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Cornea Nov 2022Although previous studies have assessed the relationship between diabetes and keratoconus, the findings were controversial and warranted further clarifications. The... (Meta-Analysis)
Meta-Analysis
PURPOSE
Although previous studies have assessed the relationship between diabetes and keratoconus, the findings were controversial and warranted further clarifications. The objective of this study was to investigate the association between diabetes and keratoconus by conducting a systematic review and meta-analysis.
METHODS
A comprehensive literature search was performed to identify eligible studies reporting the association of diabetes with keratoconus from their inception to April 2021 through PubMed, Embase, and Web of Science. The quality of included studies was assessed using the Newcastle-Ottawa scale. Combined odds ratios (ORs) and 95% confidence intervals were calculated using a random-effects model.
RESULTS
In all, 8 case-control studies and 3 cohort studies reporting the association between diabetes and keratoconus were included in the meta-analysis. Diabetes was not associated with keratoconus in the overall analysis (combined OR = 0.85, 95% confidence interval: 0.66-1.10). The associations were found to be nonsignificant in subgroup analysis when stratified by study quality, design, source, types, and population. No publication bias was detected from either the Egger test (P = 0.46) or Begg test (P = 0.16). Sensitivity analysis revealed that differences between groups were not statistically significant.
CONCLUSIONS
This meta-analysis indicates that current literature does not support a significant association between diabetes and keratoconus. Further studies with more definite control for confounders and well-designed cohorts or interventions are warranted.
Topics: Case-Control Studies; Cohort Studies; Diabetes Mellitus; Humans; Keratoconus; Odds Ratio
PubMed: 36219212
DOI: 10.1097/ICO.0000000000002876 -
Journal of Dentistry Aug 2022Poor oral health status may increase the risk of cardiovascular disease. However, whether a specific association exists between tooth loss and hypertension is... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Poor oral health status may increase the risk of cardiovascular disease. However, whether a specific association exists between tooth loss and hypertension is inconclusive. Accordingly, a quantitative systematic review was conducted to investigate the relationship between tooth loss and hypertension.
METHODS
Systematic search, data analysis and quality assessment were conducted on relevant literature published in PubMed, Embase, Web of Science and Cochrane Libraries until October 2021. Odds ratio (OR) with 95% confidence interval (CI) was used as effect size to evaluate the association between tooth loss and hypertension. Meta-regression and subgroup analyses were performed to identify whether difference was associated with study-level factors.
RESULTS
Of the 56 studies selected, 28 studies in 16 different countries involving 1,224,821 individuals were eligible for the systematic review. After adjustment for confounding factors, individuals with tooth loss had a higher risk for hypertension (OR 1.20; 95%CI 1.10-1.30, I = 40.02%). With respect to the risk of hypertension on tooth loss, individuals with hypertension still had a higher risk for tooth loss (OR 1.35; 95%CI 1.07-1.62, I = 51.10%). Age limitation of the included population is the major source of heterogeneity. However, studies in which the population was limited to the elderly did not report an increase in association between tooth loss and hypertension compared with studies without age limitation.
CONCLUSIONS
The results suggest a bidirectional association between tooth loss and hypertension. Future longitudinal prospective studies are required to establish causality between tooth loss and hypertension.
CLINICAL SIGNIFICANCE
Subjects with severe tooth loss should be carefully monitored for the manifestation of hypertension. The oral health status of hypertensive patients should also be meticulous maintained to prevent unwarranted tooth loss.
