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Archives of Iranian Medicine Jan 2021There are limited data on vascular risk factors (VRFs) in low- and middle-income countries (LMICs). This meta-analysis was completed to summarize the existing evidence... (Meta-Analysis)
Meta-Analysis
BACKGROUND
There are limited data on vascular risk factors (VRFs) in low- and middle-income countries (LMICs). This meta-analysis was completed to summarize the existing evidence on stroke risk factors (SRFs) in the Iranian population.
METHODS
An electronic literature search of the databases including PubMed, Embase, Web of Science, Scopus, Scientific Information Database (SID), Magiran, and IranMedex was performed to identify the related articles published up to March 2018. For categorical or continuous variables, the data were also pooled using the fixed- or the random-effect models, respectively, expressed as odds ratio (OR) or weighted mean difference (WMD).
RESULTS
A total of 15 articles were recruited. The risk of stroke was associated with mean age, but not gender. Among traditional VRFs, hypertension (HTN), systolic and diastolic blood pressure (DBP), diabetes mellitus (DM), and fasting blood glucose (FBG) were associated with increased risk of stroke. Apart from the high circulating levels of triglycerides (TG), low-density lipoprotein-cholesterol (LDL-C), total cholesterol (TC), and low high-density lipoprotein-cholesterol (HDL-C), other potential risk factors namely cigarette smoking (CS), opioid addiction (OD), and waist circumference (WC) were identified to be independent stroke determinants.
CONCLUSION
The present systematic review and meta-analysis provided a summary of the most important SRFs, which are potentially modifiable and preventable. Overall, Iran, similar to many other LMICs, is experiencing an ever-increasing rate of stroke-prone elderly people. The LMICs are thus suggested to develop national approaches to recognize and address VRFs, to monitor and control CS and OD rates, and to encourage a healthy lifestyle.
Topics: Age Factors; Aged; Female; Healthy Lifestyle; Humans; Hypercholesterolemia; Hypertension; Iran; Male; Middle Aged; Risk Factors; Smoking; Stroke
PubMed: 33588570
DOI: 10.34172/aim.2021.10 -
Diabetes Research and Clinical Practice Jan 2019To examine the relationship of non-high-density lipoprotein cholesterol (non-HDL-C) level with cardiovascular disease (CVD) risk in type 2 diabetes patients and the... (Meta-Analysis)
Meta-Analysis
Non-high-density lipoprotein cholesterol and risk of cardiovascular disease in the general population and patients with type 2 diabetes: A systematic review and meta-analysis.
AIMS
To examine the relationship of non-high-density lipoprotein cholesterol (non-HDL-C) level with cardiovascular disease (CVD) risk in type 2 diabetes patients and the general population by conducting a meta-analysis.
METHODS
We made a comprehensive literature search for relevant observational studies investigating the relationship of non-HDL-C level with CVD risk in the general population and type 2 diabetes patients using the PubMed and Embase databases. Pooled risk ratio (RR) with 95% confidence intervals (CI) was calculated for the highest versus the reference lower non-HDL-Cl.
RESULTS
A total of 13 studies with 156,381 individuals were included. The pooled RR of CVD was 1.59 (95% CI 1.46-1.72) in the general population and 1.99 (95% CI 1.57-2.51) in type 2 diabetes patients. Subgroup analysis showed the similar effect of non-HDL-C on CVD risk between men (RR1.98; 95% CI 1.70-2.30) and women (RR 1.63; 95% CI 1.35-1.96). However, elevated non-HDL-C was not associated with higher risk of cardiovascular mortality in the general population (RR 1.64; 95% CI 0.96-2.80) and type 2 diabetes patients (RR 1.08; 95% CI 0.57-2.07).
CONCLUSIONS
Elevated non-HDL-C level is associated with an increased risk of CVD in the general population and type 2 diabetes patients.
