{"title":"Reply to: \"Starting the journey: Understanding the roles of complement proteins in liver diseases through mendelian randomization\".","authors":"Yingzhou Shi, Guandou Yuan, Xiude Fan, Chao Xu","doi":"10.3350/cmh.2024.0266","DOIUrl":"https://doi.org/10.3350/cmh.2024.0266","url":null,"abstract":"","PeriodicalId":14,"journal":{"name":"ACS Combinatorial Science","volume":" 3","pages":""},"PeriodicalIF":8.9,"publicationDate":"2024-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140683325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Manchanda, Li Sun, Monika Sobocan, Isabel V Rodriguez, Xia Wei, A. Kalra, S. Oxley, Michail Sideris, C. Fierheller, Robert D. Morgan, D. Chandrasekaran, Kelly Rust, P. Spiliopoulou, Rowan E. Miller, Shanthini M. Crusz, Michelle Lockley, Naveena Singh, A. Faruqi, Laura Casey, E. Brockbank, Saurabh Phadnis, T. Mills-Baldock, Fatima El-Khouly, L. Jenkins, A. Wallace, Munaza Ahmed, Ajith Kumar, Elizabeth M. Swisher, C. Gourley, B. Norquist, D. G. Evans, R. Legood
Background: Parallel panel germline and somatic genetic testing of all patients with ovarian cancer (OC) can identify more pathogenic variants (PVs) that would benefit from PARP inhibitor (PARPi) therapy, and allow for precision prevention in unaffected relatives with PVs. In this study, we estimate the cost-effectiveness and population impact of parallel panel germline and somatic BRCA testing of all patients with OC incorporating PARPi therapy in the United Kingdom and the United States compared with clinical criteria/family history (FH)–based germline BRCA testing. We also evaluate the cost-effectiveness of multigene panel germline testing alone. Methods: Microsimulation cost-effectiveness modeling using data from 2,391 (UK: n=1,483; US: n=908) unselected, population-based patients with OC was used to compare lifetime costs and effects of panel germline and somatic BRCA testing of all OC cases (with PARPi therapy) (strategy A) versus clinical criteria/FH-based germline BRCA testing (strategy B). Unaffected relatives with germline BRCA1/BRCA2/RAD51C/RAD51D/BRIP1 PVs identified through cascade testing underwent appropriate OC and breast cancer (BC) risk-reduction interventions. We also compared the cost-effectiveness of multigene panel germline testing alone (without PARPi therapy) versus strategy B. Unaffected relatives with PVs could undergo risk-reducing interventions. Lifetime horizon with payer/societal perspectives, along with probabilistic/one-way sensitivity analyses, are presented. Incremental cost-effectiveness ratio (ICER) and incremental cost per quality-adjusted life year (QALY) gained were compared with £30,000/QALY (UK) and $100,000/QALY (US) thresholds. OC incidence, BC incidence, and prevented deaths were estimated. Results: Compared with clinical criteria/FH-based BRCA testing, BRCA1/BRCA2/RAD51C/RAD51D/BRIP1 germline testing and BRCA1/BRCA2 somatic testing of all patients with OC incorporating PARPi therapy had a UK ICER of £51,175/QALY (payer perspective) and £50,202/QALY (societal perspective) and a US ICER of $175,232/QALY (payer perspective) and $174,667/QALY (societal perspective), above UK/NICE and US cost-effectiveness thresholds in the base case. However, strategy A becomes cost-effective if PARPi costs decrease by 45% to 46% or if overall survival with PARPi reaches a hazard ratio of 0.28. Unselected panel germline testing alone (without PARPi therapy) is cost-effective, with payer-perspective ICERs of £11,291/QALY or $68,808/QALY and societal-perspective ICERs of £6,923/QALY or $65,786/QALY. One year’s testing could prevent 209 UK BC/OC cases and 192 deaths, and 560 US BC/OC cases and 460 deaths. Conclusions: Unselected panel germline and somatic BRCA testing can become cost-effective, with a 45% to 46% reduction in PARPi costs. Regarding germline testing, unselected panel germline testing is highly cost-effective and should replace BRCA testing alone.
