Objective To evaluate the efficacy and safety of metformin for metabolic syndrome. Methods We searched The Cochrane Library, MEDLINE, EMBASE, China Biological Medicine Database, VIP, and CMAC up to the year of 2007. Handsearches and additional searches were also conducted. Randomized controlled trials of metformin for metabolic syndrome were included. Two reviewers independently extracted data from eligible studies and evaluated the quality of included studies. Meta-analysis was performed for the results of homogeneous studies by The Cochrane Collaboration’s software RevMan 4.2.9. Results Six trials involving a total of 2442 patients with metabolic syndrome were included. Meta-analysis was not performed due to the apparent heterogeneity. Metformin, compared with placebo, exhibited more favorable effects in reducing the proportion of patients with metabolic syndrome (RR 1.27, 95% CI 1.01 to 1.60), the proportion of patients with low HDL-c (RR 1.61, 95%CI 1.16 to 2.23), wide waist circumference (RR 1.64, 95%CI 1.06 to 2.55), and high FPG (RR 1.55, 95%CI 1.17 to 2.05). Metformin was also more effective in improving FPG and insulin sensitivity. The addition of metformin to atenolol plus nitrendipine was superior to atenolol plus nitrendipine alone in reducing the proportion of patients with high TG (RR 5.57, 95%CI 1.56 to 19.84), abdominal obesity (RR 14.47, 95%CI 3.34 to 62.61), and IGT (RR 16.51, 95%CI 6.06 to 45.0). Compared with low-fat diet therapy, metformin was superior in improving FPG, 2-hour postload plasma glucose, and insulin sensitivity. No differences were observed between metformin and acarbose in the reduction of TG and FPG, but metformin was less effective than acarbose in improving 2-hour postload plasma glucose. No adverse drug reactions were reported. Conclusion Metformin has beneficial effects in reducing the incidence of high FPG, IGT, and abdominal obesity. It also proved beneficial in reducing the prevalence of metabolic syndrome and increasing insulin sensitivity. The therapeutic effects of metformin on blood pressure, obesity, and lipid profile are uncertain. There is insufficient evidence to recommend the use of metformin in the treatment of metabolic syndrome due to low methodological quality, small sample size, and limited number of trials. More high quality, large-scale randomized controlled trials are required.
Objective To explore the effects of Metabolic Syndrome (MS) and its components on the condition and prognosis of patients with Severe Pneumonia. Methods 306 patients with severe pneumonia admitted to the intensive care unit of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2020 to July 2023 were included as study subjects.The patients were divided into MS and non-MS groups according to whether they were combined with MS,and into survival and death groups according to 28-day prognosis,and the general data, laboratory indexes, condition and prognostic indexes of the two groups were compared; multifactorial logistic regression was used to analyze the independent risk factors for the prognosis of patients with severe pneumonia. ResultsThe levels of test indicators such as body mass index (BMI), fasting blood glucose (FBG), triglyceride (TG), blood lactate,white blood cell count(WBC),urea phosphate (Urea), creatinine (SCr),as well as the incidence of acute respiratory distress syndrome (ARDS), shock,multiple organ dysfunction syndrome (MODS), rate of endotracheal intubation and mortality, ICU treatment cost,and total treatment cost of the MS group were significantly higher than those of the non-MS group; the levels of high-density lipoprotein cholesterol (HDL-C) and oxygenation index (OI) of the MS group were significantly lower than those of the non-MS group (P<0.05).Multifactorial logistic regression analysis showed that the risk of death from severe pneumonia was 1.276 times higher in combined MS than in no combined MS (95%CI: 1.013, 5.114, P=0.047). Subgroup analyses also showed that the risk of death from non-viral severe pneumonia was 2.147 times higher in those with MS than those without (95%CI: 1.175, 8.428, P=0.023). ConclusionSevere pneumonia with MS may be more severe and may have a worse prognosis.