Topics: Cardiovascular Diseases; Cholesterol; Diabetes Mellitus, Type 2; Female; Humans; Lipoproteins; Male; Risk Factors
PubMed: 30448450
DOI: 10.1016/j.diabres.2018.11.002 -
Herz Sep 2020The VOYAGER meta-analysis reported on the low-density lipoprotein cholesterol (LDL-C)-lowering effect of commonly used statins in Caucasian subjects. As there is limited... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The VOYAGER meta-analysis reported on the low-density lipoprotein cholesterol (LDL-C)-lowering effect of commonly used statins in Caucasian subjects. As there is limited literature available on the efficacy of statins in Asian populations, the current meta-analysis compared the effects of rosuvastatin and atorvastatin on LDL-C levels in an East Asian population.
METHODS
The MEDLINE, PubMed, Embase, Cochrane Library, and Web of Science databases were searched for randomized controlled trials comparing lipid-lowering effects of rosuvastatin and atorvastatin in an East Asian population. Data on the study design, participant characteristics, and outcomes were extracted. Odds ratios (OR), weighted mean differences (WMD), or standardized mean differences were calculated using the random-effects model.
RESULTS
The meta-analysis comprised 16 randomized controlled trials with 5930 participants. Compared with atorvastatin, patients treated with rosuvastatin had a significant reduction in LDL-C: WMD = -7.15 mg/dl (95% confidence intervals [CI]: -10.71--3.60) mg/dl, p < 0.0001. Meta-regression analyses revealed no significant association between the superior benefits of rosuvastatin and other variables including age, sex, baseline LDL-C level, and follow-up duration. Additionally, the rosuvastatin group of patients, who were treated with half the dose of atorvastatin, achieved a significantly greater reduction in LDL-C levels (WMD = -3.57; 95% CI: -5.40--1.74 mg/dl, p < 0.001). Both rosuvastatin and atorvastatin were well tolerated, with similar incidences of adverse events.
CONCLUSION
Similar to the VOYAGER meta-analysis, which reported a greater efficacy of rosuvastatin in comparison with atorvastatin and simvastatin in Caucasian patients, we found that the efficacy of rosuvastatin was superior to atorvastatin in East Asian patients with hypercholesterolemia.
Topics: Atorvastatin; Cholesterol, LDL; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypercholesterolemia; Rosuvastatin Calcium; Treatment Outcome
PubMed: 30483816
DOI: 10.1007/s00059-018-4767-2 -
Health & Place Jan 2021Reducing the retail availability of tobacco has been proposed as a component of tobacco endgame, yet it is not known whether retail availability has a direct impact on... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Reducing the retail availability of tobacco has been proposed as a component of tobacco endgame, yet it is not known whether retail availability has a direct impact on smoking behaviours. A narrative review and a meta-analysis have been undertaken to examine the density and proximity of tobacco retail outlets, but were limited in scope, exposure and outcome variables. The aim of this current study was to undertake a systematic review of the international literature on the density and proximity of tobacco retail outlets to homes, schools and communities and their association with smoking behaviours among youth.
METHODS
We reviewed and critically appraised the evidence documenting the association between density or proximity of tobacco retail outlets and smoking behaviours among school-age youth (18 and under), between 1 January 1990 and 21 October 2019. We reviewed original quantitative research that examined the associations of tobacco retail outlet density and proximity with individual smoking status or population-level smoking prevalence; initiation of smoking; frequency of tobacco use; sales to minors; purchasing by minors; susceptibility to smoking among non-smokers; perceived prevalence of smoking, and quitting behaviours.
FINDINGS
Thirty-five peer-reviewed papers met the inclusion criteria. This review provided evidence of a relationship between density of tobacco retail outlets and smoking behaviours, particularly for the density near youths' home. A study using activity spaces also found a significant positive association between exposure to tobacco retail outlets and daily tobacco use. The review did not provide evidence of an association between the proximity of tobacco retail outlets to homes or schools and smoking behaviours among youth.
