Aims: The aim of this meta-analysis is to evaluate the potential correlation between obesity and overweight, and the vulnerability to urinary incontinence (UI) in women aged middle-aged and above.Methods: We searched PubMed, Cochrane Library, and Embase for observational studies published between the inception of the databases and April 25, 2023. A fixed-effects model was used when the P>0.1 and the I² ≤ 50%. In cases where I² ≥ 50% (indicating significant heterogeneity), a random-effects model was applied. For the purpose of evaluating publication bias, a funnel plot and Egger’s test were used. Stata 14.0 was used for all statistical analyses.Findings: This meta-analysis includes 16 observational studies, covering29,618 individuals. The pooled analysis shows that being overweight(25 kg/m²≤BMI<30kg/m²) in middle-aged and elderly women is more likely to develop UI (OR=1.27; 95% CI: 1.17-1.37; I² = 51.8%, P=0.013). Middle-aged and elderly women with obesity(30 kg/m²≤BMI<35 kg/m²) are significantly more likely to develop UI (OR=1.60; 95% CI: 1.42-1.81; I² = 71.8%, P=0.000). In addition, the results indicated a higher probability of UI in middle-aged and older women with obesity class II (BMI≥35 kg/m²) (OR=1.85; 95% CI: 1.59-2.16; I^2 = 48.1%, P=0.103). In subgroup analysis, there is no direct relationship between the obesity in middle-aged and elderly women and an increased risk of stress urinary incontinence (SUI) (OR=1.31; 95% CI: 0.99-1.74; I² = 63.7%, P=0.011). In middle-aged and elderly women with obesity are more likely to develop urgent urinary incontinence (UUI) (OR=2.11; 95% CI: 1.54-2.89; I² = 80.2%, P=0.000).Conclusion: In this meta-analysis, overweight and obesity are associated with an increased risk of UI in middle-aged and elderly women. Obesity and overweight are independent risk factors for UI, as demonstrated by this study.Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023421986.

Background: The number of prediction models for diabetic foot ulcer (DFU) risk is increasing, but their methodological quality and clinical applicability are uncertain. We conducted a systematic review to assess their performance. Methods: We searched PubMed, Cochrane Library, and Embase databases up to 10 February 2024 and extracted relevant information from selected prediction models. The Prediction model Risk Of Bias ASsessment Tool (PROBAST) checklist was used to assess bias risk and applicability. All statistical analyses were conducted in Stata 14.0. Results: Initially, 13,562 studies were retrieved, leading to the inclusion of five development and five validation models from eight studies. DFU incidence ranged from 6% to 16.8%, with age and hemoglobin A1C (HbA1c) commonly used as predictive factors. All included studies had a high risk of bias, mainly due to disparities in population characteristics and methodology. In the meta-analysis, we observed area under the curve (AUC) values of 0.78 (95% CI [0.69–0.89]) for development models and 0.84 (95% CI [0.79–0.90]) for validation models. Conclusion: DFU risk prediction models show good overall accuracy, but there is a risk of bias. Adherence to the PROBAST checklist is crucial for improving their clinical applicability.

Background: Betaine is a natural food component that plays an important role in improving body composition, but the details of its effects on adipose tissue remains to be elucidated. Here, we hypothesize that betaine can alleviate obesity-related metabolic disorders, thus gut microbiota, transcriptomics and lipidomics were used to investigate the obesity-alleviating effects of betaine on high-fat diet (HFD)-fed rats.Methods: In this study, rats fed a HFD were subjected to an 8-week oral intervention with betaine. We measured changes in body weight (BW), blood lipid profiles, and gastrointestinal hormones to assess therapeutic effects. The epididymal white adipose tissue was extracted and stained to evaluate the pathological morphology of adipocytes. The structure of the rat gut microbiota and the expression profiles of lipid metabolism-related genes in adipocytes were analyzed using 16S rRNA sequencing and transcriptomics. Furthermore, the lipid metabolomics of adipose tissue samples was investigated using an LC-MS analysis platform.Results: Our findings imply that betaine has been linked to the alleviation of community alterations in gut microbiota resulting from HFD, facilitating the proliferation of beneficial microbiota (e.g., Lactobacillu, Lachnospiraceae_NK4A136_group) and the generation of short-chain fatty acids (SCFA). Particularly, our results indicate that betaine treatment led to notable variations in the content of DHA-riched glycerophospholipids which exhibited a positive correlation with the secretion of intestinal hormone (e.g., cholecystokininand peptide YY). Additionally, betaine upregulated the expression of genes related to thermogenesis and glycerophospholipids metabolic pathways in the adipose tissues.Conclusion: Our findings indicate that betaine has the potential to decrease HFD-related obesity by regulating adipose tissue metabolism and promote the synthesis of polyunsaturated phospholipid rich in DHA. The underlying mechanism of betaine action might encompass its influence on gut microbiota modulation and SCFA metabolism.