Objective To evaluate the correlation between benign prostatic hyperplasia (BPH) and metabolic syndrome (MS). Methods Total 666 elderly male patients admitted to West China Hospital for routine physical examination in May, 2010 were included in this study. The related laboratory tests of BPH and MS were taken. The correlation among BPH, lower urinary tract Symptoms (LUTS), prostate volume (PV), MS and its component diseases were analyzed. Results Hypertension was an important risk factor for BPH (OR=1.309, 95%CI 1.033 to 1.661), low HDL-C hyperlipidemia was a risk factor for IPSS scored over 7 points (OR=1.573, 95%CI 0.330 to 0.997), and the score of PV was positively correlated to obesity, hypertension, low HDL-C hyperlipidemia and MS (all Plt;0.05). Conclusion For the patient with BPH, MS and its component diseases mainly exert their effects on PV changes rather than LUTS.
Objective To evaluate the efficacy and safety of thiazolidinediones for metabolic syndrome.Methods Up through 2007, we searched The Cochrane Library, MEDLINE, EMbase, the China Biological Medicine Database, VIP and CMAC. We also handsearched relevant literature. Randomized controlled trials about usingthiazolidinedioes to treat metabolic syndrome were included. Two reviewers independently extracted the data from the eligible studies and evaluated the quality of the included studies. Meta-analysis was performed for the results ofhomogeneous studies using RevMan 4.2.9 software. Results Ten randomized control trials involving 1,183 patients with metabolic syndrome met the inclusion criteria. Meta-analysis was not carried out because of apparent heterogeneity. Five trials compared rosiglitazone and placebo, which of single study reported CVD events at the end of 9 month follow-up. The results suggested that no significant differences were found between the two groups in occurrence of CVD events (RR=0.50, 95%CI 0.25 to 1.00), such as myocardial infarction and urgent vessel revascularization after coronary stent implantation, in the patients with metabolic syndrome, while rosiglitazone significantly decreased the proportion of metabolic syndrome (RR=4.0, 95%CI 1.63 to 9.82) and HOMA-index (WMD=-0.80, 95%CI -0.90 to -0.70) as compared with placebo. Pioglitazone did not affect TG, significantly decreased HOMA-index (WMD=0.02, 95%CI 0.01 to 0.03), and increased HDL-c (WMD=0.02, 95%CI 0.01 to 0.03), compared with placebo. Pioglitazone plus glimepirde was better than rosiglitazone plus glimepiride in TG and HDL-c improvement, with no significant differences in improving BP, FPG, PPG, HbA1c, and HOMA-index for both treatments. The combination of rosiglitazone with metformin was similar to pioglitazone-metformin combination in improving FPG, PPG, HbA1c and HOMA-index, whereas pioglitazone plus metformin was superior to rosiglitazone plus metformin in improving TG and HDL-c. No differences between rosiglitazone-metformin combination and glimepirde-metformin combination were observed in improving FPG, PPG, and HbA1c, but rosiglitazone plus metformin significantly lowered HOMA-index and SBP/DBP more than glimepirde plus metformin. The results of included trails revealed that rosiglitazone and pioglitazone had no favorable effects on BMI and WC or resulted in weight gain. The adverse drug reactions for thiazolidinediones were mild to moderate, and well tolerated. Conclusion The results suggest that thiazolidinediones produce positive effects on blood glucose level and insulin sensitivity in the absence of favorable obesity effects or resulting in weight gain. Pioglitazone favorably affects HDL-c. Thiazolidinediones show a certain effect on decreasing the proportion of metabolic syndrome, but the therapeutic effect on BP is uncertain. Overall there is insufficient evidence to recommend the use of thiazolidinediones for metabolic syndrome due to low methodological quality, small sample size, and limited number of trials. More high-quality, largescale randomized controlled trials are required.
