Impact of probiotic administration on serum C-reactive protein concentrations: systematic review and meta-analysis of randomized control trials

We conducted this systematic review and meta-analysis of prospective studies to determine the effect of probiotic administration on serum C-reactive protein (CRP) concentrations. We searched PubMed-Medline, Web of Science, the Cochrane, and Google Scholar databases (until May 2016) to identify prospective studies evaluating the impact of probiotic administration on CRP. We used a random effects models and generic inverse variance methods to synthesize quantitative data, followed by a leave-one-out method for sensitivity analysis. The systematic review registration number was: CRD42016039457. From a total of 425 entries identified via searches, 20 studies were included in the final analysis. The meta-analysis indicated a significant reduction in serum CRP following probiotic administration with a weighted mean difference (WMD) of -1.35 mg/L, (95% confidence interval (CI) -2.15 to -0.55, I² 65.1%). The WMDs for interleukin 10 (IL10) was -1.65 pg/dL, (95% CI -3.45 to 0.14, I² 3.1%), and -0.45 pg/mL, (95% CI -1.38 to 0.48, I² 10.2%) for tumor necrosis factor alpha (TNF-α). These findings were robust in sensitivity analyses. This meta-analysis suggests that probiotic administration may significantly reduce serum CRP while having no significant effect on serum IL10 and TNF-α

Treatment with GLP1 receptor agonists reduce serum CRP concentrations in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials

Aim: To undertake a systematic review and meta-analysis of randomized controlled trials of the effect of Glucagon-like peptide-1 receptor agonist (GLP-1 RAs) therapy on serum C-reactive protein (CRP) concentrations. Method: PubMed-Medline, SCOPUS, Web of Science and Google Scholar databases were searched for the period up until March 16 2016. Prospective studies evaluating the impact of GLP-1 RAs on serum CRP were identified. A random effects model (using the DerSimonian-Laird method) and generic inverse variance methods were used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. Heterogeneity was quantitatively assessed using the I2 index. Random effects meta-regression was performed using unrestricted maximum likelihood method to evaluate the impact of potential moderator. International Prospective Register for Systematic Reviews (PROSPERO) number CRD42016036868. Results: Meta-analysis of the data from 7 treatment arms revealed a significant reduction in serum CRP concentrations following treatment with GLP-1 RAs (WMD –2.14 (mg/dL), 95% CI -3.51, –0.78, P=0.002; I2 96.1%). Removal of one study in the meta-analysis did not change the result in the sensitivity analysis (WMD –2.14(mg/dL), 95% CI -3.51, –0.78, P=0.002; I2 96.1%), indicating that our results could not be solely attributed to the effect of a single study. Random effects meta-regression was performed to evaluate the impact of potential moderator on the estimated effect size. Changes in serum CRP concentration were associated with the duration of treatment (slope –0.097, 95% CI –0.158, -0.042, P<0.001). Conclusions: This meta-analysis suggests that GLP-1 RAs therapy causes a significant reduction in CRP

The effect of ginger supplementation on serum C-reactive protein, lipid profile and glycaemia: a systematic review and meta-analysis

Aim: To undertake a systematic review and meta-analysis of prospective studies to determine the effect of ginger supplementation on serum C-reactive protein (CRP), lipid profile, and glycaemia. Method: PubMed-MEDLINE, Web of Science, Cochrane Database, and Google Scholar databases were searched (up until July 2016) to identify prospective studies evaluating the impact of ginger supplementation on serum CRP. Random-effects model meta-analysis was used for quantitative data synthesis. Sensitivity analysis was conducted using the leave-one-out method. Heterogeneity was quantitatively assessed using the I2 index. Systematic review registration: CRD42016035973. Results: From a total of 265 entries identified via searches, 9 studies were included in the final selection. The meta-analysis indicated a significant reduction in serum CRP concentrations following ginger supplementation [weighted mean difference (WMD)-0.84 mg/L (95% CI -1.38 to -0.31, I2 56.3%)]. The WMD for fasting blood glucose and HbA1c was -1.35 mg/dl (95% CI -2.04 to -0.58, I2 12.1%) and -1.01 (95% CI -1.28 to -0.72, I2 9.4%), respectively. Moreover, high-density lipoprotein and triglyceride significantly improved after ginger administration [1.16 mg/dl (95% CI 0.52 to 1.08, I2 12.3%) and -1.63 mg/dl (95% CI -3.10 to -0.17, I2 8.1%), respectively]. These findings were robust in sensitivity analyses. Random-effects meta-regression revealed that changes in serum CRP levels were independent of the dosage of ginger supplementation (slope -0.20; 95% CI -0.95 to 0.55; p=0.60). Conclusions: This meta-analysis suggests that ginger supplementation significantly reduces serum CRP and improves glycaemia indexes and lipid profile. Randomized control trials with larger sample size and with a longer-term follow-up period should be considered for future investigations