{"title":"Cost-Effectiveness of Unselected Multigene Germline and Somatic Genetic Testing for Epithelial Ovarian Cancer","authors":"R. Manchanda, Li Sun, Monika Sobocan, Isabel V Rodriguez, Xia Wei, A. Kalra, S. Oxley, Michail Sideris, C. Fierheller, Robert D. Morgan, D. Chandrasekaran, Kelly Rust, P. Spiliopoulou, Rowan E. Miller, Shanthini M. Crusz, Michelle Lockley, Naveena Singh, A. Faruqi, Laura Casey, E. Brockbank, Saurabh Phadnis, T. Mills-Baldock, Fatima El-Khouly, L. Jenkins, A. Wallace, Munaza Ahmed, Ajith Kumar, Elizabeth M. Swisher, C. Gourley, B. Norquist, D. G. Evans, R. Legood","doi":"10.6004/jnccn.2023.7331","DOIUrl":"https://doi.org/10.6004/jnccn.2023.7331","url":null,"abstract":"Background: Parallel panel germline and somatic genetic testing of all patients with ovarian cancer (OC) can identify more pathogenic variants (PVs) that would benefit from PARP inhibitor (PARPi) therapy, and allow for precision prevention in unaffected relatives with PVs. In this study, we estimate the cost-effectiveness and population impact of parallel panel germline and somatic BRCA testing of all patients with OC incorporating PARPi therapy in the United Kingdom and the United States compared with clinical criteria/family history (FH)–based germline BRCA testing. We also evaluate the cost-effectiveness of multigene panel germline testing alone. Methods: Microsimulation cost-effectiveness modeling using data from 2,391 (UK: n=1,483; US: n=908) unselected, population-based patients with OC was used to compare lifetime costs and effects of panel germline and somatic BRCA testing of all OC cases (with PARPi therapy) (strategy A) versus clinical criteria/FH-based germline BRCA testing (strategy B). Unaffected relatives with germline BRCA1/BRCA2/RAD51C/RAD51D/BRIP1 PVs identified through cascade testing underwent appropriate OC and breast cancer (BC) risk-reduction interventions. We also compared the cost-effectiveness of multigene panel germline testing alone (without PARPi therapy) versus strategy B. Unaffected relatives with PVs could undergo risk-reducing interventions. Lifetime horizon with payer/societal perspectives, along with probabilistic/one-way sensitivity analyses, are presented. Incremental cost-effectiveness ratio (ICER) and incremental cost per quality-adjusted life year (QALY) gained were compared with £30,000/QALY (UK) and $100,000/QALY (US) thresholds. OC incidence, BC incidence, and prevented deaths were estimated. Results: Compared with clinical criteria/FH-based BRCA testing, BRCA1/BRCA2/RAD51C/RAD51D/BRIP1 germline testing and BRCA1/BRCA2 somatic testing of all patients with OC incorporating PARPi therapy had a UK ICER of £51,175/QALY (payer perspective) and £50,202/QALY (societal perspective) and a US ICER of $175,232/QALY (payer perspective) and $174,667/QALY (societal perspective), above UK/NICE and US cost-effectiveness thresholds in the base case. However, strategy A becomes cost-effective if PARPi costs decrease by 45% to 46% or if overall survival with PARPi reaches a hazard ratio of 0.28. Unselected panel germline testing alone (without PARPi therapy) is cost-effective, with payer-perspective ICERs of £11,291/QALY or $68,808/QALY and societal-perspective ICERs of £6,923/QALY or $65,786/QALY. One year’s testing could prevent 209 UK BC/OC cases and 192 deaths, and 560 US BC/OC cases and 460 deaths. Conclusions: Unselected panel germline and somatic BRCA testing can become cost-effective, with a 45% to 46% reduction in PARPi costs. Regarding germline testing, unselected panel germline testing is highly cost-effective and should replace BRCA testing alone.","PeriodicalId":14,"journal":{"name":"ACS Combinatorial Science","volume":" 11","pages":""},"PeriodicalIF":13.4,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140687055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-17DOI: 10.1038/s41467-024-47165-z
