Background/Objectives: Anlotinib is a novel oral antiangiogenic tyrosine kinase inhibitor (TKI) approved as a third-line treatment for advanced non-small-cell lung cancer (NSCLC). However, its efficacy in combination with docetaxel remains incompletely understood. Given the need for effective second-line therapies after platinum-based chemotherapy, this systematic review aims to evaluate the therapeutic potential of anlotinib plus docetaxel in advanced NSCLC. Methods: The PubMed, WOS, Medline, and Scopus databases were screened for published articles up to 12 April 2024. We included RCTs comparing anlotinib plus docetaxel with docetaxel alone in advanced NSCLC after receiving platinum-based chemotherapy, reporting progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR) as outcomes for both groups. Results: Our systematic review included three randomized controlled trials (RCTs) with a total of 151 patients in the anlotinib plus docetaxel group and 132 in the docetaxel-only group. Meta-analysis results demonstrated that the combination therapy significantly prolonged PFS (mean difference (MD) = 2.98, 95% confidence interval (CI), 1.95–4.00; p < 0.00001) and improved ORR (risk ratio (RR) = 3.04, 95% CI = 1.77–5.24; p < 0.00001). Additionally, the DCR was notably higher in the combination group (RR = 1.58, 95% CI = 1.34–1.87; p < 0.00001). Conclusions: Anlotinib plus docetaxel appears to be more effective as a second-line treatment of advanced NSCLC than docetaxel in prolonging PFS and increasing ORR and DCR.

Background/Objectives: Type 2 diabetes mellitus (T2DM) is increasingly recognized as a contributor to skeletal fragility despite patients often having a normal or even elevated bone mineral density (BMD), a phenomenon described as the “T2DM bone paradox.” This study aimed to use DEXA screening to explore how metabolic and demographic factors, particularly body mass index (BMI), age, sex, and glycated hemoglobin (HbA1c), influence Bone Mineral Density (BMD) among Saudi adults, a population where diabetes and obesity are highly prevalent. Methods: A retrospective cross-sectional study was conducted among 89 adults (mean age 61.1 years; 82% female) who underwent dual-energy X-ray absorptiometry (DEXA) at King Fahad Specialist Hospital in Tabuk, Saudi Arabia. Bone mineral density was evaluated at the lumbar spine, femoral neck, and total hip. Correlation and multiple regression analyses were conducted to assess how age, sex, body mass index (BMI), and glycated hemoglobin (HbA1c) were related to BMD T-scores. Results: The prevalence of osteopenia and osteoporosis was 43.8% and 23.6%, respectively, with women and older adults showing the highest rates of low bone mass. Participants had a mean age of 61.1 ± 12.1 years, average BMI of 32 kg/m², and mean HbA1c of 6.6 ± 1.8%. Females showed slightly lower T-scores at all skeletal sites compared with males (lumbar spine −1.81 vs. −1.55; femoral neck −1.15 vs. −0.76; total hip −0.62 vs. −0.12), indicating greater bone loss in women. BMI was consistently and positively associated with BMD across all skeletal sites (p < 0.05), whereas age and female sex were negative predictors at the femoral neck and hip. HbA1c showed a paradoxical positive relationship with BMD at weight-bearing sites, reflecting the complexity of metabolic effects on bone quality. The models explained up to 28% of the variance in BMD. Conclusions: Individuals with higher level BMI tended to have better bone mass, while older age and female sex were related to decreased BMD. The positive association between HbA1c and BMD supports the concept of the “diabetic bone paradox” and emphasizes the value of combining the evaluation of both metabolic and skeletal factors when assessing fracture risk in Middle Eastern populations.

The recognized biomarker of vitamin D status have been repeatedly linked to an increased risk of insulin resistance, metabolic syndrome, and the subsequent development of type 2 diabetes, according to an increasing body of epidemiological evidence. This systematic review aimed to investigate the relationship between vitamin D deficiency and insulin resistance (IR) in adults with Type 2 Diabetes Mellitus (T2DM). It highlights a consistent inverse association between vitamin D levels and IR, but the efficacy of vitamin D supplementation in improving IR remains inconsistent across various interventional studies. The review followed PRISMA guidelines and included a systematic search of studies in multiple databases, yielding 13 studies with 1,396 participants. Most observational studies (8 of 11) showed a significant inverse correlation between serum 25-hydroxyvitamin D and HOMA-IR. However, interventional studies produced conflicting results; one randomized controlled trial (RCT) indicated improvement in HOMA-IR with high-dose vitamin D supplementation, while others found no effect. The overall evidence quality was deemed low, with a high risk of bias attributed to the lack of control for confounders like body mass index (BMI) and physical activity. Despite the consistent reporting of an inverse relationship in observational studies, interventional data do not support a causal link. The inconsistency across studies may reflect confounding by BMI, sunlight exposure, and physical activity. Consequently, current evidence does not strongly advocate for vitamin D supplementation as an isolated treatment for improving insulin resistance in T2DM, underlining the necessity for more rigorous clinical trials.