-
Cancer Causes & Control : CCC Oct 2018Despite a strong association between indoor tanning and the risk of cutaneous cancers, the relationship between indoor tanning and non-cutaneous cancers is unknown. Our... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Despite a strong association between indoor tanning and the risk of cutaneous cancers, the relationship between indoor tanning and non-cutaneous cancers is unknown. Our objective was to estimate the association of indoor tanning with developing non-cutaneous cancers.
METHODS
We conducted a systematic literature review and meta-analysis of the association between indoor tanning and non-cutaneous cancer sites. Associations were estimated using random effects models. Heterogeneity was investigated through subgroup analyses and the Q-test and I statistics.
RESULTS
From 15 identified studies, 33 effect estimates for 12 cancer sites were included in the review. Adjustment for sun exposure was a significant source of heterogeneity in the association of indoor tanning and non-cutaneous cancer risk (meta-regression p = 0.0043). When restricting to studies that adjusted for solar ultraviolet radiation (7 studies and 19 effect estimates) a potential increased risk was observed among ever users of indoor tanning devices with the risk of hematologic malignancies (pooled relative risk = 1.11; 95% CI 0.96-1.28), with differing effects observed by hematologic types and subtypes of non-Hodgkin lymphoma. No association was observed among solid non-cutaneous cancers (pooled relative risk = 0.98; 95% CI 0.94-1.19). Neither study design nor geographical region was significant sources of heterogeneity in these associations.
CONCLUSION
When controlling for sun exposure, indoor tanning does not protect against solid non-cutaneous cancers and may increase the risk of some hematologic malignancies. Given the well-established relationship with skin cancer and potential relationship with hematologic malignancies, efforts to reduce the use of indoor tanning devices should continue.
Topics: Hematologic Neoplasms; Humans; Lymphoma, Non-Hodgkin; Neoplasms; Research Design; Risk Factors; Sunbathing; Ultraviolet Rays
PubMed: 30099630
DOI: 10.1007/s10552-018-1070-8 -
International Journal of Obesity (2005) Sep 2022We aimed to evaluate the relationships between body fat percentage (BF%), fat mass (FM), fat mass index (FMI) and visceral (VAT) and subcutaneous adipose tissue (SAT)... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND/OBJECTIVES
We aimed to evaluate the relationships between body fat percentage (BF%), fat mass (FM), fat mass index (FMI) and visceral (VAT) and subcutaneous adipose tissue (SAT) with risk of all-cause mortality.
METHODS
We did a systematic search in PubMed, Scopus, and Web of Science to June 2021. We selected prospective cohorts of the relationship between body fat with risk of all-cause mortality in the general population. We applied random-effects models to calculate the relative risks (RRs) and 95%CIs.
RESULTS
A total of 35 prospective cohort studies with 923,295 participants and 68,389 deaths were identified. The HRs of all-cause mortality for a 10% increment in BF were 1.11 (95%CI: 1.02, 1.20; I = 93%, n = 11) in the general adult populations, and 0.92 (95%CI: 0.79, 1.06; I = 76%, n = 7) in adults older than 60 years. The HRs were 1.06 (95%CI: 1.01, 1.12; I = 86%, n = 10) for a 5 kg increment in FM, 1.11 (95%CI: 1.06, 1.16; I = 79%, n = 7) for a 2 kg/m increment in FMI, and 1.17 (95%CI: 1.03, 1.33; I = 72%, n = 8) and 0.81 (0.66, 0.99; I = 59%, n = 6) for a 1-SD increment in VAT and SAT, respectively. There was a J shaped association between BF% and FM and all-cause mortality risk, with the lowest risk at BF% of 25% and FM of 20 kg. In subgroup analyses, although there was little evidence of between-subgroup heterogeneity, the observed positive associations were more pronounced in studies which had a longer duration, excluded participants with prevalent cardiovascular disease and cancer at baseline, with adjustment for smoking or restricted to never smokers, and less pronounced in studies which adjusted for potential intermediates, suggesting an impact of reverse causation, confounding and over-adjustment in some of the studies.
CONCLUSIONS
Higher body fat content was related to a higher risk of mortality in a J shaped manner. Any future studies should further assess the impact of reverse causation and residual confounding on these associations.
REGISTRATION
PROSPERO (CRD42021240743).
Topics: Adipose Tissue; Adult; Body Mass Index; Cardiovascular Diseases; Humans; Prospective Studies; Subcutaneous Fat
PubMed: 35717418
DOI: 10.1038/s41366-022-01165-5 -
Journal of Women's Health (2002) Jan 2019The association between age at menarche and metabolic syndrome was inconsistent across studies and remains unclear. We conducted a systematic review and meta-analysis of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The association between age at menarche and metabolic syndrome was inconsistent across studies and remains unclear. We conducted a systematic review and meta-analysis of observational studies to assess the association between age at menarche and risk of metabolic syndrome, comprehensively.