Jonah Herzog-Arbeitman, B. Bernevig, Zhi-da Song
{"title":"Author Correction: Interacting topological quantum chemistry in 2D with many-body real space invariants","authors":"Jonah Herzog-Arbeitman, B. Bernevig, Zhi-da Song","doi":"10.1038/s41467-024-47165-z","DOIUrl":"https://doi.org/10.1038/s41467-024-47165-z","url":null,"abstract":"","PeriodicalId":14,"journal":{"name":"ACS Combinatorial Science","volume":"125 6","pages":""},"PeriodicalIF":16.6,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140694415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-17DOI: 10.1001/jamacardio.2024.0534
Yi Li, Jing Li, Bin Wang, Quanmin Jing, Yujie Zeng, Aijie Hou, Zhifang Wang, Aijun Liu, Jinliang Zhang, Yaojun Zhang, Ping Zhang, Daming Jiang, Bin Liu, Jiamao Fan, Jun Zhang, Li Li, Guohai Su, Ming Yang, Weihong Jiang, Peng Qu, Hesong Zeng, Lu Li, M. Qiu, Leisheng Ru, Shaoliang Chen, Yujie Zhou, Shubin Qiao, Gregg W. Stone, D. Angiolillo, Yaling Han
Importance Purinergic receptor P2Y12 (P2Y12) inhibitor monotherapy after a certain period of dual antiplatelet therapy (DAPT) may be an attractive option of maintenance antiplatelet treatment for patients undergoing percutaneous coronary intervention (PCI) who are at both high bleeding and ischemic risk (birisk). Objective To determine if extended P2Y12 inhibitor monotherapy with clopidogrel is superior to ongoing DAPT with aspirin and clopidogrel after 9 to 12 months of DAPT after PCI in birisk patients with acute coronary syndromes (ACS). Design, Setting, and Participants This was a multicenter, double-blind, placebo-controlled, randomized clinical trial including birisk patients with ACS who had completed 9 to 12 months of DAPT after drug-eluting stent implantation and were free from adverse events for at least 6 months at 101 China centers between February 2018 and December 2020. Study data were analyzed from April 2023 to May 2023. Interventions Patients were randomized either to clopidogrel plus placebo or clopidogrel plus aspirin for an additional 9 months. Main Outcomes and Measures The primary end point was Bleeding Academic Research Consortium (BARC) types 2, 3, or 5 bleeding 9 months after randomization. The key secondary end point was major adverse cardiac and cerebral events (MACCE; the composite of all-cause death, myocardial infarction, stroke or clinically driven revascularization). The primary end point was tested for superiority, and the MACCE end point was tested for sequential noninferiority and superiority. Results A total of 7758 patients (mean [SD] age, 64.8 [9.0] years; 4575 male [59.0%]) were included in this study. The primary end point of BARC types 2, 3, or 5 bleeding occurred in 95 of 3873 patients (2.5%) assigned to clopidogrel plus placebo and 127 of 3885 patients (3.3%) assigned to clopidogrel plus aspirin (hazard ratio [HR], 0.75; 95% CI, 0.57-0.97; difference, -0.8%; 95% CI, -1.6% to -0.1%; P = .03). The incidence of MACCE was 2.6% (101 of 3873 patients) in the clopidogrel plus placebo group and 3.5% (136 of 3885 patients) in the clopidogrel plus aspirin group (HR, 0.74; 95% CI, 0.57-0.96; difference, -0.9%; 95% CI, -1.7% to -0.1%; P < .001 for noninferiority; P = .02 for superiority). Conclusions and Relevance Among birisk patients with ACS who completed 9 to 12 months of DAPT after drug-eluting stent implantation and were free from adverse events for at least 6 months before randomization, an extended 9-month clopidogrel monotherapy regimen was superior to continuing DAPT with clopidogrel in reducing clinically relevant bleeding without increasing ischemic events. Trial Registration ClinicalTrials.gov Identifier: NCT03431142.