CONCLUSIONS
The existing evidence supports a positive association between tobacco retail outlet density and smoking behaviours among youth, particularly for the density near youths' home. This review provides evidence for the development and implementation of policies to reduce the density of tobacco retail outlets to reduce smoking prevalence among youth.
Topics: Adolescent; Adolescent Behavior; Commerce; Humans; Smoking; Nicotiana; Tobacco Products; Tobacco Use
PubMed: 33526204
DOI: 10.1016/j.healthplace.2019.102275 -
American Journal of Public Health Dec 2012It has been suggested that people in racial/ethnic minority groups are healthier when they live in areas with a higher concentration of people from their own ethnic... (Review)
Review
It has been suggested that people in racial/ethnic minority groups are healthier when they live in areas with a higher concentration of people from their own ethnic group, a so-called ethnic density effect. Ethnic density effects are still contested, and the pathways by which ethnic density operates are poorly understood. The aim of this study was to systematically review the literature examining the ethnic density effect on physical health, mortality, and health behaviors. Most studies report a null association between ethnic density and health. Protective ethnic density effects are more common than adverse associations, particularly for health behaviors and among Hispanic people. Limitations of the literature include inadequate adjustment for area deprivation and limited statistical power across ethnic density measures and study samples.
Topics: Aged; Black People; Ethnicity; Health Behavior; Health Status; Hispanic or Latino; Humans; Infant Mortality; Infant, Newborn; Middle Aged; Minority Groups; Mortality; Population Density; United States
PubMed: 23078507
DOI: 10.2105/AJPH.2012.300832 -
Toxins Jul 2022Owing to their low minimal environmental risk and other ethical considerations, plant-derived sterilants are used to control rodent populations. However, the effects of... (Meta-Analysis)
Meta-Analysis Review
Owing to their low minimal environmental risk and other ethical considerations, plant-derived sterilants are used to control rodent populations. However, the effects of plant-derived sterilants are not immediate, and their efficacy on rodent control is controversial, which negatively affects sterilant research and application. Here, a meta-analysis of the available literature was conducted to evaluate the effects of two plant-derived sterilants, triptolide and curcumol, on rodent populations. Using a random-effects and a fixed-effects model, we calculated the weighted mean difference (WMD) and relative risk (RR) and their corresponding 95% confidence intervals (95% CIs). After the application of plant-derived sterilants, the rodent population density tended to decrease. Three outcome-related measures in rodents, i.e., capture rate (RR = 0.31, 95% CI [0.20, 0.47]), pregnancy rate (RR = 0.49, 95% CI [0.40, 0.61]), and sperm survival rate (WMD = -17.53, 95% CI [-28.96, -6.06]), significantly decreased, as shown by a significant reduction of ovarian, uterine, and testicular organ coefficients. However, the number of effective rodent holes did not change significantly after the interventions, indicating that the studied sterilants did not directly eradicate the rodent populations. This study provides a theoretical basis for elucidating the inhibitory mechanisms of plant-derived sterilants on rodent populations and for the rational use of these sterilants.