Frequency and types of workplace violence against emergency medical technicians: a cross-sectional study in Tehran, Iran

Objective: This study was implemented to assess various types of violent incidents involving emergency medical technicians (EMTs) working in Tehran, Iran. Furthermore, the characteristics of violent people and possible causes of their violence were assessed.&nbsp;Methods: In this cross-sectional study, 500 EMTs working in the capital city of Tehran were randomly invited. The participants were asked to fill out a questionnaire of workplace violence. Univariate and multivariate logistic regression were also performed for identifying the possible risk factors of violence. In addition, the distribution and association of violence patterns were also analyzed considering demographic features and characteristics of violent people.&nbsp;Results: In total, 320 EMTs with the mean age of 31.8 ± 6.7 years participated, 315 (98.4%) of whom were men. Overall, 279 (87.2%) out of the 320 participants experienced 654 episodes of violence, mostly bullying, in the last 4 months. The relationship between the level of education and experiencing violent incidents was statistically significant (p=0.035). Also, non-Persian EMTs had experienced significantly more violent behaviors than Persian EMTs [171 (91.0%) vs. 108 (81.8%); p=0.016]. Nonetheless, the prevalence of violent incidents was not significantly correlated with marital status, years of work experience, employment situation, and working hours. The odds of facing violent behavior among EMTs with associate degree was 2.9 times higher than those with technical diploma (p=0.048). Furthermore, the odds of experiencing violence among non-Persian EMTs was 2.2 times higher than Persian EMTs (p=0.039).&nbsp;Conclusion: We found that EMTs had faced numerous episodes of violence in their workplace, especially verbal threats, which were more prevalently committed by patients’ relatives during night shifts

The effects of the bitter substance, quinine, on postprandial blood glucose, energy intake and associated gut functions in health and type 2 diabetes

The research reported in this thesis investigated whether the bitter substance, quinine, administered intraduodenally or intragastrically, in different doses, has the potential to reduce blood glucose in health and T2D by modulating GI functions, including gut hormones, and gastric motility/emptying. The key findings of the studies are: 1. Both intraduodenal and intragastric administration of quinine hydrochloride (QHCl), in a dose of 600 mg, when administered 30 min or 60 min, before a mixed-nutrient drink, to allow time for sufficient interaction of quinine with small intestinal bitter receptors, had comparable effects to lower plasma glucose, stimulate insulin and GLP-1, and slow gastric emptying in healthy men (Chapter 2). These findings indicated that the stimulation of small intestinal bitter receptors is critical to the GI effects of quinine. 2. Intraduodenal administration of QHCl, in a dose of 600 mg, had greater effects on plasma gut and pancreatic hormones and pyloric pressures than intragastric administration in healthy individuals, consistent with the importance of the interaction of QHCl with small intestinal bitter receptors. Moreover, the effects of quinine to stimulate insulin and lower plasma glucose were greater in females than in males, with modestly greater effects to increase antral and duodenal motility, by contrast there was no evidence of sex effects on any of the GI hormones measured or pyloric pressures (Chapter 3). 3. Intraduodenal administration of QHCl stimulated plasma insulin, C-peptide, GLP-1 and CCK, particularly before the meal, slowed gastric emptying, and dose-dependently (300 mg vs 600 mg), reduced plasma glucose and peak glucose, delayed the rise in plasma glucose, and increased the C-peptide/glucose ratio, after the meal in healthy males and females. Moreover, the magnitude of glucose lowering and increase in the C-peptide/glucose ratio after the meal were greater in females than in males, in the absence of differential effects on glucoregulatory GI functions (Chapter 4), consistent with the concept of enhanced sensitivity to the glucose lowering effect of glucoregulatory hormones, e.g. GLP-1 and/or insulin, in females compared with males. 4. In people with T2D, intraduodenal QHCl, in both doses of 300 mg and 600 mg, markedly lowered nutrient stimulated plasma glucose and peak glucose, increased the C-peptide/glucose ratio, and slowed gastric emptying. In the dose of 600 QHCl, also stimulated plasma GLP-1 and C-peptide (Chapter 5). These findings have important implications for the potential use of quinine to reduce postprandial glycaemic excursions in T2D. In conclusion, the research presented in this thesis has established that quinine modulates glucoregulatory functions, including the stimulation of gut and glucoregulatory hormones as well as slowing gastric emptying, leading to a reduction in postprandial plasma glucose in both health and T2D. Targeting the duodenum, rather than the stomach, apparently represents the most effective and potent approach to optimise these effects of quinine. These studies also provide evidence of a sex-dependent effect of quinine in lowering plasma glucose, with a greater effect in females than males. More research is required, and warranted, to determine the potential of quinine to represent an innovative approach to the management of type 2 diabetes and for impaired glucose tolerance.Thesis (Ph.D.) -- University of Adelaide, Adelaide Medical School, 202

