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Another meta-analysis of 19 RCTs on cocoa flavan-3-ols found significant effects on inflammation and oxidative stress biomarkers: CRP (WMD: 0.83 mg/dL, 95% CI: 0.88, 0.77), VCAM-1 (WMD: 85.6 mg/mL, 95% CI: 16.0, 155), lipid metabolism (TG, HDL-C), and insulin resistance modulation (fasting insulin, HOMA-IR, QUICKI, quantitative insulin sensitivity check index, and the insulin sensitivity index, ISI) (307)