Background: Emerging research indicates that depression among parents of children/adolescents with type 1 diabetes mellitus (T1DM) has increased signi fifi cantly. However, the prevalence rates reported by different studies vary substantially. Methods: Seven databases were systematically searched (Pubmed, Embase, MEDLINE, Scopus, Web of Science, Cochrane Library, PsycInfo) from the inception to 15th October 2022. We pooled prevalence rates from each study with a random-effect model. We conducted a strati fifi ed meta-analysis to identify the potential sources of heterogeneity among studies. The GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach was utilized to evaluate the quality of evidence. Results: Twenty-two studies were included, with a total of 4639 parents living with type 1 diabetic children. Overall, the pooled prevalence rate of depression or depressive symptoms was 22.4% (95%CI 17.2% to 28.7%; I 2 = 96.8%). The prevalence was higher among mothers (31.5%) than fathers (16.3%) as well as parents of children (aged < 12 years) with T1DM (32.3%) than those with adolescents (aged ≥ 12 years) (16.0%). Conclusion: Our research suggests that more than 1 in 5 parents of type 1 diabetic children/adolescents worldwide suffer from depression or depressive symptom. Depression screening and interventions are required for parents of children with T1DM.

High uric acid (HUA) is associated with insulin resistance (IR) in cardiomyocytes. We investigated whether metformin protects against HUA‐induced IR in cardiomyocytes. We exposed primary cardiomyocytes to HUA, and cellular glucose uptake was quantified by measuring the uptake of 2‐NBDG, a fluorescent glucose analog. Western blot was used to examine the levels of signalling protein. Membrane of glucose transporter type 4 (GLUT4) was analysed by immunofluorescence. We monitored the impact of metformin on HUA‐induced IR and in myocardial tissue of an acute hyperuricaemia mouse model established by potassium oxonate treatment. Treatment with metformin protected against HUA‐reduced glucose uptake induced by insulin in cardiomyocytes. HUA directly inhibited the phosphorylation of Akt and the translocation of GLUT4 induced by insulin, which was blocked by metformin. Metformin promoted phosphorylation of AMP‐activated protein kinase (AMPK) and restored the insulin‐stimulated glucose uptake in HUA‐induced IR cardiomyocytes. As a result of these effects, in a mouse model of acute hyperuricaemia, metformin improved insulin tolerance and glucose tolerance, accompanied by increased AMPK phosphorylation, Akt phosphorylation and translocation of GLUT4 in myocardial tissues. As expected, AICAR, another AMPK activator, had similar effects to metformin, demonstrating the important role of AMPK activation in protecting against IR induced by HUA in cardiomyocytes. Metformin protects against IR induced by HUA in cardiomyocytes and improves insulin tolerance and glucose tolerance in an acute hyperuricaemic mouse model, along with the activation of AMPK. Consequently, metformin may be an important potential new treatment strategy for hyperuricaemia‐related cardiovascular disease.

Background: There is a growing interest in the role of immune and inflammatory responses in mental disorders (MDs). Mean platelet volume (MPV) is an extensively utilized hemogram parameter that reflects systemic inflammation and immune function. Our research sought to determine whether a connection exists between MPV and various types of MDs.Methods: We searched PubMed, EMBASE, PsychINFO, and Web of Science for eligible studies from inception to 15 February 2023, supplemented by manual searching the references from relevant articles. We applied standardized mean difference (SMD) and its 95% confidence interval (CI) to estimate the differences in MPV values in patients with MDs compared to controls.Results: We analyzed data from 24 surveys with 4843 participants (2450 patients with MDs and 2393 healthy controls). Two‐step meta‐analyses were conducted to estimate the SMD in MPV value between individuals with and without MDs. Higher MPV values were substantially linked to MDs (i.e., depression, anxiety, bipolar disorder, and schizophrenia). Moderator and stratified analyses revealed that the aggregate effects were more robust in specific populations, such as younger patients and those who had not taken antipsychotic medication within the previous month.Conclusions: Our findings corroborate the role of inflammatory response in the pathogenesis of MDs and the pharmacological treatment of these conditions. Regarding the considerable heterogeneity among studies, the level of evidence was very low to moderate.

Objective: The current study aimed to address and rank which exercise‐based interventions are preferable to standard care/no therapy or another exercise intervention for postpartum depression (PPD) management and provide estimates for future definitive evidence.Methods: The authors systematically searched PubMed, Embase, the Web of Science, PsycInfo, and ClinicalTrails.gov for randomized controlled trials (RCTs) on exercise‐based interventions for PPD from their inception to May 9, 2023. Included were RCTs of exercise‐based interventions for PPD with at least 4 weeks' duration. The pooled effects of intervention comparisons were generated by the Bayesian random‐effects model, and the quality of evidence was evaluated by the Grading of Recommendations, Assessment, Development, and Evaluations framework.Results: Twelve RCTs (1260 women; mean age, 20–35 years) comparing exercise‐based interventions with usual care/no therapy were included. Exercise effectively treats depressive symptoms (standard mean difference [SMD], −0.81 [95% confidence interval (CI), −1.20 to −0.42], P < 0.001). Pram walking was significantly associated with a reduction of depressive symptoms during the postpartum period (SMD, −1.00 [95% CI, −2.60 to −0.10], P = 0.020), as well as yoga (SMD, −0.73 [95% CI, −1.84 to −0.43], P < 0.001) and supervised mixed exercise (SMD, −0.77 [95% CI, −1.67 to −0.01], P = 0.041) compared with usual care/no therapy. In indirect comparisons, pram walking (surface under the cumulative ranking curve, 58.9%) was better than yoga (SMD, −0.28 [95% CI, −1.86 to 1.22], P = 0.322) and supervised mixed exercise (SMD, −0.23 [95% CI, −1.59 to 1.12], P = 0.358). However, the difference was not statistically significant. The confidence in evidence was very low to moderate.Conclusion: In women with PPD, all commonly prescribed physical exercises were effective alternative or complementary treatments. However, pram walking may perform better in improving the symptoms of PPD.

Doxorubicin (DOX) is an anthracycline chemotherapeutic agent widely used for treating various malignancies due to its remarkable efficacy. However, the dose-limiting cardiotoxicity induced by DOX remains a critical clinical concern with limited therapeutic strategy. Several molecular mechanisms underlying the pathogenesis of doxorubicin-induced cardiotoxicity (DIC) have been proposed, including oxidative stress, dysregulation of Top2β, mitochondrial damage, imbalance of calcium homeostasis, ferroptosis, and inflammatory responses. Increasing studies have posed the promise of the natural products flavonoids against DIC attributed to its advantages in antioxidant activity as well as anti-cancer properties. This paper reviews relevant publications to date and comprehensively summarizes the evidence from preclinical and clinical studies in support of the cardioprotective effect of seven flavonoids subclasses against DIC, including flavones with 18 compounds, flavonols with 11 compounds, isoflavones with 7 compounds, flavanones with 6 compounds, chalcones with 3 compounds, flavanols with 2 compounds and anthocyanins with 2 compounds. Specially, several lines of evidence have also demonstrated the anti-cancer property of flavonoids in addition to the cardioprotective property. This review synthesizes comprehensive mechanistic and translational insights to inform future preclinical and clinical investigations aiming at integrating flavonoid-based interventions into oncotherapeutic regimens. The accumulated evidence underscores flavonoids as promising candidates for DIC as well as adjuvant cancer therapy.