Topics: Animals; Female; Male; Pest Control; Population Dynamics; Pregnancy; Rodentia; Semen; Spermatozoa; Testis
PubMed: 35878225
DOI: 10.3390/toxins14070487 -
Cureus Apr 2022Coconut oil has been gaining popularity recently, especially with health enthusiasts claiming it to be the best fat for consumption. What is the ideal cooking fat? The... (Review)
Review
Coconut oil has been gaining popularity recently, especially with health enthusiasts claiming it to be the best fat for consumption. What is the ideal cooking fat? The answer that we are all looking for is just not solely based on one health consequence but several. Our study focuses on the cardiovascular aspects of using coconut oil by its influence on low-density lipoprotein (LDL). Cardiovascular diseases (CVDs) are the major cause of death and mortality worldwide. Hence, they are the focus of this study. For centuries, coconut oil has been used by several populations worldwide who consume it as part of their staple diets. However, they have also been consuming the flesh/meat of coconuts and decreased processed foods. One such population is the pacific islanders, who had increased LDL and decreased high-density lipoprotein (HDL) when they moved out of their natural habitat and accepted a more westernized diet. Even though coconut oil has a stronghold on the LDL aspect of the lipid parameters, which is our study's focus, it also increases HDL, whose effects on cardiovascular health are still controversial although it is called "good cholesterol." Cardiologists now utilize the ratio of total to HDL cholesterol to assess CVD risk more reliably. There have not been many human studies to support coconut oil's LDL and CVD advantages, considering all these variables. A thorough search of five databases, including PubMed, PubMed Central, Google Scholar, Cochrane Library, and ScienceDirect, was done. The last search was done on October 8th, 2021. Studies were selected based on the following criteria: last five years, English language, human studies, randomized controlled trials (RCTs), systematic reviews and meta-analysis, narrative reviews, and cross-sectional studies were included using medical subject headings (MeSH) search and keyword search. Eight hundred and ninety-nine articles were found, and eight papers were picked after quality appraisal. These included one narrative review, three RCTs, one cross-sectional study, and three systematic reviews and meta-analyses. The results showed that coconut oil did not behave differently than other saturated fats to reduce LDL. One study showed that coconut oil did not increase LDL compared to additional saturated fat like butter or lard. Coconut oil also has antioxidant properties that may prevent oxidative stress that affects cardiovascular health. However, studies in this sector are limited.
PubMed: 35637823
DOI: 10.7759/cureus.24212 -
Health Policy (Amsterdam, Netherlands) Jul 2009Supplier-induced demand (SID) for health care could be a crucial factor of rising health expenditures. However, there is thus far no consensus on the topic. (Review)
Review
BACKGROUND
Supplier-induced demand (SID) for health care could be a crucial factor of rising health expenditures. However, there is thus far no consensus on the topic.
OBJECTIVE
To assess how physician density (physician-to-population ratio) and health care consumption correlate.
METHODS
A systematic review of studies retrieved through electronic databases: Medline, Econlit, PsychINFO and Embase. Search, inclusion and quality appraisal were based on standard procedures and applied independently by two researchers.
RESULTS
Twenty-five studies, generally of moderate quality, were included. Despite a substantial heterogeneity in study design and data modelling, a significant association between physician density and health care consumption was consistently observed. However, estimates varied according to a number of method parameters such as the definition of the dependent variable (physician volume or care intensity), the geographical entity or the medical specialty under consideration, and the adjustment for confounding factors.
CONCLUSIONS
The exact importance of SID and the underlying motivations remain poorly understood. We discuss technical issues for better SID assessment. In the absence of more accurate information, limiting physician supply as a measure of cost containment should also be considered cautiously.
Topics: Health Services; Humans; Physicians
PubMed: 19150579
DOI: 10.1016/j.healthpol.2008.11.013 -
Sports Medicine (Auckland, N.Z.) Sep 2023High-intensity interval training (HIIT) remains a promising exercise mode in managing cardiometabolic health. Large-scale analyses are necessary to understand its... (Meta-Analysis)
Meta-Analysis
BACKGROUND
High-intensity interval training (HIIT) remains a promising exercise mode in managing cardiometabolic health. Large-scale analyses are necessary to understand its magnitude of effect on important cardiometabolic risk factors and inform guideline recommendations.
OBJECTIVE
We aimed to perform a novel large-scale meta-analysis on the effects of HIIT on cardiometabolic health in the general population.
METHODS
PubMed (MEDLINE), the Cochrane library and Web of Science were systematically searched. Randomised controlled trials (RCTs) published between 1990 and March 2023 were eligible. Research trials reporting the effects of a HIIT intervention on at least one cardiometabolic health parameter with a non-intervention control group were considered.