Objective To analyze the current status of metabolic syndrome (MetS) and its influencing factors among physical examination population aged 60 years old and above in Chengdu, and to provide evidence for the screening and management of MetS in people aged 60 years old and above. Methods Retrospective analysis of the data of people aged 60 years old and above who participated in physical examination in the North District of the Department of Health Management of Sichuan Provincial People’s Hospital between January 2018 and December 2020. According to whether the elderly occurred to have MetS, they were divided into MetS group and non-MetS group, to observe the distribution of MetS in different genders and different age groups, and to analyze the influencing factors of MetS by multivariate logistic regression. Results A total of 10 335 elderly were enrolled, 2 769 cases (26.79%) in MetS group and 7 566 cases (73.21%) in non-MetS group. Except for gender and low-density lipoprotein cholesterol (LDL-C) (P>0.05), there were significant differences in other general data between the two groups (P<0.05). There was a statistically significant difference in the detection rate of MetS among different age groups (χ²=64.332, P<0.001). In MetS group, 951 cases (34.34%) of abdominal obesity, 716 cases (25.86%) of high fasting blood glucose (FBG), 1 938 cases (69.99%) of hypertension, 1 011 cases (36.51%) of high triglycerides (TG) and 303 cases (10.94%) of low high-density lipoprotein cholesterol (HDL-C) were detected. Except hypertension and high TG (P>0.05), there were statistically significant differences in the detection rates of abdominal obesity, high FBG and low HDL-C among different genders in MetS (P<0.05). Except hypertension (P<0.05), there was no significant difference in the detection rates of MetS abdominal obesity, high FBG, low HDL-C and high TG in different age groups (P>0.05). Logistic regression analysis showed that body mass index [odds ratio (OR)=1.055, 95% confidence interval (CI) (1.014, 1.097), P=0.008], systolic blood pressure [OR=1.032, 95%CI (1.027, 1.037), P<0.001], diastolic blood pressure [OR=0.992, 95%CI (0.985, 1.000), P=0.049], FBG [OR=1.853, 95%CI (1.764, 1.947), P<0.001], TG [OR=3.787, 95%CI (3.352, 4.278), P<0.001], hemoglobin [OR=0.991, 95%CI (0.986, 0.996), P<0.001], waist circumference [OR=1.158, 95%CI (1.141, 1.175), P<0.001], HDL-C [OR=0.243, 95%CI (0.170, 0.346), P<0.001], total cholesterol [OR=0.615, 95%CI (0.490, 0.773), P<0.001], LDL-C [OR=1.594, 95%CI (1.303, 1.948), P<0.001], and uric acid [OR=1.001, 95%CI (1.000, 1.002), P=0.042] were related to MetS. Conclusions The prevalence of MetS is high among people aged 60 years old and above who undergo physical examination. Routine screening should be carried out during physical examination to take measures to intervene the controllable risk factors, so as to improve the health level of the region.
Objective To investigate the differences in characteristics and susceptibility factors between infectious stones and calcium oxalate stones, and provide reference value for screening infectious stones in clinical work. Methods According to the results of analysis of stone components in the extracorporeal shock wave lithotripsy center of West China Hospital of Sichuan University between June 2014 and April 2017, 392 patients with infectious stones (including 56 patients with magnesium ammonium phosphate stones in group A and 336 patients with calcium carbonate apatite in group B) and 392 patients with calcium oxalate stone (group C) were selected to discuss the difference of clinical features by retrospectively analyzing the clinical data. Results The proportion of females, the long diameter of stones and the proportion of staghorn stones in group A [75.0%, (3.9±2.5) cm, 41.1%] were higher than those in group B [39.3%, (2.4±1.3) cm, 6.0%], and the proportion of females and the long diameter of stones in group A and B were larger than those in group C [30.1%, (1.9±0.7) cm]; the differences above were statistically significant (P<0.05). There was no significant difference among the three groups in surgically history or complicated factors of urinary tract such as ureteral stricture (P>0.05). The prevalences of diabetes, renal tubular acidosis and hyperlipidemia in patients with infectious stones were higher than those in group C. The prevalences of renal tubular acidosis and hyperlipidemia in group A (16.1%, 39.3%) were higher than those in group B (0.6%, 21.1%), the positive rate of urine culture in group A (58.9%) was higher than that in group B (20.5%), which were both higher than that in group C (8.9%); these differences were statistically significant (P<0.017). The bacteria cultured from urine were mainlyProteus mirabilis and Escherichia coli in group A, and Escherichia coli in group B and group C. Conclusion Patients with large volume of stones, complicated with diabetes, renal tubular acidosis, hyperlipidemia and positive urine culture are more likely to have infectious stones.