{"title":"Extended Clopidogrel Monotherapy vs DAPT in Patients With Acute Coronary Syndromes at High Ischemic and Bleeding Risk: The OPT-BIRISK Randomized Clinical Trial.","authors":"Yi Li, Jing Li, Bin Wang, Quanmin Jing, Yujie Zeng, Aijie Hou, Zhifang Wang, Aijun Liu, Jinliang Zhang, Yaojun Zhang, Ping Zhang, Daming Jiang, Bin Liu, Jiamao Fan, Jun Zhang, Li Li, Guohai Su, Ming Yang, Weihong Jiang, Peng Qu, Hesong Zeng, Lu Li, M. Qiu, Leisheng Ru, Shaoliang Chen, Yujie Zhou, Shubin Qiao, Gregg W. Stone, D. Angiolillo, Yaling Han","doi":"10.1001/jamacardio.2024.0534","DOIUrl":"https://doi.org/10.1001/jamacardio.2024.0534","url":null,"abstract":"Importance\u0000Purinergic receptor P2Y12 (P2Y12) inhibitor monotherapy after a certain period of dual antiplatelet therapy (DAPT) may be an attractive option of maintenance antiplatelet treatment for patients undergoing percutaneous coronary intervention (PCI) who are at both high bleeding and ischemic risk (birisk).\u0000\u0000\u0000Objective\u0000To determine if extended P2Y12 inhibitor monotherapy with clopidogrel is superior to ongoing DAPT with aspirin and clopidogrel after 9 to 12 months of DAPT after PCI in birisk patients with acute coronary syndromes (ACS).\u0000\u0000\u0000Design, Setting, and Participants\u0000This was a multicenter, double-blind, placebo-controlled, randomized clinical trial including birisk patients with ACS who had completed 9 to 12 months of DAPT after drug-eluting stent implantation and were free from adverse events for at least 6 months at 101 China centers between February 2018 and December 2020. Study data were analyzed from April 2023 to May 2023.\u0000\u0000\u0000Interventions\u0000Patients were randomized either to clopidogrel plus placebo or clopidogrel plus aspirin for an additional 9 months.\u0000\u0000\u0000Main Outcomes and Measures\u0000The primary end point was Bleeding Academic Research Consortium (BARC) types 2, 3, or 5 bleeding 9 months after randomization. The key secondary end point was major adverse cardiac and cerebral events (MACCE; the composite of all-cause death, myocardial infarction, stroke or clinically driven revascularization). The primary end point was tested for superiority, and the MACCE end point was tested for sequential noninferiority and superiority.\u0000\u0000\u0000Results\u0000A total of 7758 patients (mean [SD] age, 64.8 [9.0] years; 4575 male [59.0%]) were included in this study. The primary end point of BARC types 2, 3, or 5 bleeding occurred in 95 of 3873 patients (2.5%) assigned to clopidogrel plus placebo and 127 of 3885 patients (3.3%) assigned to clopidogrel plus aspirin (hazard ratio [HR], 0.75; 95% CI, 0.57-0.97; difference, -0.8%; 95% CI, -1.6% to -0.1%; P = .03). The incidence of MACCE was 2.6% (101 of 3873 patients) in the clopidogrel plus placebo group and 3.5% (136 of 3885 patients) in the clopidogrel plus aspirin group (HR, 0.74; 95% CI, 0.57-0.96; difference, -0.9%; 95% CI, -1.7% to -0.1%; P < .001 for noninferiority; P = .02 for superiority).\u0000\u0000\u0000Conclusions and Relevance\u0000Among birisk patients with ACS who completed 9 to 12 months of DAPT after drug-eluting stent implantation and were free from adverse events for at least 6 months before randomization, an extended 9-month clopidogrel monotherapy regimen was superior to continuing DAPT with clopidogrel in reducing clinically relevant bleeding without increasing ischemic events.\u0000\u0000\u0000Trial Registration\u0000ClinicalTrials.gov Identifier: NCT03431142.","PeriodicalId":14,"journal":{"name":"ACS Combinatorial Science","volume":" 28","pages":""},"PeriodicalIF":24.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140692839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-16DOI: 10.1038/s41467-024-47723-5
