Comparative effectiveness of glucagon-like peptide-1 receptor agonists on body composition and anthropometric indices: A protocol for a systematic review and network meta-analysis of randomized controlled trials.

BackgroundTo date, no studies have addressed the comparative efficacy of glucagon-like peptide-1 receptor agonists (GLP1-RAs) therapy on body composition and anthropometric indices among adult overweight or obese patients with or without type 2 diabetes. To provide evidence-based recommendations, we will conduct a traditional pairwise and network meta-analysis of all available randomized clinical trials that evaluated the effects of GLP1-RAs interventions for adult overweight or obese patients with or without type 2 diabetes.Methods and designElectronic databases, including Medline, Embase, PubMed, Cochrane Library (CENTRAL), Scopus, and CINAHL, will be searched from inception without language restriction. Grey literature will be searched, including Google Scholar, ongoing clinical trial registries, and preprint reports. Reference lists of included trials, relevant major endocrinology scientific meetings, and manual hand searches from key general medicine and obesity and endocrinology journals will also be browsed. Two authors will screen, select, extract, appraise the risk of bias, and rate the evidence findings. Any disagreement will be resolved through team discussion. Based on a random-effects model, we will employ a two-step approach of traditional pairwise meta-analysis and network meta-analysis for quantitative synthesis. The pooled effect estimates using a frequentist approach with 95% confidence intervals for continuous endpoints will be expressed as the standardized mean difference, whereas odds ratios will be used for categorical endpoints. The quality of included trials will be evaluated using the Cochrane risk-of-bias version 2 assessment tool. Certainty of evidence for each outcome will be assessed using the modified confidence in network meta-analysis approach and the Grading of Recommended Assessment, Development, and Evaluation approach. The magnitude of the effect size, prediction intervals, surface under the cumulative ranking curve values, and certainty of evidence will be incorporated to draw evidence-based conclusions.ConclusionThis systematic review and network meta-analysis will summarize the comparative efficacy of GLP1-RAs therapy on body composition and anthropometric indices. Evidence identified from this review will promote the rational use of interventions for adult overweight or obese patients with or without type 2 diabetes and will serve as an important step for evidence-based practice within this area.Trial registrationPROSPERO registration number: CRD42023458228

Supplementary Material for: Effect of Fludrocortisone on Intradialytic Hypotension: An Open-Label, Randomized, Crossover Study

Introduction: Intradialytic hypotension (IDH) is an important complication during chronic hemodialysis due to its adverse cardiovascular and hemodialysis outcomes. Case reports have demonstrated that administration of fludrocortisone before undergoing hemodialysis might increase intradialytic blood pressure. This study is a randomized crossover study aiming to evaluate the intradialytic hemodynamic effects of fludrocortisone. Material and Methods: A randomized, controlled two-period crossover trial was conducted at Lampang Hospital in stable chronic hemodialysis patients who experienced IDH >30% in their sessions during the past 3 months. All participants have randomly received a single dose of 0.2-mg fludrocortisone 30 min before each hemodialysis session, or had no treatment for 4 weeks. After a 2-week washout period, the participants were then switched to the other treatment for 4 weeks. The primary outcome was the mean lowest intradialytic mean arterial pressure (MAP) during the hemodialysis session. Results: A total of 17 patients were recruited with a mean age of 61.7 ± 14.8 years. By analysis of crossover design, the mean lowest intradialytic MAP was not different between receiving fludrocortisone or with no treatment (76.1 ± 12.5 vs. 73.9 ± 11.5 mm Hg, p for treatment effect = 0.331, p for period effect = 0.855, p for sequence effect = 0.870). There was no difference in the incidence of IDH between the two groups (34.4% in fludrocortisone vs. 42.7% in no treatment, p = 0.137). However, in diabetic patients and patients with residual kidney function, the incidence of IDH was significantly lower when receiving fludrocortisone (30.8 vs. 52.6%, p p Conclusions: In chronic hemodialysis patients who had IDH, fludrocortisone administration did not improve intradialytic hemodynamics and did not decrease the incidence of IDH

Comparison of three microwave-assisted drying methods on the physiochemical, nutritional and sensory qualities of re-structured purple-fleshed sweet potato granules

10.1111/j.1365-2621.2011.02819.xInternational Journal of Food Science and Technology471141-14

Bioactive Proteins and Energy Value of Okara as a Byproduct in Hydrothermal Processing of Soy Milk

The nutritional properties of raw okara obtained as a byproduct from six soybean varieties during hydrothermal cooking (HTC) of soy milk were assessed. The composition and residual activity (rTIA) of trypsin inhibitors (TIs), contents of lectin, proteins, fats, and carbohydrates, and energy values (EV) were correlated with the respective physicochemical properties of soybean and okara. Kunitz (KTI) and Bowman-Birk (BBI) TIs both comprised okara rTIA. TIs content was higher in okara (5.19-14.40%) than in soybean (3.10-12.17%), which additionally enriched okara by cysteine. Contents of KTI (r = 1.00;p lt 0.05) and BBI (r = 0.89;p lt 0.05) as well as BBI monomeric (r = 0.89;p lt 0.05) and polymeric forms (r = 0.95;p lt 0.05) in okara and in soybean were strongly correlated. Low urease index activity indicated that okara was heated adequately to inactivate antinutritional factors. The proximate composition of raw okara, advantageous rTIA, and a very low EV (2.74-3.78 kJ/g) qualify this byproduct for potential application in food preparation as a functional ingredient in dietary products

Energy value and bioactive proteins of inulin-enriched tofuproduced by hydrothermal process with chymosin-pepsin rennet

Nutritional properties of inulin-enriched tofu obtained after hydrothermal cooking of soymilk, using chymosin-pepsin rennet and inulin as a functional ingredient, were assessed. This procedure significantly differs from the traditional one. The residual activity (rTIA) of trypsin inhibitors (TIs) and lectins, content of proteins, carbohydrates, fats and their energy values (EV) were suitable for human nutrition. Inulin-enriched tofu was characterised with low rTIA (3.08–5.71%) and TIs content of 3.62–18.99%. Content of Kunitz and Bowman-Birk TIs as well as total TIs content (r = 0.98) in tofu were strongly correlated with tofu protein content. Content of Bowman-Birk polymeric forms (3.11–5.36%) was higher than Bowman-Birk monomeric forms (0.51–2.31%) in inulin-enriched tofu. Low urease activity (0.60–1.78%) indicated that soybean was heated adequately to inactivate TIs. Increasing content of inulin did not increase tofu EV (~18 kJ per g tofu). The proximate composition of inulin-enriched tofu, advantageous rTIA and a very low EV qualifies this product for human nutrition