Table 4.
GRADE profile of CLA supplementation for glycemic control, adipokine, cytokine, malondialdehyde and liver function enzymes in subjects with metabolic disorders
| Outcomes | Risk of bias | Inconsistency | Indirectness | Imprecision | Publication Bias | Quality of evidence |
|---|---|---|---|---|---|---|
| FBG | No serious limitation | Very serious limitation a | No serious limitation | No serious limitation | serious limitation | ⊕ ◯◯◯ Very low |
| Insulin | No serious limitation | No serious limitation | No serious limitation | Serious limitation c | No serious limitation | ⊕ ⊕ ⊕ ◯ Moderate |
| HbA1c | No serious limitation | Serious limitation b | No serious limitation | Serious limitation c | No serious limitation | ⊕ ⊕ ◯◯ Low |
| HOMA | No serious limitation | Very serious limitation a | No serious limitation | Serious limitation c | No serious limitation | ⊕ ◯◯◯ Very low |
| CRP | No serious limitation | No serious limitation | No serious limitation | Serious limitation c | No serious limitation | ⊕ ⊕ ⊕ ◯ Moderate |
| IL-6 | No serious limitation | Serious limitation b | No serious limitation | No serious limitation | No serious limitation | ⊕ ⊕ ⊕ ◯ Moderate |
| TNF-α | No serious limitation | Serious limitation b | No serious limitation | Serious limitation c | Serious limitation d | ⊕ ◯◯◯ Very low |
| Adiponectin | No serious limitation | Very serious limitation a | No serious limitation | Serious limitation c | No serious limitation | ⊕ ◯◯◯ Very low |
| Leptin | No serious limitation | No serious limitation | No serious limitation | No serious limitation | No serious limitation | ⊕ ⊕ ⊕ ⊕ High |
| MDA | No serious limitation | Very serious limitation a | No serious limitation | Serious limitation c | No serious limitation | ⊕ ◯◯◯ Very low |
| ALT | No serious limitation | Very serious limitation a | No serious limitation | Serious limitation c | No serious limitation | ⊕ ◯◯◯ Very low |
| AST | No serious limitation | Serious limitation b | No serious limitation | No serious limitation | No serious limitation | ⊕ ⊕ ⊕ ◯ Moderate |
aThere is high heterogeneity (I2 > 75) for FBG, HOMA-IR, adiponectin, MDA and ALT
bThere is moderate heterogeneity (I2 > 40) for HbA1c, IL-6, TNF-α, and AST
cThere is no evidence of significant effects of CLA supplementation on insulin, HbA1c, HOMA-IR, CRP, TNF-α, adiponectin, MDA and ALT
dThere is a significant publication bias based on egger regression test for TNF-α (P = 0.04)