The effectiveness of fasting regimens on serum levels of some major weight regulating hormones: a GRADE-assessed systematic review and meta-analysis in randomized controlled trial

Table 5 Certainty assessment

							№ of patients		Effect		Certainty	Importance
№ of studies	Study design	Risk of bias	Inconsistency	Indirectness	Imprecision	Other considerations	fasting regimens	energy restricted or usual intake	Relative (95% CI)	Absolute (95% CI)	Certainty	Importance
Adiponectin (follow-up: range 4 weeks to 64 weeks; assessed with Kit)
12	randomised trials	not serious	not serious	not serious	serious^a	all plausible residual confounding would reduce the demonstrated effect	211	197	-	MD 0.41 0.41 higher (0.07 lower to 0.89 higher)	⨁⨁⨁⨁ High^a	CRITICAL
Leptin (follow-up: range 3 weeks to 64 weeks; assessed with: Kit)
15	randomised trials	not serious	not serious	not serious	serious^b	strong association all plausible residual confounding would reduce the demonstrated effect	292	284	-	MD 2.65 2.65 lower (3.86 lower to 1.44 lower)	⨁⨁⨁⨁ High^b	CRITICAL
Ghrelin (follow-up: range 6 weeks to 8 weeks; assessed with: Kit)
3	randomised trials	not serious	serious^c	not serious	Serious^d	very strong association all plausible residual confounding would reduce the demonstrated effect	57	55	-	MD 0.57 0.57 lower (1.01 lower to 0.03 lower)	⨁⨁⨁⨁ moderate^c,d	IMPORTANT

CI: confidence interval; MD: mean difference
Explanations
^aIn some studies sample size were lower than estimated optimal sample size. ^bsome studies had lower sample size in compare with evaluated optimal sample size. ^cabout this variable, the number of studies were low and heterogeneity was high although the source of heterogeneity was investigated, it cannot be relied upon due to the small number of studies.^dsome studies' sample sizes were below of optimal sample size
Question: Fasting regimens compared to energy-restricted or usual intake for management of weight-regulating hormones
Setting: Normal-weight or obese adults

ISSN: 2072-1315