Background: Emerging lipid-related biomarkers, including the Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), and Atherogenic Index of Plasma (AIP), have demonstrated potential in predicting metabolic disorders such as diabetes mellitus (DM) and associated microvascular complications, particularly diabetic kidney disease (DKD) and diabetic retinopathy (DR). Objectives: This systematic review and meta-analysis aims to evaluate the association between these biomarkers and microvascular complications in individuals with DM, as well as to assess their diagnostic performance. Data sources and methods: A systematic literature search was performed in PubMed, Scopus, Embase, and Web of Science following PRISMA guidelines. Eligible studies examined the relationship between VAI, LAP, and AIP and microvascular complications in DM. The meta-analysis synthesized data using pooled weighted mean differences (WMDs) and area under the receiver operating characteristic curve (AUC) values to evaluate the predictive utility of these biomarkers for DKD and DR. Results: A total of 23 studies were included. Patients with DKD had significantly higher levels of LAP (WMD: 12.67; 95% CI: 7.83–17.51; P < .01), AIP (WMD: 0.11; 95% CI: 0.03–0.19; P < .01), and VAI (WMD: 0.63; 95% CI: 0.38–0.89; P < .01) compared to those without DKD. Additionally, each 1-unit increase in LAP (OR: 1.005; 95% CI: 1.003–1.006; P < .01), AIP (OR: 1.08; 95% CI: 1.04–1.12; P < .01), and VAI (OR: 1.05; 95% CI: 1.03–1.07; P < .01) was associated with an elevated risk of DKD. In contrast, no significant associations were identified between these biomarkers and DR. The diagnostic performance of VAI, LAP, and AIP was limited for both DR and DKD, with low discriminatory power. Conclusion: VAI, LAP, and AIP are significant predictors of DKD in individuals with DM but exhibit limited relevance for the detection of DR. Although these biomarkers show potential in identifying DKD risk, their overall diagnostic accuracy for DKD and DR remains modest, underscoring the need for further studies to enhance their clinical applicability.

Background Weight regain (WR) and insufficient weight loss (WL) occur in 20–25% of patients after bariatric surgery due to various factors. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have shown promise in promoting WL; however, evidence regarding their effectiveness in managing WL and preventing WR post-bariatric surgery remains limited. Objective This study aims to evaluate the role of GLP-1RAs in treating and preventing WR following bariatric surgery. Methods A systematic search was conducted across PubMed, Scopus, and Web of Science for studies assessing the impact of GLP-1RAs on WR after bariatric surgery. Results Our search identified 27 original studies, with 10 included in the meta-analysis involving 769 participants (392 treated with GLP-1RAs). The mean age was 44.05 years, with 30.47% male. The time interval from surgery to the initiation of GLP-1RAs treatment ranged from 1.5 to 86.7 months, with treatment durations between 4 and 12 months. The analysis showed significantly greater WL in the GLP-1RAs group compared to placebo (SMD = 0.82, 95% CI 0.23 to 1.42). Subgroup analysis for treatment durations ≤ 6 months indicated a higher WL in the GLP-1RAs group (SMD = 0.79, 95% CI 0.25 to 1.34). Adverse events were primarily gastrointestinal, with nausea significantly more frequently in the GLP-1RAs group (OR = 2.01, 95% CI 1.24 to 3.27). Conclusion GLP-1RAs effectively promote WL among participants experiencing WR after bariatric surgery. Initiating GLP-1RAs therapy shortly after surgery may help prevent WR. Further research is warranted to explore long-term outcomes and optimize treatment protocols for this patient population. Graphical Abstract

Background: Insulin resistance (IR) contributes significantly to major adverse cardio-cerebrovascular events (MACCE), with the estimated glucose disposal rate (eGDR) serving as a novel marker for assessing IR. This systematic review and meta-analysis investigate the association between eGDR and MACCE outcomes, aiming to clarify its predictive value across different diabetes statuses. Methods: We searched databases for studies examining the relationship between eGDR and MACCE, including myocardial infarction (MI), stroke, ischemic heart disease (IHD), cardiovascular disease (CVD), and all-cause mortality. We compared groups with the lowest versus highest eGDR. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using random effect models. Subgroup analyses assessed eGDR efficacy by diabetes status. Results: Our search identified 16 studies with 198 626 participants. The group with the lowest eGDR had a significantly higher risk of MACCE compared to the group with the highest eGDR (HR = 2.21, 95% CI 1.17-4.18). Additionally, the group with the lowest eGDR had notably worse outcomes for all-cause mortality, MI, stroke, CVD, and IHD with HRs of 2.03 (95% CI 1.05-3.90), 1.82 (95% CI 1.30-2.55), 2.82 (95% CI 1.66-4.69), 2.95 (95% CI 1.99-4.37), and 7.97 (95% CI 2.57-24.73), respectively. Subgroup analyses revealed consistent results for CVD in both populations with diabetes and non-diabetes status, for stroke in the population with non-diabetes status, and for IHD in the population with diabetes. Conclusions: Lower eGDR, indicating higher IR, is linked with a significantly increased risk of MACCE. This parameter could enhance risk stratification models for predicting MACCE. Further studies are needed to evaluate the clinical role of eGDR in managing cardio-cerebrovascular risk across subgroups.

Background: Surgical treatment of colorectal cancer (CRC) carries risks of complications such as hernia, obstruction, and infections. Recent studies have assessed the effect of some preoperative body composition (BC) measures on postoperative outcomes in CRC patients. However, the available data is scattered and inconsistent for different BC metrics and complications. We aim to evaluate the predictive value of all BC measures reported in the literature regarding CRC surgery outcomes. Methods: This systematic review and meta-analysis followed PRISMA guidelines, searching PubMed, Scopus, Web of Science, and Embase from inception to January 2024. We included original studies that reported preoperative BC parameters and postoperative outcomes in CRC patients. Relevant data were extracted from the included studies. Our analysis involved calculating odds ratios and corresponding 95% confidence intervals. Results: We found 19 eligible studies with a total population of 7416 patients. We found that, unlike subcutaneous fat area, higher visceral fat area values were associated with higher rates of postoperative complications (MD = 31.91, 95% CI 21.15–42.67). Sarcopenia was associated with higher rates of postoperative total complications (RR = 1.24, 95% CI 1.02–1.51), ileus (RR = 1.40, 95% CI 1.01–1.95), and readmission (RR = 2.18, 95% CI 1.35–3.52); but not postoperative infection, leak, obstruction, and hospital length of stay. Conclusions: Preoperative BC metrics may be useful predictors of some CRC surgery outcomes and complications. However further studies with more homogenous methods are needed for integrating these values into routine pre-operation assessment.