MATERIALS AND METHODS
The PubMed and ISI Web of Science databases were searched for all articles published through May 2017, and the reference lists of the retrieved articles were reviewed. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model through combining the study-specific estimates adjusting for potential confounders.
RESULTS
Sixteen observational studies were eligible for the meta-analysis of age at menarche and metabolic syndrome, which included 13,657 cases among 51,453 subjects. The pooled RR of metabolic syndrome for the youngest versus the oldest categories of age at menarche was 1.62 (95% CI: 1.40-1.88) (p for heterogeneity = 0.01, I = 57.3%). The analysis of 1-year decrease in age at menarche conferred a pooled RR of 1.08 (95% CI: 1.01-1.15), suggesting an 8% increase in risk of metabolic syndrome. The association between age at menarche and the risk of metabolic syndrome did not vary by study design, geographical region, number of subjects, and adjustment for confounders.
CONCLUSIONS
Our findings from the current meta-analysis suggest that earlier menarcheal age is associated with higher risk of metabolic syndrome. Age at menarche may help identify women with higher risk of metabolic syndrome. Further well-designed cohort studies are warranted to provide definitive evidence.
Topics: Age Factors; Female; Humans; Menarche; Menstruation Disturbances; Metabolic Syndrome; Observational Studies as Topic
PubMed: 30285527
DOI: 10.1089/jwh.2018.6998 -
BMC Medicine Jan 2014Diabetes history in biologically-related individuals increases diabetes risk. We assessed diabetes concordance in spouses (that is, biologically unrelated family... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Diabetes history in biologically-related individuals increases diabetes risk. We assessed diabetes concordance in spouses (that is, biologically unrelated family members) to gauge the importance of socioenvironmental factors.
METHODS
We selected cross-sectional, case-control and cohort studies examining spousal association for diabetes and/or prediabetes (impaired fasting glucose or impaired glucose tolerance), indexed in Medline, Embase or Scopus (1 January 1997 to 28 February 2013). Effect estimates (that is, odds ratios, incidence rate ratios, and so on) with body mass index (BMI) adjustment were pooled separately from those without BMI adjustment (random effects models) to distinguish BMI-dependent and independent concordance.
RESULTS
Searches yielded 2,705 articles; six were retained (n = 75,498 couples) for systematic review and five for meta-analysis. Concordance was lowest in a study that relied on women's reports of diabetes in themselves and their spouses (effect estimate 1.1, 95% CI 1.0 to 1.30) and highest in a study with systematic assessment of glucose tolerance (2.11, 95% CI 1.74 to 5.10). The random-effects pooled estimate adjusted for age and other covariates but not BMI was 1.26 (95% CI 1.08 to 1.45). The estimate with BMI adjustment was lower (1.18, 95% CI 0.97 to 1.40). Two studies assessing between-spouse associations of diabetes/prediabetes determined by glucose testing reported high concordance (OR 1.92, 95% CI 1.55 to 2.37 without BMI adjustment; 2.32, 95% CI 1.87 to 3.98 with BMI adjustment). Two studies did not distinguish type 1 and type 2 diabetes. However given that around 95% of adults is type 2, this is unlikely to have influenced the results.
CONCLUSIONS
Our pooled estimate suggests that a spousal history of diabetes is associated with a 26% diabetes risk increase. Recognizing shared risk between spouses may improve diabetes detection and motivate couples to increase collaborative efforts to optimize eating and physical activity habits.
Topics: Body Mass Index; Case-Control Studies; Cohort Studies; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Female; Glucose Intolerance; Humans; Life Style; Male; Risk Factors; Spouses
PubMed: 24460622
DOI: 10.1186/1741-7015-12-12 -
Journal of Psychiatric Research Dec 2022Adjustment disorder (AD) is one of the most commonly diagnosed mental health disorders and is generally conceptualized to be mild and short-lived. Despite the frequent... (Review)
Review
Adjustment disorder (AD) is one of the most commonly diagnosed mental health disorders and is generally conceptualized to be mild and short-lived. Despite the frequent use of AD in clinical settings, little is known about the prognosis of this condition. Our goal was to systematically review research on a range of AD outcomes in order to provide a broad characterization of AD prognosis. We conducted searches in MEDLINE, EMBASE, and PsycINFO. We included 31 cohort or randomized controlled trials with a total of 1,385,358 participants. Many patients maintained an AD diagnosis or were diagnosed with another mental health disorder months to years after initial diagnosis. Patients with AD tended to show symptom improvement at higher rates and to utilize less treatment than did patients with other disorders. AD-diagnosed groups experienced subsequent development of numerous physical conditions, such as infection, cancers, Parkinson's disease, and cardiovascular events, at higher rates than did control groups. Results were mixed regarding suicidality and occupational impairment. We rated most studies as having a moderate risk of bias. Based on limited findings, AD appears to progress as a milder disorder than do other disorders, but it not uncommonly transitions to more severe mental health states and may predict the development of future health issues, both mental and physical. Future prospective research that conforms to prognosis study guidelines is needed to better understand the course of this common disorder.