Topics: Aged; Cardiovascular Diseases; Humans; Hypertension; Odds Ratio; Prospective Studies; Tooth Loss
PubMed: 35661800
DOI: 10.1016/j.jdent.2022.104178 -
Acta Ophthalmologica Jun 2022After decades of investigation, the role of near work in myopia remains unresolved, with some studies reporting no relationship and others finding the opposite. This... (Review)
Review
After decades of investigation, the role of near work in myopia remains unresolved, with some studies reporting no relationship and others finding the opposite. This systematic review is intended to summarize classic and recent literature investigating near work and the onset and progression of myopia, potential mechanisms and pertinent clinical recommendations. The impact of electronic device use is considered. PubMed and Medline were used to find peer-reviewed cross-sectional and longitudinal studies related to near work and myopia from 1980 to July 2020 using the PRISMA checklist. Studies were chosen using the Joanna Briggs Institute checklist, with a focus on studies with a sample size greater than 50. Studies were independently evaluated; conclusions were drawn per these evaluations. Numerous cross-sectional studies found increased odds ratio of myopia with increased near work. While early longitudinal studies failed to find this relationship, more recent longitudinal studies have found a relationship between myopia and near work. Rather than daily duration of near work, interest has increased regarding absolute working distance and duration of continuous near viewing. Several reports have found that shorter working distances (<30 cm) and continuous near-work activity (>30 min) are risk factors for myopia onset and progression. Novel objective continuously measuring rangefinding devices have been developed to better address these questions. The literature is conflicting, likely due to the subjective and variable nature in which near work has been quantified and a paucity of longitudinal studies. We conclude that more precise objective measures of near viewing behaviour are necessary to make definitive conclusions regarding the relationship between myopia and near work. Focus should shift to utilizing objective and continuously measuring instruments to quantify near-work behaviours in children, followed longitudinally, to understand the complex factors related to near work. A better understanding of the roles of absolute working distance, temporal properties, viewing breaks and electronic device use on myopia development and progression will aid in the development of evidence-based clinical recommendations for behavioural modifications to prevent and slow myopia.
Topics: Child; Cross-Sectional Studies; Humans; Longitudinal Studies; Myopia; Odds Ratio; Risk Factors
PubMed: 34622560
DOI: 10.1111/aos.15043 -
BMJ Open Mar 2023To determine the incidence of pneumoconiosis worldwide and its influencing factors. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To determine the incidence of pneumoconiosis worldwide and its influencing factors.
DESIGN
Systematic review and meta-analysis.
SETTING
Cohort studies on occupational pneumoconiosis.
PARTICIPANTS
PubMed, Embase, the Cochrane Library and Web of Science were searched until November 2021. Studies were selected for meta-analysis if they involved at least one variable investigated as an influencing factor for the incidence of pneumoconiosis and reported either the parameters and 95% CIs of the risk fit to the data, or sufficient information to allow for the calculation of those values.
PRIMARY OUTCOME MEASURES
The pooled incidence of pneumoconiosis and risk ratio (RR) and 95% CIs of influencing factors.
RESULTS
Our meta-analysis included 19 studies with a total of 335 424 participants, of whom 29 972 developed pneumoconiosis. The pooled incidence of pneumoconiosis was 0.093 (95% CI 0.085 to 0.135). We identified the following influencing factors: (1) male (RR 3.74; 95% CI 1.31 to 10.64; p=0.01), (2) smoking (RR 1.80; 95% CI 1.34 to 2.43; p=0.0001), (3) tunnelling category (RR 4.75; 95% CI 1.96 to 11.53; p<0.0001), (4) helping category (RR 0.07; 95% CI 0.13 to 0.16; p<0.0001), (5) age (the highest incidence occurs between the ages of 50 and 60), (6) duration of dust exposure (RR 4.59, 95% CI 2.41 to 8.74, p<0.01) and (7) cumulative total dust exposure (CTD) (RR 34.14, 95% CI 17.50 to 66.63, p<0.01). A dose-response analysis revealed a significant positive linear dose-response association between the risk of pneumoconiosis and duration of exposure and CTD (P-non-linearity=0.10, P-non-linearity=0.16; respectively). The Pearson correlation analysis revealed that silicosis incidence was highly correlated with cumulative silica exposure (r=0.794, p<0.001).
CONCLUSION
The incidence of pneumoconiosis in occupational workers was 0.093 and seven factors were found to be associated with the incidence, providing some insight into the prevention of pneumoconiosis.
PROSPERO REGISTRATION NUMBER
CRD42022323233.
