2016-11-16T20:15:18

Metabolic syndrome (MS) has been associated with proteinuria and reduced glomerular filtration rate. Immunosuppressive agents increase the incidence of traditional risk factors for cardiovascular disease (CVD) and have known effects on MS components after kidney transplantation. The purpose of this meta-analysis was to evaluate the impact of MS on relevant outcomes after kidney transplantation. MEDLINE, EMBASE, and Cochrane Library were searched up to November 7, 2015. Papers that compared patients with and without MS and assessed one of the following outcomes, graft loss, death by cardiovascular disease, and all-cause mortality, were included. Of 585 studies identified, five studies including 1269 patients were evaluated. MS was identified as a risk factor for graft loss [relative risk, 3.06; 95% confidence interval (CI), 2.17, 4.32; I² = 0%; P heterogeneity = 0.72] and death by CVD (relative risk, 3.53; 95% CI, 1.27, 9.85; I² = 0%; P heterogeneity = 0.40). Results on the association between MS and all-cause mortality were inconclusive (relative risk, 2.61; 95% CI, 0.70, 9.81; I² = 58%; P heterogeneity = 0.09). Graft loss and death by CVD were associated with the presence of MS after transplantation. Randomized clinical trials should be conducted to define whether interventions on each MS component would result in better outcomes after transplantation.

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Background: Sarcopenia is a progressive and generalized skeletal muscle disorder with unfavorable muscle changes throughout life, which can be associated with chronic disease. Testosterone supplementation is emerging as a possible therapy; however, it is still necessary to explore its effectiveness Objectives: This systematic review and meta-analysis aimed to evaluate and summarize the evidence related to the effect of testosterone supplementation on sarcopenia components of chronic disease patients. Methods: We performed a systematic review and meta-analysis with studies that assessed the effect of testosterone supplementation on sarcopenia components of chronic disease patients. Papers were identified using Medical Subject Heading (MeSH) terms, combining “sarcopenia”, “muscular atrophy”, and “testosterone”, searching MEDLINE, EMBASE, and Cochrane Library databases, and also hand searching. Results: The database search resulted in 1602 applicable citations that could be included. Of those, 1560 were removed at the first phase, by reading the title and abstract, and a total of 17 studies were finally included after full-text assessment and manual searches of previous review references. With regard to the effects of testosterone supplementation on sarcopenia components, when taken together, the evaluated studies presented an increase in muscle mass and/or muscle strength, but results for muscle functional capacity were inconsistent. Conclusions: Testosterone supplementation increased the muscle mass and muscle strength in chronic disease patients. However, current evidence does not indicate that those patients could benefit from testosterone supplementation in order to improve their muscle function.