Polycystic ovary syndrome (PCOS) is a common endocrinopathy among reproductive-age women. Various therapeutical approaches are currently used to manage or control symptoms associated with PCOS. This systematic review intended to assess the effects of Vit E supplementation on cardiometabolic risk factors, inflammatory and oxidative markers, and hormonal functions in PCOS women based on the clinical trial's results. The databases including PubMed, Scopus, Cochrane, Web of Science, and Embase were used to find all relevant studies. The authors reviewed all relevant clinical trials via systematic evaluation of abstracts and titles. Searches were conducted on August 1, 2020. After the initial search and reading of the article's title and abstract, 353 articles were reviewed; finally, 12 articles met the inclusion criteria. Vitamin E supplementation improves lipid profile, decreases insulin and HOMA-IR levels. Furthermore, while Vitamin E supplementation decreases LH and testosterone concentrations, it increases FSH and progestrone concentrations. The following meta-analysis showed that vitamin E supplementation made statistically significant improvements in triglyceride (TG) and low-density lipoproteins (LDL) levels, meanwhile, pooled mean difference for waist circumference (WC) and HOMA-IR were also statistically significant. Supplementary regimens containing vitamin E can positively affect metabolic and hormonal parameters in women with PCOS.

Background: Type 2 diabetes mellitus (T2DM) is considered a global health challenge with increasing prevalence in recent years. One of the key elements in managing T2DM patients is controlling their lipid profile. Recent studies suggest microbiome-targeted therapy (MTT) as a treatment strategy for enhancing lipid profiles in these patients. Objective: The current study aimed to investigate the impact of MTT on lipid indices of T2DM patients by performing an umbrella approach. Methods: Three international databases including PubMed, Scopus, and Web of Sciences were searched from inception up to April 2023 to find meta-analyses evaluating the impact of MTT (prebiotics, probiotics, and synbiotics) on the lipid profile of T2DM patients. Two independent researchers extracted data from the relevant meta-analyses. To find the source of heterogeneity various subgroup analyses were performed. Comprehensive Meta-Analyses (CMA) software version 3 was utilized for the final analysis Results: Based on the results of the current study MTT had a significant effect on total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) (ES: - 0.092; 95%CI: -0.111, -0.074; P< 0.001, ES: -0.109; 95%CI: -0.137, -0.081; P< 0.001, ES: -0.036; 95%CI: -0.068, -0.005; P= 0.024, ES: 0.109; 95%CI: 0.056, 0.162; P<0.000, respectively). In subgroup analysis, probiotics showed the most substantial effect on all lipid biomarkers. Conclusion: This research has provided promising insights into the potential impact of MTT on lipid levels in patients diagnosed with T2DM. Notably, MTT had the greatest impact on HDL levels, followed by TG, TC, and LDL. As a result of our study, MTT is recommended as an adjunctive therapeutic option for T2DM treatment due to its capability to regulate lipid profiles.

Background: Primary aldosteronism (PA) is now recognized as the most prevalent form of secondary hypertension globally, contributing significantly to cardiovascular morbidity and mortality. This umbrella review aims to systematically compare cardiovascular outcomes and all-cause mortality in PA patients undergoing adrenalectomy versus mineralocorticoid receptor antagonist (MRA) treatment, aiming to inform optimal management strategies. Method: Following PRISMA guidelines, Supplemental Digital Content 1, https://links.lww.com/JS9/D386 , Supplemental Digital Content 2, https://links.lww.com/JS9/D387 , a comprehensive search strategy was employed across multiple databases. Meta-analyses focusing on cardiovascular outcomes or all-cause mortality, comparing adrenalectomy and MRAs treatment in PA patients, were included. Studies were independently screened and assessed for quality using AMSTAR 2, Supplemental Digital Content 3, https://links.lww.com/JS9/D388 and GRADE checklists. Results: A total of 8 studies met the inclusion criteria. Adrenalectomy showed potential benefits over MRAs in reducing the risk of arrhythmias (OR=2.17; 95% CI: 1.25-3.76) and major adverse cardiovascular events (OR=1.81; 95% CI: 1.33-2.46). Patients treated with MRAs exhibited a higher risk of cardiovascular events (OR=1.23; 95% CI: 1.05-1.44), hypertension (OR=3.22; 95% CI: 1.15-8.97), and all-cause mortality (OR=3.03; 95% CI: 1.36-6.70) compared to adrenalectomy. Conclusion: Adrenalectomy appears to offer favorable outcomes compared to MRAs treatment in PA patients, particularly in reducing the risk of major adverse cardiovascular events and all-cause mortality. These findings suggest the importance of considering surgical intervention as a primary treatment modality for PA. Export