scholarly journals Fasting insulin, insulin resistance, and risk of cardiovascular or all-cause mortality in non-diabetic adults: a meta-analysis

2017 ◽  
Vol 37 (5) ◽  
Author(s):  
Xiaohong Zhang ◽  
Jun Li ◽  
Shuiping Zheng ◽  
Qiuyun Luo ◽  
Chunmei Zhou ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Mortality Risk ◽  
Cardiovascular Mortality ◽  
Observational Studies ◽  
Meta Analysis ◽  
Model Assessment ◽  
Fasting Insulin ◽  
Homeostasis Model Assessment ◽  
Insulin Levels ◽  
All Cause Mortality

Studies on elevated fasting insulin or insulin resistance (IR) and cardiovascular or all-cause mortality risk in non-diabetic individuals have yielded conflicting results. This meta-analysis aimed to evaluate the association of elevated fasting insulin levels or IR as defined by homeostasis model assessment of IR (HOMA-IR) with cardiovascular or all-cause mortality in non-diabetic adults. We searched for relevant studies in PubMed and Emabse databases until November 2016. Only prospective observational studies investigating the association of elevated fasting insulin levels or HOMA-IR with cardiovascular or all-cause mortality risk in non-diabetic adults were included. Risk ratio (RR) with its 95% confidence intervals (CIs) was pooled for the highest compared with the lowest category of fasting insulin levels or HOMA-IR. Seven articles involving 26976 non-diabetic adults were included. The pooled, adjusted RR of all-cause mortality comparing the highest with the lowest category was 1.13 (95% CI: 1.00–1.27; P=0.058) for fasting insulin levels and 1.34 (95% CI: 1.11–1.62; P=0.002) for HOMA-IR, respectively. When comparing the highest with the lowest category, the pooled adjusted RR of cardiovascular mortality was 2.11 (95% CI: 1.01–4.41; P=0.048) for HOMA-IR in two studies and 1.40 (95% CI: 0.49–3.96; P=0.526) for fasting insulin levels in one study. IR as measured by HOMA-IR but not fasting insulin appears to be independently associated with greater risk of cardiovascular or all-cause mortality in non-diabetic adults. However, the association of fasting insulin and HOMA-IR with cardiovascular mortality may be unreliable due to the small number of articles included.

scholarly journals Prognostic Value of Serum Magnesium in Mortality Risk among Patients on Hemodialysis: A Meta-Analysis of Observational Studies

2020 ◽  
pp. 1-10
Author(s):  
Hongwei Wu ◽  
Qiang Li ◽  
Lijing Fan ◽  
Dewang Zeng ◽  
Xianggeng Chi ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Cardiovascular Mortality ◽  
Observational Studies ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Serum Magnesium ◽  
Cochrane Library ◽  
Lower Serum ◽  
All Cause Mortality ◽  
End Stage

<b><i>Background:</i></b> Previous studies have reported that serum magnesium (Mg) deficiency is involved in the development of heart failure, particularly in patients with end-stage kidney disease. The association between serum Mg levels and mortality risk in patients receiving hemodialysis is controversial. We aimed to estimate the prognostic value of serum Mg concentration on all-cause mortality and cardiovascular mortality in patients receiving hemodialysis. <b><i>Methods:</i></b> We did a systematic literature search in PubMed, EMBASE, Cochrane Library, and Web of Science to identify eligible studies that reported the prognostic value of serum Mg levels in mortality risk among patients on hemodialysis. We performed a meta-analysis by pooling and analyzing hazard ratios (HRs) and 95% confidence intervals (CIs). <b><i>Results:</i></b> We identified 13 observational studies with an overall sample of 42,967 hemodialysis patients. Higher all-cause mortality (adjusted HR 1.58 [95% CI: 1.31–1.91]) and higher cardiovascular mortality (adjusted HR 3.08 [95% CI: 1.27–7.50]) were found in patients with lower serum Mg levels after multivariable adjustment. There was marked heterogeneity (<i>I</i><sup>2</sup> = 79.6%, <i>p</i> &#x3c; 0.001) that was partly explained by differences in age stratification and study area. In addition, subgroup analysis showed that a serum Mg concentration of ≤1.1 mmol/L might be the vigilant cutoff value. <b><i>Conclusion:</i></b> A lower serum Mg level was associated with higher all-cause mortality and cardiovascular mortality in patients receiving hemodialysis.