RESULTS
This meta-analysis included 97 RCTs with a pooled sample size of 3399 participants. HIIT produced significant improvements in 14 clinically relevant cardiometabolic health parameters, including peak aerobic capacity (VO) [weighted mean difference (WMD): 3.895 ml min kg, P < 0.001), left ventricular ejection fraction (WMD: 3.505%, P < 0.001), systolic (WMD: - 3.203 mmHg, P < 0.001) and diastolic (WMD: - 2.409 mmHg, P < 0.001) blood pressure, resting heart rate (WMD: - 3.902 bpm, P < 0.001) and stroke volume (WMD: 9.516 mL, P < 0.001). Body composition also significantly improved through reductions in body mass index (WMD: - 0.565 kg m, P < 0.001), waist circumference (WMD: - 2.843 cm, P < 0.001) and percentage body fat (WMD: - 0.972%, P < 0.001). Furthermore, there were significant reductions in fasting insulin (WMD: - 13.684 pmol L, P = 0.004), high-sensitivity C-reactive protein (WMD: - 0.445 mg dL, P = 0.043), triglycerides (WMD: - 0.090 mmol L, P = 0.011) and low-density lipoprotein (WMD: - 0.063 mmol L, P = 0.050), concurrent to a significant increase in high-density lipoprotein (WMD: 0.036 mmol L, P = 0.046).
CONCLUSION
These results provide further support for HIIT in the clinical management of important cardiometabolic health risk factors, which may have implications for physical activity guideline recommendations.
Topics: Humans; High-Intensity Interval Training; Exercise; Body Mass Index; Blood Pressure; Cardiovascular Diseases; Randomized Controlled Trials as Topic
PubMed: 37204620
DOI: 10.1007/s40279-023-01863-8 -
Acta Psychiatrica Scandinavica May 2016To provide meta-analytical evidence of bone mineral density (BMD), fractures, and osteoporosis rates in eating disorders (ED) vs. healthy controls (HCs). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To provide meta-analytical evidence of bone mineral density (BMD), fractures, and osteoporosis rates in eating disorders (ED) vs. healthy controls (HCs).
METHOD
Three independent authors searched major electronic databases from inception till August 2015 for cross-sectional studies reporting BMD in people with ED (anorexia nervosa, (AN); bulimia nervosa, (BN); eating disorders not otherwise specified, (EDNOS)) vs. HCs. Standardized mean differences (SMDs) ±95% and confidence intervals (CIs) were calculated for BMD, and odds ratios (ORs) for osteopenia, osteoporosis, and fractures.
RESULTS
Overall, 57 studies were eligible, including 21 607 participants (ED = 6485, HCs = 15 122). Compared to HC, AN subjects had significantly lower BMD values at lumbar spine (SMD = -1.51, 95% CI = -1.75, -1.27, studies = 42), total hip (SMD = -1.56, 95%CI = -1.84, -1.28, studies = 23), intertrochanteric region (SMD = -1.80, 95%CI = -2.46, -1.14, studies = 7), trochanteric region (SMD = -1.05, 95%CI = -1.44, -0.66, studies = 7), and femoral neck (SMD = -0.98, 95%CI = -1.12, -0.77, studies = 20). Reduced BMD was moderated by ED illness duration and amenorrhea (P < 0.05). AN was associated with an increased likelihood of osteoporosis (OR = 12.59, 95%CI = 3.30-47.9, P < 0.001, studies = 4) and fractures (OR = 1.84, 95% CI = 1.17-2.89, I(2) = 56, studies = 6). No difference in BMD was found between BN and EDNOS vs. HC.
CONCLUSION
People with AN have reduced BMD, increased odds of osteoporosis and risk of fractures. Proactive monitoring and interventions are required to ameliorate bone loss in AN.
Topics: Bone Density; Comorbidity; Feeding and Eating Disorders; Fractures, Bone; Humans; Osteoporosis
PubMed: 26763350
DOI: 10.1111/acps.12556