In 2014, The International Diabetes Federation (IDF), American Diabetes Association (ADA), International Society for Paediatric and Adolescent Diabetes (ISPAD), and Chinese Diabetes Society (CDS) published several guidelines and consensuses in the clinical diagnosis, treatment and comprehensive management of diabetes mellitus. In addition, guidelines and consensuses published by the American Stroke Association (ASA), American National Lipid Association (ANLA), Chinese Society for Metabolic & Bariatric Surgery (CSMB) and European Association for the Study of Obesity (EASO) also included some contents related to the management and control of diabetes mellitus. In order to further strengthen the clinical management and treatment of diabetes mellitus, this paper reviewed the important advantages of clinical practice guidelines and consensuses published in 2014 in the field of diabetes mellitus.
Objective To explore the difference of intervention effect between high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on patients with metabolic syndrome (MetS). Methods China National Knowledge Infrastructure, WanFang Data, PubMed, Web of Science and EBSCO were searched for randomized controlled trials (RCTs) till May 2022. Two reviewers independently reviewed the literature, extracted data, and assessed the risk of bias of included RCTs. Comprehensive Meta-Analysis software was used for meta-analysis. Result A total of 5 RCTs were included, including 216 patients. The results of meta-analysis showed that: except fasting blood glucose, high-density lipoprotein cholesterol, systolic blood pressure, waist circumference, body mass index and body fat percentage (P>0.005), low-density lipoprotein cholesterol [mean difference (MD)=−7.487 mg/dL, 95% confidence interval (CI) (−12.543, −2.431) mg/dL, P=0.004], total cholesterol [MD=−11.487 mg/dL, 95%CI (−16.523, −6.452) mg/dL, P<0.001], triglycerides [MD=−26.296 mg/dL, 95%CI (−50.557, −2.035) mg/dL, P=0.034] and diastolic blood pressure [MD=−2.770 mm Hg (1 mm Hg=0.133 kPa), 95%CI (−5.131, −0.409) mm Hg, P=0.021] of HIIT were better than MICT. Conclusion In terms of blood glucose indicators and morphological indicators, the effect of HIIT group and MICT group was similar, but the effect of HIIT on blood lipid indicators and blood pressure indicators of patients with MetS was better than MICT.
ObjectiveTo investigate the bidirectional causal relationship between metabolic syndrome (MS) and inflammatory bowel disease (IBD) using Mendelian randomization (MR). MethodsWe extracted genetic variants with strong correlations from genome-wide association study data on MS as instrumental variables. Inverse variance weighting, MR-Egger regression methods, and weighted median methods were used to estimate the causal effect of MS and risk of developing IBD. ResultsInverse variance weighting found that genetically predicted MS was associated with an increased risk of developing IBD overall (OR=1.113, 95%CI 1.020 to 1.216, P=0.017) and Crohn's disease (OR=1.195, 95%CI 1.072 to 1.333, P=0.001). And inverse MR analysis found ulcerative colitis was associated with a reduced risk of developing MS (OR=0.969, 95%CI 0.948 to 0.991, P=0.005). ConclusionThe results based on MR analysis suggest that genetically predicted MS is associated with the risk of IBD as a whole and Crohn's disease and ulcerative colitis are associated with a reduced risk of developing MS.
ObjectiveTo investigate the association between metabolic syndrome and arterial stiffness in elderly people. Methods1 599 participants aged over 65 years old were recruited from 10 communities located in the northern Shanghai. Carotid-femoral pulse wave velocity (cf-PWV) of each participant was measured by SphygmoCor device. Measurements for the diagnosis of metabolic syndrome were all investigated for each participant. SPSS 20.0 was used for data management and statistical analysis. ResultsCf-PWV was significantly associated with metabolic syndrome and its diagnostic measurements (P<0.001). Moreover, with the accumulating diagnostic measurements, cf-PWV increased gradually and significantly. The increasing trend remained significant in all participants, in men and in women (P<0.001). ConclusionArterial stiffness is significantly associated with metabolic syndrome and the accumulation of its diagnostic measurements.