scholarly journals A comparative study of insulin resistance in acne vulgaris

2017 ◽  
Vol 3 (3) ◽  
pp. 403
Author(s):  
Prathima Munichandrappa ◽  
Manjunath K. G. ◽  
Kiran C. ◽  
Anirudh Variyar
Keyword(s):  
Insulin Resistance ◽  
Fasting Glucose ◽  
Acne Vulgaris ◽  
Model Assessment ◽  
Fasting Insulin ◽  
Homeostasis Model Assessment ◽  
Insulin Levels ◽  
Glucose Levels ◽  
Significant Difference

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Acne is common skin problem among adolescents and young adults. Recently the role of insulin resistance in acne is being widely researched.</span>The o<span lang="EN-IN">bjectives of the study were to evaluate insulin resistance in acne, to compare the insulin resistance among cases and controls using homeostasis model assessment of insulin resistance</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">45 cases and 45 controls were recruited. Acne severity was graded using the global acne grading system(GAGS). Fasting glucose, fasting insulin levels were done and insulin resistance was assessed using homeostasis model assessment of insulin resistance (HOMA-IR)</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">We did not find any statistically significant difference in fasting insulin levels between cases and controls. However, a weak positive correlation between acne severity and fasting insulin levels (r =0.3, p=0.04) were observed. Fasting glucose levels and HOMA-IR values observed between cases and controls were not statistically significant (p=0.05, p=0.59 respectively). </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Our study did not suggest a major role of insulin resistance in acne.</span></p>

Predictive Value of Insulin Resistance as Determined by Homeostasis Model Assessment in Acute Ischemic Stroke Patients: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 53 (11) ◽  
pp. 746-751
Author(s):  
An Wu ◽  
Yunping Li ◽  
Rongcai Liu ◽  
Dongjing Qi ◽  
Guofeng Yu ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Ischemic Stroke ◽  
Functional Outcome ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Stroke Recurrence ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Poor Functional Outcome ◽  
All Cause Mortality

AbstractStudies on association between homeostasis model assessment of insulin resistance (HOMA-IR) and adverse outcomes have yielded conflicting results in patients with acute ischemic stroke (AIS). This meta-analysis aimed to assess the predictive value of HOMA-IR in AIS patients. Two authors comprehensively searched PubMed and Embase databases until February 28, 2021. All observational studies investigating the association between HOMA-IR and adverse outcomes in AIS patients were included. Outcome measures were poor functional outcome (Modified Rankin Scale≥3), all-cause mortality, stroke recurrence, and neurologic worsening. Seven studies (eight articles) involving 8330 AIS patients were identified. For the highest versus lowest HOMA-IR, the pooled risk ratio (RR) of poor functional outcome was 2.55 (95% CI 1.76–3.70) after adjustment of conventional confounding factors. In addition, elevated HOMA-IR was associated with higher risk of neurologic worsening (RR 1.93; 95% CI 1.15–3.26). However, there were conflicting findings on the association of HOMA-IR with stroke recurrence and all-cause mortality. This meta-analysis confirms that HOMA-IR is significantly associated with an increased risk of poor functional outcome in patients with AIS. However, interpretation of the results of mortality, stroke recurrence, and neurologic worsening should be done with caution due to small number of studies available.

scholarly journals Plasma resistin, adiponectin and leptin levels in lean and obese subjects: correlations with insulin resistance

2003 ◽  
Vol 149 (4) ◽  
pp. 331-335 ◽  
Author(s):  
JV Silha ◽  
M Krsek ◽  
JV Skrha ◽  
P Sucharda ◽  
BL Nyomba ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Mass Index ◽  
Adipose Tissue ◽  
Statistical Significance ◽  
Model Assessment ◽  
Fasting Insulin ◽  
Homeostasis Model Assessment ◽  
Glucose Levels ◽  
Obese Subjects ◽  
The Relationship

OBJECTIVE: Adipose tIssue regulates insulin sensitivity via the circulating adipocytokines, leptin, resistin and adiponectin. The objective of this study was to compare the levels of resistin, adiponectin and leptin in lean and obese subjects and determine the relationship between circulating adipocytokines and insulin resistance. METHODS: We examined plasma levels of resistin, adiponectin and leptin in 17 lean subjects with a mean body mass index (BMI) of approximately 23 and 34 non-diabetic obese individuals with a mean BMI approximately 33. Insulin resistance was assessed using the homeostasis model assessment ratio (HOMA-R) formula derived from fasting insulin and glucose levels. RESULTS: Resistin levels were not significantly different between the two groups but were significantly higher in women compared with men, 35.4+/-6.5 (s.e.) vs 15.4+/-2.9 microg/L, P<0.01. Resistin did not correlate with BMI but did significantly correlate with HOMA-R, P<0.01, and this correlation remained significant after adjustment for gender and BMI. Adiponectin levels were significantly lower in obese compared with lean subjects, P<0.005, and higher in women, P<0.001, but showed no significant correlation with HOMA-R. Leptin levels were significantly higher in obese subjects and women and correlated with HOMA-R and resistin. DISCUSSION: In this small group of patients we demonstrated that insulin resistance correlated most strongly with leptin levels. A significant correlation between resistin levels and insulin resistance was also observed. Although a similar trend was apparent for adiponectin, the correlation with insulin resistance did not achieve statistical significance.

