrations were significantly lower in diabetic patients than in healthy controls (p = 0.018 and 95% CI: 0.587 to −0.054). Conclusion: This meta-analysis suggests that vitamin D supplementation improves indices of glycemic control (FBG, HOMA-IR, and HbA1C) in patients with diabetes mellitus. Hence, vitamin D supplements may be of potential therapeutic value in diabetic patients, as an adjuvant therapy along with other treatment

Personalized peptide-based vaccination for treatment of colorectal cancer: rational and progress

Colorectal cancer (CRC) is one of the most common cancers globally and is associated with a high rate of morbidity and mortality. A large proportion of patients with early stage CRC who undergo conventional treatments develop local recurrence or distant metastasis and in this group of advanced disease, the survival rate is low. Furthermore there is often a poor response and/or toxicity associated with chemotherapy and chemo-resistance may limit continuing conventional treatment alone. Choosing novel and targeted therapeutic approaches based on clinicopathological and molecular features of tumors in combination with conventional therapeutic approach could be used to eradicate residual micrometastasis and therefore improve patient prognosis and also be used preventively. Peptide-based vaccination therapy is one class of cancer treatment that could be used to induce tumor-specific immune responses, through the recognition of specific antigen-derived peptides in tumor cells, and this has emerged as a promising anti-cancer therapeutic strategy. The aim of this review was to summarize the main findings of recent studies in exciting field of peptide-based vaccination therapy in CRC patients as a novel therapeutic approach in treatment of CRC

Prooxidant-antioxidant balance and hs-CRP in patients with Beta-thalassemia major

Background: Beta-thalassemia major is one of the most frequent hemoglobinopathies in the world. This is a study on the levels of prooxidant-antioxidant balance (PAB) that can measure the pro-oxidant burden and the anti-oxidant capacity simultaneously in one assay, giving a redox index, as well as an assessment of high-sensitivity C-reactive protein (hs-CRP) in patients with β-thalassemia major. It also determines the impact both on kidney function tests. Methods: Ninety subjects with β-thalassemia major (βTM) and 90 more healthy subjects as the control group were enrolled in the study. Laboratory parameters, serum hs-CRP, and the novel assay of prooxidant-antioxidant balance were measured. Results: Biochemical and hematological variables, except MCHC, were significantly decreased in patients. Ferritin (p 0.05) did not significantly increase in patients. Spearman's correlation univariate analysis showed no significant correlation between PAB with hs-CRP or ferritin. However, there was a significant statistical correlation between hs-CRP with creatinine and triglycerides. Also we found a slight and negative correlation between high-density lipoprotein cholesterol, hemoglobin, and hemotocrit with inflammatory factor. Conclusions: Briefly, we found higher levels of PAB values and a slight increase in hs-CRP concentration in patients, which may be involved in the pathological consequences of β-thalassemia major and contribute to the gradual development of injury to the organs

Mashhad stroke and heart atherosclerotic disorder (MASHAD) study: design, baseline characteristics and 10-year cardiovascular risk estimation

Objective: The Mashhad stroke and heart atherosclerotic disorder (MASHAD) study is a 10-year cohort study that aims to evaluate the impact of various genetic, environmental, nutritional and psychosocial risk factors on the incidence of cardiovascular events among an urban population in eastern Iran. Methods: The MASHAD study comprises a cohort of 9704 individuals aged 35-65 years using a stratified cluster random sampling design. This cohort will be followed up until 2020, with follow-up examinations being undertaken every 3 years. Ten-year cardiovascular disease (CVD) risk estimation was determined using NCEP ATP III criteria. Results: Overall, 88.4 of women and 79.2 of men (P 20 were observed to be 86.6, 11 and 2.5 , respectively. Predicted risk of CVD > 10 using the Framingham algorithm was considerably higher in men compared to women. Overall, 9.5 95 % confidence interval (CI) 8.9�10.1 % of our subjects had prevalent CAD. Conclusion: The prevalence of CVD risk factors within our population is high compared to Western countries, indicating the necessity for interventional risk modifications. © 2015, Swiss School of Public Health