Objectives: Health-related quality-of-life (HRQoL) instruments for cardiovascular diseases (CVD) have been commonly used to measure important patient-reported outcomes (PROs) in clinical trials and practices. This study aimed at systematically identifying and assessing the content validity of CVD-specific HRQoL instruments in clinical studies. Methods: The research team searched Cumulative Index to Nursing and Allied Health Literature, Embase, and PubMed from inception to January 20, 2022. The research team included studies that reported the development and content validity for CVD-specific instruments. Two reviewers independently assessed the methodological quality using the Consensus-based Standards for the Selection of Health Measurement Instruments methods on evaluating content validity of PROs. Content analysis was used to categorize the items included in the instruments. Results: The research team found 69 studies reporting the content validity of 40 instruments specifically developed for CVD. Fourteen (35.0%) were rated "sufficient" with very low to moderate quality of evidence. For PRO development, all instruments were rated "doubtful" or "inadequate." Twenty-eight (70.0%) instruments cover the core concepts of HRQoL. Conclusions: The quality of development and content validity vary among existing CVD-specific instruments. The evidence on the content validity should be considered when choosing HRQoL instrument in CVD clinical studies and health economic evaluations.

Gut microbiota has been identified as a unique endocrine organ linked to the development of cardiovascular disease and other illnesses, especially deteriorated in overweight and obese postmenopausal women. The object of this systematic review and meta-analysis aimed to assess the effects of oral supplementation with probiotics for overweight and obese postmenopausal women. We performed a systematic search for randomized controlled trials (RCTs) from inception to April 2022 in MEDLINE, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov. We also performed a hand search by reviewing reference lists to identify trials. The risk of bias in individual studies was assessed with the Cochrane risk of bias tool for randomized trials (RoB). Two reviewers independently selected studies and collected data. There were 6 studies from 5 RCTs with 281 participants in this systematic review. Compared with the placebo, the probiotics supplementation group had reductions in insulin (MD - 4.20 IU/L (95% CI - 8.11 to - 0.30 IU/L), I-2 = 54%), HOMA-IR (MD - 1.25 (95% CI - 2.49 to - 0.01), I-2 = 50%), and TNF-alpha (MD - 0.12 pg/mL (95% CI - 0.22 to - 0.01 pg/mL), I-2 = 44%). Improvements were also shown in body adiposity and lipid profile, but these effects were nonsignificant. In addition to body adiposity and cardiovascular risk markers, one trial showed the administration of probiotics also had an effect on iron metabolism. In conclusion, probiotics have a potential benefit on glucose metabolism and inflammatory process in overweight and obese postmenopausal women, but this effect is mild. It demonstrates that oral probiotics supplementation can be a complementary treatment for improving the fitness of postmenopausal women with overweight and obesity.

BackgroundLong-term exposure to particulate matter (PM) has essential and profound effects on human health, but most current studies focus on high-income countries. Evidence of the correlations between PM and health effects in low- and middle-income countries (LMICs), especially the risk factor PM1 (particles < 1 mu m in size), remains unclear. ObjectiveTo explore the effects of long-term exposure to particulate matter on the morbidity and mortality of cardiovascular and respiratory diseases in LMICs. MethodsA systematic search was conducted in the PubMed, Web of Science, and Embase databases from inception to May 1, 2022. Cohort studies and case-control studies that examine the effects of PM1, PM2.5, and PM10 on the morbidity and mortality of cardiovascular and respiratory diseases in LMICs were included. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Outcomes were analyzed via a random effects model and are reported as the relative risk (RR) with 95% CI. ResultsOf the 1,978 studies that were identified, 38 met all the eligibility criteria. The studies indicated that long-term exposure to PM2.5, PM10, and PM1 was associated with cardiovascular and respiratory diseases: (1) Long-term exposure to PM2.5 was associated with an increased risk of cardiovascular morbidity (RR per 1.11 mu g/m(3), 95% CI: 1.05, 1.17) and mortality (RR per 1.10 mu g/m(3), 95% CI: 1.06, 1.14) and was significantly associated with respiratory mortality (RR 1.31, 95% CI: 1.25, 1.38) and morbidity (RR 1.08, 95% CI: 1.02, 1.04); (2) An increased risk of respiratory mortality was observed in the elderly (65+ years) (RR 1.21, 95% CI: 1.00, 1.47) with long-term exposure to PM2.5; (3) Long-term exposure to PM10 was associated with cardiovascular morbidity (RR 1.07, 95% CI 1.01, 1.13), respiratory morbidity (RR 1.43, 95% CI: 1.21, 1.69) and respiratory mortality (RR 1.28, 95% CI 1.10, 1.49); (4) A significant association between long-term exposure to PM1 and cardiovascular disease was also observed. ConclusionsLong-term exposure to PM2.5, PM10 and PM1 was all related to cardiovascular and respiratory disease events. PM2.5 had a greater effect than PM10, especially on respiratory diseases, and the risk of respiratory mortality was significantly higher for LMICs than high-income countries. More studies are needed to confirm the effect of PM1 on cardiovascular and respiratory diseases.

White rice is the food more than half of the world's population depends on. White rice intake can significantly increase the glycemic load of consumers and bring some adverse health effects. However, the quality of evidence implicating white rice in adverse health outcomes remains unclear. To evaluate the association between white rice consumption and the risk of cardiometabolic and cancer outcomes, a systematic review and dose-response meta-analysis of the relevant publications were performed. Twenty-three articles including 28 unique prospective cohorts with 1,527,198 participants proved eligible after a comprehensive search in four databases. For the risk of type 2 diabetes mellitus (T2DM), the pooled RR was 1.18 (16 more per 1000 persons) for comparing the highest with the lowest category of white rice intake, with moderate certainty evidence. Females presented a higher risk (23 more per 1000 persons) in subgroup analysis. And every additional 150 grams of white rice intake per day was associated with a 6% greater risk of T2DM (5 more per 1000 persons) with a linear positive trend. We found no significant associations between white rice intake and risk of cardiovascular diseases (CVD), CVD mortality, cancer, and metabolic syndrome. In conclusion, moderate certainty evidence demonstrated that white rice intake was associated with T2DM risk, with a linear positive trend. However, low to very low certainty of evidence suggested that no substantial associations were found between white rice intake and other cardiometabolic and cancer outcomes. More cohorts are needed to strength the evidence body.