scholarly journals Prognostic Impact of Metabolic Syndrome in Patients With Heart Failure: A Meta-Analysis of Observational Studies

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhuo-Ming Huang ◽  
Wen-Rong Chen ◽  
Qi-Wen Su ◽  
Zhuo-Wen Huang
Keyword(s):  
Heart Failure ◽  
Metabolic Syndrome ◽  
Cardiovascular Mortality ◽  
Cardiovascular Events ◽  
Observational Studies ◽  
Meta Analysis ◽  
Prognostic Impact ◽  
The Metabolic Syndrome ◽  
All Cause Mortality ◽  
The Impact

Background: The metabolic syndrome (MS) is significantly associated with the risk of incident heart failure (HF). However, there are still great controversies about the impact of MS on the prognosis in patients with established HF. This meta-analysis aimed to ascertain the effect of MS on the prognosis in patients with HF.Methods: We searched multiple electronic databases, including PubMed, Opengrey, EMBASE, and Cochran Library, for potential studies up to February 15, 2021. Observational studies that reported the impact of MS on the prognosis in patients with established HF were included for meta-analysis.Results: Ten studies comprising 18,590 patients with HF were included for meta-analysis. The median follow-up duration of the included studies was 2.4 years. Compared with HF patients without MS, the risk of all-cause mortality and cardiovascular mortality was not increased in HF with MS (HR = 1.04, 95% CI = 0.88–1.23 for all-cause mortality; HR = 1.66, 95% CI = 0.56–4.88 for cardiovascular mortality, respectively). However, there was a significant increase in composited cardiovascular events in the HF patients with MS compared with those without MS (HR = 1.73, 95% CI = 1.23–2.45).Conclusions: In patients with established HF, the presence of MS did not show an association on the risk of all-cause mortality or cardiovascular mortality, while it may increase the risk of composite cardiovascular events.

scholarly journals Cinacalcet Treatment Significantly Improves All-Cause and Cardiovascular Survival in Dialysis Patients: Results from a Meta-Analysis

2019 ◽  
Vol 44 (6) ◽  
pp. 1327-1338 ◽  
Author(s):  
Yuan Zu ◽  
Xiangxue Lu ◽  
Jinghong Song ◽  
Ling Yu ◽  
Han Li ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Observational Studies ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Fixed Effects Model ◽  
Long Term Effects ◽  
Dialysis Patients ◽  
All Cause Mortality

Objective: To assess the long-term effects including all-cause mortality, cardiovascular mortality, and fracture incidence, of cinacalcet on secondary hyperparathyroidism (SHPT) in patients on dialysis. Methods: PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched from their inception to October 2018. Randomized controlled trials (RCTs) and cohort design prospective observational studies assessing cinacalcet for the treatment of SHPT in dialysis patients were included. Data extraction was independently completed by 2 authors who determined the methodological quality of the studies and extracted data in duplicate. Study-specific risk estimates were tested by using a fixed effects model. Results: A total of 14 articles with 38,219 participants were included, of which 10 RCTs with 7,471 participants and 4 prospective observational studies with 30,748 participants fulfilled the eligibility criteria. Compared with no cinacalcet, cinacalcet administration reduced all-cause mortality (relative risk [RR] 0.91, 95% CI 0.89–0.94, p < 0.001) and cardiovascular mortality (RR 0.92, 95% CI 0.89–0.95, p < 0.001), but it did not significantly reduce the incidence of fractures (RR 0.93, 95% CI 0.87–1.00, p = 0.05). Conclusions: The results of this meta-analysis indicated that the treatment of SHPT with cinacalcet may in fact reduce all-cause mortality and cardiovascular mortality among patients receiving maintenance dialysis.