M. Tišma, F. P. Bock, Jacob W. J. Kerssemakers, Hammam Antar, A. Japaridze, S. Gruber, C. Dekker
{"title":"Author Correction: Direct observation of a crescent-shape chromosome in expanded Bacillus subtilis cells","authors":"M. Tišma, F. P. Bock, Jacob W. J. Kerssemakers, Hammam Antar, A. Japaridze, S. Gruber, C. Dekker","doi":"10.1038/s41467-024-47723-5","DOIUrl":"https://doi.org/10.1038/s41467-024-47723-5","url":null,"abstract":"","PeriodicalId":14,"journal":{"name":"ACS Combinatorial Science","volume":"24 24","pages":""},"PeriodicalIF":16.6,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140696659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Ruiz-González, I. Cavero-Redondo, A. Hernández-Martínez, Andrés Baena-Raya, S. Martínez-Forte, S. Altmäe, Ana M Fernández-Alonso, A. Soriano‐Maldonado
BACKGROUND The increasing prevalence of obesity worldwide poses a significant threat to reproductive function owing, in part, to hormonal disturbances caused by negative feedback between excess adiposity and the hypothalamic-pituitary-ovarian axis. Consequently, finding the most appropriate strategies to lose weight and improve ovulation in women with overweight or obesity is a clinically relevant matter that needs to be investigated. A comprehensive comparison of the independent and combined efficacy of lifestyle and/or pharmacological interventions on BMI, ovulation, and hormonal profile in women with overweight or obesity at risk of anovulatory infertility would facilitate improving fertility strategies in this population. OBJECTIVE AND RATIONALE This study aimed to evaluate the comparative efficacy of exercise, diet, and pharmacological interventions on BMI, ovulation, and hormonal profile in reproductive-aged women with overweight or obesity. SEARCH METHODS A systematic review was performed by searching PubMed, Scopus, Web of Science, PsycINFO, and Cochrane Library up to 14 December 2023, for randomized controlled trials assessing the effects of exercise, diet and/or pharmacological interventions (i.e. weight-lowering drugs or ovulation inducers) on BMI, ovulation, and/or hormonal profile in reproductive-aged women with overweight or obesity. We performed frequentist random-effect network meta-analyses and rated the certainty of the evidence. The primary outcomes were BMI and ovulation rate, and the secondary outcomes were serum reproductive hormone levels (gonadotrophins, androgens, or oestrogens). We performed sensitivity analyses, including the studies that only involved women with PCOS. OUTCOMES Among 1190 records screened, 148 full texts were assessed for eligibility resulting in 95 trials (9910 women), of which 53% presented a high or unclear risk of bias. The network meta-analyses revealed that, compared to control: diet combined with weight-lowering drugs (mean difference (MD) -2.61 kg/m2; 95% CI -3.04 to -2.19; τ2 = 0.22) and adding exercise (MD -2.35 kg/m2; 95% CI -2.81 to -1.89; τ2 = 0.22) led to the greatest decrease in BMI; exercise combined with diet and ovulation inducers (risk ratio (RR) 7.15; 95% CI 1.94-26.40; τ2 = 0.07) and exercise combined with diet and weight-lowering drugs (RR 4.80; 95% CI 1.67-13.84; τ2 = 0.07) produced the highest increase in ovulation rate; and exercise combined with diet and weight-lowering drugs was the most effective strategy in reducing testosterone levels (standardized mean difference (SMD) -2.91; 95% CI -4.07 to -1.74; τ2 = 2.25), the third most effective strategy in increasing sex hormone-binding globulin levels (SMD 2.37; 95% CI 0.99-3.76; τ2 = 2.48), and it was coupled with being ranked first in terms of free androgen index reduction (SMD -1.59; 95% CI -3.18 to 0.01; τ2 = 1.91). The surface under the cumulative ranking curve scores suggested that: diet combined with weight-lowering dr