Topics: Male; Humans; Middle Aged; Incidence; Pneumoconiosis; Dust; Odds Ratio; PubMed
PubMed: 36858466
DOI: 10.1136/bmjopen-2022-065114 -
Psychopharmacology Nov 2021Disturbances of gastrointestinal microbiome may result in the development of attention-deficit/hyperactivity disorder (ADHD). Antibiotic therapy is commonly known to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Disturbances of gastrointestinal microbiome may result in the development of attention-deficit/hyperactivity disorder (ADHD). Antibiotic therapy is commonly known to influence the gastrointestinal microbiome. However, results from studies on the association between antibiotic exposure and ADHD have been inconsistent.
METHODS
Several databases (PubMed, PsychInfo, EMBASE) were searched on January 1, 2021, to identify relevant studies. A random effects model was used to calculate the pooled risk estimate. Statistical heterogeneity was tested using the chi-square test and the I statistic.
RESULTS
There were four risk estimates on antibiotic intake during pregnancy and eight risk estimates on antibiotic intake after birth. The pooled odds ratio for ADHD comparing antibiotic exposure with non-exposure during pregnancy was 1.14 (95% confidence interval [CI], 1.10-1.18). The pooled odds ratio with postnatal antibiotic exposure was 1.12 (95% CI, 0.99-1.26). Substantial heterogeneity existed among these analyses. The timing of antibiotic exposure, type of antibiotic, and number of antibiotic intakes might influence the association between antibiotic exposure and ADHD.
CONCLUSIONS
Our findings suggest that maternal antibiotic intake during pregnancy may be associated with an increased risk of ADHD in the offspring. However, there was insufficient evidence for the association between antibiotic intake after birth and ADHD risk. Further studies should be performed before a definitive conclusion can be established.
Topics: Anti-Bacterial Agents; Attention Deficit Disorder with Hyperactivity; Child; Female; Gastrointestinal Microbiome; Humans; Odds Ratio; Pregnancy; Prenatal Exposure Delayed Effects
PubMed: 34687335
DOI: 10.1007/s00213-021-05989-3 -
The Australian and New Zealand Journal... Jul 2022Evidence indicates that mood disorders often co-occur with substance-related disorders. However, pooling comorbidity estimates can be challenging due to heterogeneity in... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVES
Evidence indicates that mood disorders often co-occur with substance-related disorders. However, pooling comorbidity estimates can be challenging due to heterogeneity in diagnostic criteria and in the overall study design. The aim of this study was to systematically review and, where appropriate, meta-analyse estimates related to the pairwise comorbidity between mood disorders and substance-related disorders, after sorting these estimates by various study designs.
METHODS
We searched PubMed (MEDLINE), Embase, CINAHL and Web of Science for publications between 1980 and 2017 regardless of geographical location and language. We meta-analysed estimates from original articles in 4 broadly defined mood and 35 substance-related disorders.
RESULTS
After multiple eligibility steps, we included 120 studies for quantitative analysis. In general, regardless of variations in diagnosis type, temporal order or use of adjustments, there was substantial comorbidity between mood and substance-related disorders. We found a sixfold elevated risk between broadly defined mood disorder and drug dependence (odds ratio = 5.7) and fivefold risk between depression and cannabis dependence (odds ratio = 4.9) while the highest pooled estimate, based on period prevalence risk, was found between broadly defined dysthymic disorder and drug dependence (odds ratio = 11.3). Based on 56 separate meta-analyses, all pooled odds ratios were above 1, and 46 were significantly greater than 1 (i.e. the 95% confidence intervals did not include 1).
CONCLUSION
This review found robust and consistent evidence of an increased risk of comorbidity between many combinations of mood and substance-related disorders. We also identified a number of under-researched mood and substance-related disorders, suitable for future scrutiny. This review reinforces the need for clinicians to remain vigilant in order to promptly identify and treat these common types of comorbidity.