Impact of vitamin D supplementation on C-reactive protein; a systematic review and meta-analysis of randomized controlled trials

Abstract Background To evaluate the effect of vitamin D supplementation on C-reactive protein (CRP) through a systematic review and meta-analysis of randomized control trials (RCTs). Methods PubMed-Medline, SCOPUS, Google Scholar and Web of Science databases were searched (up until April 2016) to identify RCTs evaluating the impact of vitamin D supplementation on CRP. We used random effects models (using DerSimonian-Laird method) as well as the generic inverse variance methods for quantitative data synthesis. For sensitivity analysis, we applied leave-one-out approach. To examine the heterogeneity we used I2 index. Registration code: CRD42016036932. Results Among 1274 search items, 24 studies met the inclusion criteria in the final evaluation. Pooling the data together indicated a non-significant decrease in CRP level following administration of vitamin D (weighted mean difference [WMD] -0.26(mg/l), (95% CI -0.75 to 0.22, N = 26 arms, heterogeneity p = 0.042; I2 54.2%). The WMDs for IL6 was 0.67 pg/ml, (95% CI 0.29 to 1.06, N = 16 arms, heterogeneity p = 0.234; I2 19.1%), 0.43 pg/ml, (95% CI 0.08 to 1.05, N = 26 arms, heterogeneity p = 0.120; I2 42.1%), for IL10, and −0.11 pg/ml, (95% CI -0.53 to 0.30, N = 12 arms, heterogeneity p = 0.423; I2 9.2%) for TNF-α, 4.03 pg/ml, (95% CI 3.50 to 4.57, N = 3 arms, heterogeneity p = 0.752; I2 8.1%) for adiponectin. Sensitivity analyses confirmed the robustness of the findings. Conclusions This study provided evidence that vitamin D supplementation had no impact on serum CRP, IL10, and TNF-α, while significantly increased serum IL6. We recommend RCTs with longer period of follow-up time (12 months) for future studies to provide explicit results

Ghrelin, food intake, and botanical extracts: A Review

A kind of growth hormone secretagogue (GHS), ghrelin, was first isolated from the rat stomach and plays a major role in the activation of the growth hormone secretagogue receptor 1a (GHS-R1a) resulting the release of growth hormone (GH). The preproghrelin gene is placed on chromosome 3, at locus 3p25 –2 in humans and constitutes five exons and three introns. Ghrelin is most plentifully expressed in particular cells in the oxyntic glands of the gastric epithelium, initially named X/A-like cells. Almost 60-70% of circulating ghrelin is secreted by the stomach. Plasma ghrelin concentration alters throughout the day. Ghrelin has been suggested to act as a meal initiator because of its appetite-stimulating influences in free feeding rats in short period. In addition to ghrelin’s function as a meal motivator, it seems to contribute in long-term energy balance and nutritional status. In addition, many studies have been carried out in order to investigate the effects of natural and medicinal plants and botanical extracts on appetite, food intake, energy hemostasis, and the level of related hormones including ghrelin. Due to the importance of ghrelin in nutritional and medical sciences, this review was performed to understand new aspects of this hormone’s function

The effects of Ramadan fasting on growth parameters: A narrative review

Abstract Ramadan fasting is prescribed by Quran for every able‐bodied, adult Muslim and is considered an obligatory act of worship. During Ramadan, the majority of Muslims eat two major meals- one before dawn (Sahar) and another immediately after the sunset (Iftar). Islamic fasting, due to its particular nature, may cause metabolic and hormonal changes in the body, which are different from those in regular fasting. To the best of our knowledge, no comprehensive study has been conducted on changes in growth parameters during fasting periods. Therefore, the aim of this review, which is based on scientific literature review, was to describe the effects of fasting on growth parameters in humans