Table 3.
Quality appraisal.
| References | Treatment | Participant accountability | Double blind | Treatment/outcome | Validity |
|---|---|---|---|---|---|
| Alkhalaf et al. (23) | Baseline characteristics shows equal treatment | Participants were accounted for and the lack of follow-up was explained. However, they were all males in the older category which limits representation across groups | Yes | Not significant: Inflammation induced T2DM angiopathy unaffected by benfotiamine | Low quality: Incomplete accounting of outcome events and selective outcome reporting Limitation: Participants also had other medications such as angiotensin receptor blockers (ARBs), ACE inhibitors |
| Choi et al. (24) | Baseline characteristics show equal treatment | It was unclear why 3 participants were dropped during intervention. Only Asian women with T2DM | Not applicable | Significant: Aerobic exercise improved systemic inflammatory state in T2DM | High quality. Limitation: Comprehensive detailing and clustering of the participants based on drug types to support disclosure that other medications did not influence the findings |
| Homayouni et al. (25) | Baseline shows equal treatment | Participants were accounted for and the lack of follow-up was explained. Unreported or poor dietary compliance of hesperidin supplement by the participants is a limitation | Yes | Significant: Hesperidin was found to have anti-inflammatory effects in T2DM | Moderate quality: Incomplete accounting of outcome events Limitation: Unreported or poor dietary compliance of hesperidin supplement by the participants |
| Schell et al. (26) | Baseline shows equal treatment | Unclear why 3 participants were dropped for the crossover 4-week study. Skewed toward males (25 male participants and 5 females) | No | Significant: Daily raspberry consumption lowered IL-6 and hs-TNF-α (p < 0.05) Not significant: CRP levels |
Moderate quality: No blinding Limitation: Short duration of study |
| Barzilay et al. (27) | Participants who received salsalate had a higher heart rate (74.16 10.8 vs. 71.06 9.1) and used less non-ACE/angiotensin receptor blocker hypertension medications (33.1 vs. 46.8%; p = 0.03) than those who received placebo | Unclear. Slight difference between participants in the intervention and control. Lack of information on number of participants during follow-up. Participants were older adults less likely to be non-whites and depend on lifestyle modification for T2DM treatment | Single masked | Mixed - Salsalate moderated hyperglycemia and serum levels of AGEs - Early AGE was reduced, late AGE was not. There was reduced HbA1c and inflammatory markers | Moderate quality: Incomplete accounting of outcome events Limitation: Change in serum-protein-bound AGE levels was not exactly known. Most participants in the salsalate-treated group also took reduced doses of antidiabetic drugs |
| Kadoglou et al. (28) | Baseline study did not differ | Participants were accounted for. There were more women (34) than men (26) | No | Significant: There was a reduction in hs-CRP after aerobic exercise - Anti-inflammatory mechanisms were stimulated | Moderate quality: No blinding Limitation: - The participants had no history of cardiovascular complications - The intensity of exercise for the experimental group was unclear |
| Krysiak et al. (29) | Baseline shows equal treatment | Participants were accounted for. There were more males (108) than females (82) | Yes | Significant: Found significant decrease (p = 0.001) in all of TNF, IL-1, IL-2, IL-6, MCP-1, and CRP inflammatory markers after a combined treatment with simvastatin and fenofibrate, but a weak correlation (r = 0.20) with single fenofibrate administration | High quality. Limitation: While there was agreement on combined simvastatin and fenofibrate administration, there were mixed results with the ACCORD trial on monotherapy |
| Zarezadeh et al. (30) | Baseline shows equal treatment | Participants were accounted for. Data on gender of selected participants were missing | Yes | Significant: Ginger supplementation led to a change in ADMA after intervention, but a decrease in sICAM-1 was not statistically significant | Moderate quality: Incomplete accounting of outcome events Limitation: ADMA and serum ICAM-1 differences between the study groups were not statistically significant |
| Mizoguchi et al. (31) | Baseline shows equal treatment | Participants were accounted for. Skewed toward males (39) than females (13) | Yes | Significant: HDL increased, while hs-CRP levels decreased after pioglitazone (p < 0.01) treatment. Glimepiride increased hs-CRP (p < 0.05) | High quality. Limitation: Small participant size, participants were on other drugs, short duration of studies but findings concurred with few similar studies |