Topics: Comorbidity; Humans; Mood Disorders; Odds Ratio; Prevalence; Substance-Related Disorders
PubMed: 34708662
DOI: 10.1177/00048674211054740 -
Scientific Reports Oct 2023Multiple evidence indicates that perinatal factors make impact on immune development and affect offspring allergic rhinitis (AR) risk. In this systematic review and... (Meta-Analysis)
Meta-Analysis
Multiple evidence indicates that perinatal factors make impact on immune development and affect offspring allergic rhinitis (AR) risk. In this systematic review and meta-analysis, we examined available published studies to clarify the relationship between cesarean section (C-section) and offspring AR in children. To explore the relationship between C-section, especially the special attention was paid to different cesarean delivery mode, and the risk of AR in children. Articles were searched using PubMed, Web of Science, EMBASE, Cochrane Library, China knowledge Network, Wanfang, and China Science and Technology Journal databases. A meta-analysis of 22 studies published before August 1, 2022, which included 1,464,868 participants, was conducted for statistical analysis with RevMan5.4. The correlation strength between C-section and offspring AR was determined by combining odds ratio (OR) and 95% confidence interval (95% CI). Meta-regression and subgroup analyses were used to explore potential sources of heterogeneity. Publication bias was detected using the funnel chart and Egger tests. Meta-analysis revealed that there was a significant correlation between C-section and children AR (OR = 1.19, 95% CI: 1.12-1.27, P < 0.001), especially C-section with a family history of allergy (OR = 1.82, 95% CI: 1.36-2.43, P < 0.001). Moreover, elective C-section (without genital tract microbe exposure) had the higher risk of offspring AR (OR = 1.24, 95% CI: 1.05-1.46, P = 0.010) compared with the whole study. Meta-regression demonstrated that sample size explained 38.0% of the variability between studies, and year of publication explained 18.8%. Delivery by C-section, particularly elective C-section and C-section with a family history of allergy can increase the risk of AR in children.
Topics: Child; Female; Humans; Pregnancy; Cesarean Section; Odds Ratio; Rhinitis, Allergic
PubMed: 37884557
DOI: 10.1038/s41598-023-44932-8 -
The Journal of Dermatological Treatment Jun 2022Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by painful nodules, abscesses, sinus tract formation and scarring. The relationship... (Meta-Analysis)
Meta-Analysis
PURPOSE
Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition characterized by painful nodules, abscesses, sinus tract formation and scarring. The relationship between HS and strokes is not well established. To assess this potential association, a systematic review and meta-analysis was performed according to PRISMA guidelines.
MATERIALS AND METHODS
Electronic searches were performed from six online databases. All eligible case-control studies comparing patients with HS versus non-HS were included. All studies must have included either the proportion of patients with strokes (identified ICD-9 or ICD-10 codes) in each group, or the summary effect size for association between HS and strokes. Odds ratio (OR) with 95% confidence interval (CI) was used as the effect size.
RESULTS
Through our search, we identified six case-control studies for inclusion. From pooled data, we found a significantly higher proportion of strokes in HS cases compared with controls (OR 1.74, 95% CI 1.45-2.09; < .00001). Limitations included those studies reviewed were observational by design which are susceptible to bias and lack of randomization.
CONCLUSION
Our pooled findings demonstrate that the odds of stroke are increased in patients with HS when compared with controls. Dermatologists and other clinicians should be vigilant cerebrovascular risk assessment and risk mitigation in patients with HS.
Topics: Case-Control Studies; Hidradenitis Suppurativa; Humans; Inflammation; Odds Ratio; Stroke
PubMed: 34289795
DOI: 10.1080/09546634.2021.1959502 -
Journal of Neurology Oct 2020Season of birth is considered to be associated with multiple sclerosis (MS) although some findings opposing to this assumption raise doubts about the seasonality pattern... (Meta-Analysis)
Meta-Analysis Review
Season of birth is considered to be associated with multiple sclerosis (MS) although some findings opposing to this assumption raise doubts about the seasonality pattern in MS births. The present work synthesizes the evidence of previous published studies aiming at examining whether the month of birth is associated with a higher number of MS births. Pubmed and Scopus were systematically searched and a multivariate meta-analysis of case-control studies was conducted. Data of healthy controls births were retrieved from census reports when not included in the studies. For comparisons, October was set as a reference month and autumn (September-October-November) as a reference season. The meta-analysis included studies that provided the number of MS births for each month or season. Twenty-two eligible studies were included in the meta-analysis involving twenty-four different populations and overall 145,672 MS patients and 75,169,550 healthy controls. The multivariate analysis supports that MS births in spring are higher compared to autumn [odds ratio (OR) 1.14, 95% confidence interval (CI) 1.04, 1.24]. Univariate analyses confirm the same for April (OR 1.12, 95% CI 1.05, 1.21), March (OR 1.05, 95% CI 1.00, 1.11) and May (OR 1.07, 95% CI 1.00, 1.14). A reduction of MS births was found in November (OR 0.96, 95% CI 0.93, 0.99). The month and the season of birth are significantly associated with MS births.