背景全世界肥胖症的发病率越来越高，对生殖功能构成了严重威胁，部分原因是过多的脂肪和下丘脑-垂体-卵巢轴之间的负反馈导致激素紊乱。因此，为超重或肥胖妇女找到最合适的减肥和改善排卵的策略是一个需要研究的临床相关问题。本研究旨在评估运动、饮食和药物干预对超重或肥胖育龄妇女的体重指数、排卵和激素水平的比较效果。检索方法通过检索PubMed、Scopus、Web of Science、PsycINFO和Cochrane图书馆（截至2023年12月14日），对评估运动、饮食和/或药物干预（即降体重药物或排卵诱导剂）对超重或肥胖育龄妇女的BMI、排卵和/或激素水平的影响的随机对照试验进行了系统综述。我们进行了频数随机效应网络荟萃分析，并对证据的确定性进行了评级。主要结果是体重指数和排卵率，次要结果是血清生殖激素水平（促性腺激素、雄激素或雌激素）。我们进行了敏感性分析，包括仅涉及多囊卵巢综合症女性的研究。结果在筛选出的 1190 条记录中，有 148 条全文通过了资格评估，最终得出 95 项试验（9910 名女性），其中 53% 的偏倚风险较高或不明确。网络荟萃分析表明，与对照组相比：饮食与降体重药物相结合（平均差 (MD) -2.61 kg/m2；95% CI -3.04 至 -2.19；τ2 = 0.22）和增加运动（MD -2.35 kg/m2；95% CI -2.81 至 -1.89 ；τ2 = 0.22）可使体重下降幅度最大。22）导致 BMI 下降幅度最大；运动结合饮食和排卵诱导剂（风险比 (RR) 7.15; 95% CI 1.94-26.40; τ2 = 0.07）以及运动结合饮食和降体重药物（RR 4.80; 95% CI 1.67-13.84; τ2 = 0.07）对排卵率的提高最高；运动结合饮食和减轻体重药物是降低睾酮水平最有效的策略（标准化平均差 (SMD) -2.91; 95% CI -4.07 to -1.74; τ2 = 2.25），在提高性激素结合球蛋白水平方面排名第三（SMD 2.37；95% CI 0.99-3.76；τ2 = 2.48），同时在降低游离雄激素指数方面排名第一（SMD -1.59；95% CI -3.18-0.01；τ2 = 1.91）。累积排名曲线下的表面得分表明：饮食与降低体重药物相结合是最有可能（94%）降低体重指数的策略；运动与饮食和排卵诱导剂相结合是最有可能（89%）提高排卵率的策略。总体而言，这项网络荟萃分析的结果表明，运动、饮食和药物干预相结合对超重或肥胖妇女减轻体重、改善排卵和使雄激素水平正常化是有效的。尽管还需要进行更高质量的研究，但这些结果支持在共同决策过程中，对希望怀孕的超重或肥胖女性的最佳治疗策略必须考虑运动、饮食和药物干预。
{"title":"Comparative efficacy of exercise, diet and/or pharmacological interventions on BMI, ovulation, and hormonal profile in reproductive-aged women with overweight or obesity: a systematic review and network meta-analysis.","authors":"D. Ruiz-González, I. Cavero-Redondo, A. Hernández-Martínez, Andrés Baena-Raya, S. Martínez-Forte, S. Altmäe, Ana M Fernández-Alonso, A. Soriano‐Maldonado","doi":"10.1093/humupd/dmae008","DOIUrl":"https://doi.org/10.1093/humupd/dmae008","url":null,"abstract":"BACKGROUND\u0000The increasing prevalence of obesity worldwide poses a significant threat to reproductive function owing, in part, to hormonal disturbances caused by negative feedback between excess adiposity and the hypothalamic-pituitary-ovarian axis. Consequently, finding the most appropriate strategies to lose weight and improve ovulation in women with overweight or obesity is a clinically relevant matter that needs to be investigated. A comprehensive comparison of the independent and combined efficacy of lifestyle and/or pharmacological interventions on BMI, ovulation, and hormonal profile in women with overweight or obesity at risk of anovulatory infertility would facilitate improving fertility strategies in this population.\u0000\u0000\u0000OBJECTIVE AND RATIONALE\u0000This study aimed to evaluate the comparative efficacy of exercise, diet, and pharmacological interventions on BMI, ovulation, and hormonal profile in reproductive-aged women with overweight or obesity.\u0000\u0000\u0000SEARCH METHODS\u0000A systematic review was performed by searching PubMed, Scopus, Web of Science, PsycINFO, and Cochrane Library up to 14 December 2023, for randomized controlled trials assessing the effects of exercise, diet and/or pharmacological interventions (i.e. weight-lowering drugs or ovulation inducers) on BMI, ovulation, and/or hormonal profile in reproductive-aged women with overweight or obesity. We performed frequentist random-effect network meta-analyses and rated the certainty of the evidence. The primary outcomes were BMI and ovulation rate, and the secondary outcomes were serum reproductive hormone levels (gonadotrophins, androgens, or oestrogens). We performed sensitivity analyses, including the studies that only involved women with PCOS.