Fatemeh Pourteymour Fard Tabrizi

Empirical studies examining the impact of vitamin D supplementation on the liver function in non-alcoholic fatty liver (NAFLD) disease patients have yielded incongruous outcomes. In this systematic review and meta-analysis of randomized controlled trials (RCTs), we investigated the effect of vitamin D supplementation on liver enzymes (alanine transaminase (ALT), aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP)) in NAFLD patients. A systematic literature search was conducted using scientific databases including PubMed/Medline, Embase, Web of Science, Cochrane library and Scopus, through May 2026. The search strategy included terms for the interventions (vitamin D, cholecalciferol, calcitriol) and outcomes (ALT, AST, ALP, and GGT) in NAFLD patients. Weighted/standardized mean differences (WMD, SMD) and 95% CI were analyzed utilizing a random-effects model. Overall, 16 RCTs met our inclusion criteria. The current meta-analysis demonstrates a significant reduction in ALT (SMD: -0.45; 95% CI: - 0.87 to -0.04; P = 0.032), and ALP (WMD: -12.91 IU/L; 95% CI: - 18.75 to -7.08; P < 0.001). However, analysis of studies indicated a non-significant effect on AST, GGT. Subgroup analysis showed that the effect of vitamin D on AST is more pronounced in studies with a dose ≤ 3500 IU/day, duration > 12 weeks and using cholecalciferol (as opposed to calcitriol). The findings of this study indicate that vitamin D supplementation may be associated with improvements in ALT and ALP levels, while no significant effects were observed for AST and GGT. These results suggest a possible beneficial role of vitamin D in supporting liver function among patients with NAFLD; however, the evidence remains inconclusive. Future studies are needed to investigate the effect of vitamin D on health status in in NAFLD patients. CRD42024545499.

Several studies have investigated the potential beneficial effects of L-carnitine in hemodialysis (HD) patients. Therefore, we conducted a systematic review and meta-analysis of clinical trials that evaluated the impact of L-carnitine supplementation on cardiometabolic risk factors, including weight, body mass index (BMI), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), albumin, and hemoglobin in HD patients. A systematic search was conducted in Web of Science, Scopus, PubMed, and Cochrane databases without language or time restrictions up to January 2026 to identify relevant clinical trials. The pooled weighted mean differences (WMDs) and 95% CIs were computed using the random-effects model. Sixteen studies comprising a total of 699 patients were included in the meta-analysis. The findings showed that L-carnitine supplementation had no significant effect on weight (P = 0.890), BMI (P = 0.733), TG (P = 0.898), LDL-C (P = 0.465), TC (P = 0.180), HDL-C (P = 0.988), albumin (P = 0.820), or hemoglobin (P = 0.322) in HD patients. In exploratory subgroup analyses, L-carnitine supplementation was associated with significant reductions in TG (dose ≥ 1000 mg/day), TC (age < 50 years), SBP (dose < 1000 mg/day), and DBP (duration > 12 weeks), as well as an increase in HDL-C (dose < 1000 mg/day and duration ≤ 12 weeks). All subgroup findings are hypothesis-generating and require confirmation. Taken together, the present study found no significant overall effects of oral L-carnitine supplementation on cardiometabolic risk factors in HD patients. Exploratory subgroup analyses proposed potential effects on TG, HDL-C, TC SBP, and DBP in specific subgroups; however, these results are hypothesis-generating due to the risk of Type I error, small subgroup sample sizes, and substantial heterogeneity. These findings should be interpreted with caution and confirmed in future well-designed studies. CRD42023480114.

