Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
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Journal of epidemiology and community health
Analysis of the potential association between physical activity and skin autofluorescence: a systematic review.
INTRODUCTION: Accumulation of advanced glycation end products, measured by skin autofluorescence (SAF), has been shown to be associated with several chronic non-communicable diseases, particularly cardiovascular diseases (CVDs). The promotion of physical activity (PA) as a strategy for the prevention of CVD by modifying healthy habits has been widely studied. AIM: To assess the evidence for the association between PA and SAF in the general adult population. METHODS: A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Synthesis Without Meta-analysis framework. A search was performed in MEDLINE (via PubMed), Web of Science, Scopus, Cochrane Library and SportDiscuss (via EBSCOhost), from inception to September 2024. Study quality was assessed using the National Heart, Lung and Blood Institute tools and the certainty of evidence was evaluated with Grading of Recommendations, Assessment Development and Evaluation. Vote counting based on the direction of effect was used as the standardised synthesis metric. RESULTS: In the systematic review, 17 studies were included. The qualitative synthesis showed a predominant consistency in favour of a beneficial association. Specifically, 58.8% of the studies reported a statistically significant inverse association, indicating that higher levels of PA or exercise frequency are correlated with lower SAF levels. The remaining studies (41.2%) reported non-significant results, though several showed favourable trends. No studies reported a positive association between PA and SAF. The quality of the studies was generally fair, and the certainty of evidence low. CONCLUSIONS: PA is inversely associated with SAF. Therefore, while causality cannot be proven, it is hypothesised that PA may reduce SAF and thus have a positive impact on health.
11 July 2026
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Cross-Cultural Perspectives on Metabolic Syndrome Management and Attitudes Toward Using Digital Health Tools in Two Distinct Populations: Protocol for a Qualitative Descriptive Study
BACKGROUND: Metabolic syndrome (MetS) is defined by the presence of at least 3 out of 5 clinical risk factors, including abdominal obesity, elevated blood pressure, high fasting glucose, elevated triglycerides, and low high-density lipoprotein cholesterol. Individuals with MetS face significantly increased risks of cardiovascular disease, type 2 diabetes, and all-cause mortality. OBJECTIVE: This study aims to explore the multilevel factors influencing individuals' engagement in self-management of MetS. Specifically, it seeks to identify key barriers and facilitators to effective self-management and to assess participants' attitudes toward the use of digital health tools in supporting disease management. METHODS: This qualitative descriptive study will be conducted at 2 international sites: the University of Memphis (United States) and King Saud bin Abdulaziz University for Health Sciences (Saudi Arabia), in collaboration with local primary care clinics. Participants will be recruited using purposive sampling with a maximum variation strategy, aiming for 20 to 30 individuals per site who meet eligibility criteria. Data will be collected through semi-structured, 60-minute one-on-one interviews. An abductive thematic analysis approach (integrating both inductive and deductive reasoning) will be used to analyze the data with NVivo 15 software. RESULTS: This study will begin participant enrollment in August 2026. Thematic analysis will be used to examine barriers and facilitators to MetS self-management and participants' views on digital health tools across 2 international sites. CONCLUSIONS: Findings will offer culturally grounded insights into how social, dietary, and familial factors influence chronic disease management. This knowledge can inform the design of equitable, context-sensitive digital health interventions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/91903.
27 June 2026
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