\u0000\u0000\u0000OUTCOMES\u0000Among 1190 records screened, 148 full texts were assessed for eligibility resulting in 95 trials (9910 women), of which 53% presented a high or unclear risk of bias. The network meta-analyses revealed that, compared to control: diet combined with weight-lowering drugs (mean difference (MD) -2.61 kg/m2; 95% CI -3.04 to -2.19; τ2 = 0.22) and adding exercise (MD -2.35 kg/m2; 95% CI -2.81 to -1.89; τ2 = 0.22) led to the greatest decrease in BMI; exercise combined with diet and ovulation inducers (risk ratio (RR) 7.15; 95% CI 1.94-26.40; τ2 = 0.07) and exercise combined with diet and weight-lowering drugs (RR 4.80; 95% CI 1.67-13.84; τ2 = 0.07) produced the highest increase in ovulation rate; and exercise combined with diet and weight-lowering drugs was the most effective strategy in reducing testosterone levels (standardized mean difference (SMD) -2.91; 95% CI -4.07 to -1.74; τ2 = 2.25), the third most effective strategy in increasing sex hormone-binding globulin levels (SMD 2.37; 95% CI 0.99-3.76; τ2 = 2.48), and it was coupled with being ranked first in terms of free androgen index reduction (SMD -1.59; 95% CI -3.18 to 0.01; τ2 = 1.91). The surface under the cumulative ranking curve scores suggested that: diet combined with weight-lowering dr","PeriodicalId":14,"journal":{"name":"ACS Combinatorial Science","volume":"47 S226","pages":""},"PeriodicalIF":13.3,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140694847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-16DOI: 10.1038/s41467-024-47675-w
T. Hayes, E. Aquilanti, N. Persky, Xiaoping Yang, Erica E Kim, Lisa Brenan, A. Goodale, Doug Alan, Ted Sharpe, Robert E Shue, Lindsay Westlake, Lior Golomb, Brianna R Silverman, Myshal D Morris, Ty Running Fisher, Eden Beyene, Yvonne Y Li, Andrew D Cherniack, F. Piccioni, J. K. Hicks, Andrew S Chi, Daniel P. Cahill, Jorg Dietrich, Tracy T Batchelor, D. Root, Cory M. Johannessen, Matthew Meyerson
{"title":"Author Correction: Comprehensive mutational scanning of EGFR reveals TKI sensitivities of extracellular domain mutants","authors":"T. Hayes, E. Aquilanti, N. Persky, Xiaoping Yang, Erica E Kim, Lisa Brenan, A. Goodale, Doug Alan, Ted Sharpe, Robert E Shue, Lindsay Westlake, Lior Golomb, Brianna R Silverman, Myshal D Morris, Ty Running Fisher, Eden Beyene, Yvonne Y Li, Andrew D Cherniack, F. Piccioni, J. K. Hicks, Andrew S Chi, Daniel P. Cahill, Jorg Dietrich, Tracy T Batchelor, D. Root, Cory M. Johannessen, Matthew Meyerson","doi":"10.1038/s41467-024-47675-w","DOIUrl":"https://doi.org/10.1038/s41467-024-47675-w","url":null,"abstract":"","PeriodicalId":14,"journal":{"name":"ACS Combinatorial Science","volume":"70 s313","pages":""},"PeriodicalIF":16.6,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140694555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-15DOI: 10.1038/s41413-024-00329-5
Yuan-Yuan Zhang, Na Xie, Xiao-Dong Sun, Edouard C. Nice, Y. Liou, Canhua Huang, Huili Zhu, Zhisen Shen
{"title":"Author Correction: Insights and implications of sexual dimorphism in osteoporosis","authors":"Yuan-Yuan Zhang, Na Xie, Xiao-Dong Sun, Edouard C. Nice, Y. Liou, Canhua Huang, Huili Zhu, Zhisen Shen","doi":"10.1038/s41413-024-00329-5","DOIUrl":"https://doi.org/10.1038/s41413-024-00329-5","url":null,"abstract":"","PeriodicalId":14,"journal":{"name":"ACS Combinatorial Science","volume":"84 5","pages":""},"PeriodicalIF":12.7,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140702614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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