Topics: Humans; Multiple Sclerosis; Multivariate Analysis; Odds Ratio; Risk Factors; Seasons
PubMed: 31055633
DOI: 10.1007/s00415-019-09346-5 -
Human Reproduction (Oxford, England) Apr 2021Is there an association between hereditary thrombophilia in pregnant women and risk of recurrent pregnancy loss (RPL)? (Meta-Analysis)
Meta-Analysis
STUDY QUESTION
Is there an association between hereditary thrombophilia in pregnant women and risk of recurrent pregnancy loss (RPL)?
SUMMARY ANSWER
Pregnant women with hereditary thrombophilia have an increased risk of RPL, especially for pregnant women with the G1691A mutation of the factor V Leiden (FVL) gene, the G20210A mutation of the prothrombin gene (PGM), and deficiency of protein S (PS).
WHAT IS KNOWN ALREADY
Prior studies have suggested that pregnant women with hereditary thrombophilia have a higher risk of RPL, however, the results are inconsistent; furthermore, a complete overview is missing. This lack of information is an obstacle to the risk assessment of RPL in pregnant women with hereditary thrombophilia. A comprehensive meta-analysis on the relation between hereditary thrombophilia and the risk of RPL is needed.
STUDY DESIGN, SIZE, DURATION
A systematic review and meta-analysis was performed using observational studies published in English before 1 April 2020 to evaluate the relation between hereditary thrombophilia and risk of RPL.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Relevant studies were identified from PubMed, Web of Science, and EMBASE searches and complemented with perusal of bibliographies of retrieved articles. The exposure of interest was hereditary thrombophilia, including FVL mutation, PGM, deficiency of antithrombin (AT), deficiency of protein C (PC), and deficiency of PS. The overall risk estimates were pooled using random effects models. Subgroup and sensitivity analyses were carried out to explore possible sources of heterogeneity and assess the robustness of the results.
MAIN RESULTS AND THE ROLE OF CHANCE
A total of 89 studies involving 30 254 individuals were included. Results showed that women with FVL mutation (odds ratio (OR): 2.44, 95% CI: 1.96-3.03), PGM (OR: 2.08, 95% CI: 1.61-2.68), or deficiency of PS (OR: 3.45, 95% CI: 1.15-10.35) had higher risks of developing RPL. Compared with the reference group, there was no observed relation between a deficiency in AT or PC and RPL (all P > 0.05). Heterogeneity in the risk estimates of RPL was partially explained by geographic region, definitions of RPL, types of RPL, and controlled confounders. Sensitivity analyses validated the robustness of the findings.
LIMITATIONS, REASONS FOR CAUTION
Only 39 of the included studies controlled for one or more confounders, and the heterogeneity across all included studies was high. Based on the data available, we cannot determine whether this association is confounded by other potential risk factors of RPL.
WIDER IMPLICATIONS OF THE FINDINGS
This systematic review and meta-analysis show a possible association between hereditary thrombophilia and an increased risk of RPL, suggesting that testing for hereditary thrombophilia should be considered in individuals with RPL.
STUDY FUNDING/COMPETING INTEREST(S)
The study was funded by the Hunan Provincial Key Research and Development Program (Grant number: 2018SK2062) and National Natural Science Foundation Program (Grant number: 81973137). There are no conflicts of interest.
REGISTRATION NUMBER
N/A.
Topics: Abortion, Habitual; Female; Humans; Mutation; Odds Ratio; Pregnancy; Risk Factors; Thrombophilia
PubMed: 33575779
DOI: 10.1093/humrep/deab010