scholarly journals Effects of Beta-Blockers on Cardiovascular Events and Mortality in Dialysis Patients: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 48 (1) ◽  
pp. 51-59 ◽  
Author(s):  
Jingjing Jin ◽  
Xiaoyang Guo ◽  
Qiyao Yu
Keyword(s):  
Cardiovascular Mortality ◽  
Cardiovascular Events ◽  
Observational Studies ◽  
Beta Blockers ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Dialysis Patients ◽  
Statistical Heterogeneity ◽  
All Cause Mortality ◽  
Β Blockers

Background: The effects of beta-blockers are uncertain in dialysis patients. Except antihypertension, β-blockers may play a unique cardiovascular protective role in the population. This meta-analysis aimed to explore the effects of β-blockers therapy in adult patients treated with dialysis. Methods: We searched MEDLINE, EMBASE, and the Cochrane library from inception to May 2018 for randomized controlled trials (RCTs) and observational studies about the role of β-blockers on all-cause mortality, cardiovascular mortality, cardiovascular events, or hospitalizations in dialysis population. Results: Three RCTs and 9 observational studies met the predefined inclusion criteria. The RCTs showed significant association between β-blockers and reduced all-cause mortality (n = 363; risk ratio [RR] 0.73; 95% CI 0.54–0.97), cardiovascular mortality (n = 314; RR 0.44; 95% CI 0.29–0.68), cardiovascular events (n = 363; RR 0.52; 95% CI 0.31–0.88), or hospitalizations (n = 314; RR 0.61; 95% CI 0.48–0.78) in dialysis patients. The observational studies showed significant difference in all-cause mortality (n = 35,233; hazard ratio [HR] 0.86; 95% CI 0.80–0.92) between β-blockers and no β-blockers therapy in patients with dialysis, while the studies showed no difference in cardiovascular mortality (n = 19,413; HR 0.79; 95% CI 0.57–1.11), or cardiovascular events (n = 87,060; HR 0.79; 95% CI 0.50–1.26). Conclusions: β-blockers seem to be associated with reduced mortality in patients on dialysis. Both the statistical heterogeneity in observational studies and the small number of participants and studies in RCTs limit the strength of these findings. Video Journal Club “Cappuccino with Claudio Ronco” at  https://www.karger.com/Journal/ArticleNews/496083?sponsor=52

Abstract 118: Right Bundle Branch Block and Clinical Outcomes in Patients with Heart Failure: A Systematic Review and Meta-analysis

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Ahmad Hazem ◽  
Sunita Sharma ◽  
Amit Sharma ◽  
Cameron Leitch ◽  
Roopalakshmi Sharadanant ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Clinical Outcomes ◽  
Cardiovascular Mortality ◽  
Observational Studies ◽  
Meta Analysis ◽  
Bundle Branch Block ◽  
Increased Risk ◽  
Patients With Heart Failure ◽  
All Cause Mortality

Importance: Right bundle branch block (RBBB) is observed in approximately 5-14% of patients with heart failure (HF). Multiple observational studies have reported the association of RBBB with clinical outcomes in patients with HF. We performed a systematic review and meta-analysis to determine the prognostic significance of RBBB for patients with HF. Data Sources: We have systematically searched MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science and Scopus through January 2014. Study Selection: Reviewers working independently and in duplicate screened all eligible abstracts that described all cause or cardiovascular mortality in patients with RBBB and HF. We excluded studies that reported unadjusted outcome, i.e.: unadjusted event rates. Knowledge synthesis: We pooled reported risk ratio and hazard ratio. Main Outcomes: All-cause mortality and cardiovascular mortality (death). Results: We found 12 relevant observational studies enrolling over 38,000 patients. Risk of bias was assessed using the Newcastle-Ottawa Scale. Included studies had at least a moderate quality. Seven of those evaluated prognosis of patients with RBBB and heart failure. After a mean follow up period of 2.5 years (range: 1-5 years), RBBB was associated with a statistically significant increased risk of all-cause mortality compared to patients with heart failure but no BBB, RR 1.27, 95% CI (1.08-1.50), Figure 1. The other 5 studies evaluated CHF patients receiving cardiac resynchronization therapy (CRT), comparing outcomes of patients with RBBB to those with LBBB. After a mean f/u period of 3 years, patients with RBBB were once again found to have an increased risk of all-cause mortality, RR 1.45, 95% CI 1.12-1.89. Conclusion and Relevance: RBBB in patients with HF is associated with higher all-cause mortality in comparison to patients without inter-ventricular conduction defects, as well as LBBB patients in patients undergoing CRT setting.

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