Background. Hyperandrogenism is a common disorder in women with polycystic ovary syndrome (PCOS) that can cause changes in body fat distribution and the amount of visceral adipose tissue. Visceral adiposity impairs insulin action, leading to insulin resistance (IR), cardiovascular disease, and renal disorders due to obesity and insulin resistance. Dietary thylakoids reduce visceral fat mass by suppressing appetite and regulating body weight. The present trial aimed to evaluate the fat distribution and renal function after thylakoid membranes of spinach supplementation along with a hypo-caloric diet. Methods. Forty-four obese women with PCOS participated in this randomized, double-blind, placebo-controlled clinical trial for 12 weeks and were allocated to receive 5 gr of thylakoid membranes of spinach extract combined with hypo-caloric diet or 5 gr placebo along with a hypo-caloric diet. Novel atherogenic and anthropometric indices including the atherogenic index of plasma (AIP), Castelli risk index I (CRI-I), Castelli risk index II (CRI-II), TyG-BMI (TyG-BMI), metabolic score for insulin resistance (METS-IR), abdominal volume index (AVI), body adiposity index (BAI), a body shape index (ABSI), and serum urea, creatinine, and total protein were assessed at the baseline and end of the intervention period. Results. Thylakoid membranes of spinach supplementation along with a calorie restriction diet showed a significant decrease in the AIP, CRI-I, II, TyG-BMI, and METS-IR ( < 0.05). AVI, BAI, and ABSI were found to reduce in the thylakoid and placebo groups ( < 0.05). However, the changes in serum urea, creatinine, and total protein did not show significant differences between the intervention and placebo groups. Conclusion. After 12-week supplementation with thylakoid membranes extracted from spinach, improvements in the value of atherogenic indices and insulin resistance surrogate markers were observed, while this intervention did not make a significant difference in the serum levels of renal function factors. This trial is registered with IRCT20140907019082N9.

Background. During pregnancy, it is crucial to minimize maternal anxiety to maintain the mental and physical health of both the mother and fetus, especially in high-risk pregnancies. This study aimed to investigate the effect of family support on decreasing depressive and anxiety symptoms in women hospitalized with high-risk pregnancies in their third trimester. Methods. This randomized controlled clinical trial was performed on 70 high-risk pregnant women in their third trimester. Samples were randomly divided into intervention and control groups. The intervention group walked for five weeks, five days a week, with their spouse or a family member for half an hour a day in the hospital. The control group received routine care. Participants completed the Spielberger Anxiety and Beck Depression Inventory once before and once a week during the intervention. Data were analyzed using SPSS.21 software using ANCOVA, independent t-test, and Mann-Whitney U. Results. Results showed that the subjects were homogeneous in terms of mean overall score of anxiety before the intervention, and there is no significant difference between the intervention group 43.2 (±2.93) and the control group 42.63 (±3.3) (P=0.53). Statistical tests showed that, three weeks after the intervention, the mean anxiety score in the study group decreased significantly, and there was a significant difference in the mean anxiety score of women in the intervention 41.3(±3.07) and control 42.12(±3.6) groups (P=0.032). On the other hand, the level of state anxiety in the study group decreased (P=0.03). The results showed that the depression score after the intervention in the study group decreased significantly (P=0.001). Conclusion. Anxiety level and depression score decreased after the intervention. Practical Implications. The current study's results showed that talking to a spouse or relatives during pregnancy can increase women's peace of mind, and social support during hospitalization can reduce the anxiety and depression of the pregnant mother. Therefore, using such methods will be beneficial for the pregnant mother.

Background: Clinical studies, investigating the effect of β-Alanine (BA) supplementation on recovery biomarkers in physically active individuals, have generated inconsistent results. This systematic review and meta-analysis study aimed to clarify the clinically relevant dietary effects of BA supplementation. Methods: A comprehensive search was done in the electronic databases of Scopus, PubMed, ISI Web of Science and Embase from inception to 2022. Meta-analysis was done using the random-effects model. Pooled effect size was evaluated using standard mean difference (SMD) and 95% confidence intervals (CI). Heterogeneity of between-study was evaluated according to Cochran’s Q test and I2 . Subgroup analysis was conducted to identify the potential sources of heterogeneity. Results: Overall, 32 studies were included in the current study. The results suggested that BA supplementation increases carnosine level significantly (SMD: 0.22mmol/L, 95%CI: -0.17, 0.61, P=0.27) but no effect was shown about lactate, fatigue, VO2 , pH and bicarbonate (HCO3 - ) (P>0.05). Subgroup analysis revealed a significant association of VO2, carnosine and fatigue with supplementation dosage, gender and duration of administration respectively. Conclusion: BA supplementation emerged its beneficial effects on enhancing carnosine level which highlights its ergogenic effects. In contrast, no significant effects had been shown in term of fatigue delay and blood levels of lactate, HCO3 - , pH, and VO2 value. These results warrant more investigation in a prospective design to clarify the exact mechanism in this way.

Vitamin D Status in Preeclamptic and Non-preeclamptic Pregnant Women: A Case-Con­trol Study in the North West of Iran