Topics: Humans; Adjustment Disorders; Suicidal Ideation
PubMed: 36347110
DOI: 10.1016/j.jpsychires.2022.10.052 -
CMAJ : Canadian Medical Association... Jan 2008The number of women who delay childbirth to their late 30s and beyond has increased significantly over the past several decades. Studies regarding the relation between... (Review)
Review
BACKGROUND
The number of women who delay childbirth to their late 30s and beyond has increased significantly over the past several decades. Studies regarding the relation between older maternal age and the risk of stillbirth have yielded inconsistent conclusions. In this systematic review we explored whether older maternal age is associated with an increased risk of stillbirth.
METHODS
We searched MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews for all relevant articles (original studies and systematic reviews) published up to Dec. 31, 2006. We included all cohort and case-control studies that measured the association between maternal age and risk of stillbirth. Two reviewers independently abstracted data from all included studies using a standardized data abstraction form. Methodologic and statistical heterogeneities were reviewed and tested.
RESULTS
We identified 913 unique citations, of which 31 retrospective cohort and 6 case-control studies met our inclusion criteria. In 24 (77%) of the 31 cohort studies and all 6 of the case-control studies, we found that greater maternal age was significantly associated with an increased risk of stillbirth; relative risks varied from 1.20 to 4.53 for older versus younger women. In the 14 studies that presented adjusted relative risk, we found no extensive change in the direction or magnitude of the relative risk after adjustment. We did not calculate a pooled relative risk because of the extreme methodologic heterogeneity among the individual studies.
INTERPRETATION
Women with advanced maternal age have an increased risk of stillbirth. However, the magnitude and mechanisms of the increased risk are not clear, and prospective studies are warranted.
Topics: Adult; Case-Control Studies; Cohort Studies; Female; Humans; Maternal Age; Ontario; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnancy, High-Risk; Risk Assessment; Stillbirth
PubMed: 18195290
DOI: 10.1503/cmaj.070150 -
Journal of Alzheimer's Disease : JAD 2020It has been estimated that one third of dementia cases may be preventable through modifiable lifestyle interventions. Epidemiological evidence suggests a link between...
BACKGROUND
It has been estimated that one third of dementia cases may be preventable through modifiable lifestyle interventions. Epidemiological evidence suggests a link between stressful life events and aging-related cognitive decline and dementia; however, inherent methodological limitations in examining subjective and biological measures of stress separately leads to interpretive constraints.
OBJECTIVE
The aim of the current study was to conduct a systematic review of the research literature investigating the effect of perceived and biological measures of stress on dementia risk.
METHODS
A systematic review was conducted of cohort, case-control, longitudinal prospective or retrospective studies examining the association between stress and risk of developing dementia. Studies were identified from a systematic search across major electronic databases from inception to February 2020.
RESULTS
Overall, 22 studies were identified including a total of 496,556 participants, approximately 50% were females, with sample sizes ranging from 62-270,977. There was considerable heterogeneity in the definition and measurement of stress. Most of the identified studies reported a significant positive association between stress and dementia risk.
CONCLUSION
Evidenced from the current review is that personality traits linked to increased perceived stress and elevated reported perceived stress, are associated with greater statistical risk for dementia. However, this review highlights that caution must be exhibited in interpreting these findings, as methodological issues with confounding adjustment may mediate these results. Future research should focus on the investigation of stress on dementia risk with a full range of confounding adjustment, and on biological measures of stress.
Topics: Adult; Aged; Alzheimer Disease; Case-Control Studies; Cohort Studies; Dementia; Female; Humans; Male; Middle Aged; Personality; Prospective Studies; Retrospective Studies; Stress, Psychological
PubMed: 33016901
DOI: 10.3233/JAD-191096 -
PloS One 2018Pregnancy-related critical illness leads to death for 3-14% of affected women. Although identifying patients at risk could facilitate preventive strategies, guide... (Meta-Analysis)
Meta-Analysis
PURPOSE
Pregnancy-related critical illness leads to death for 3-14% of affected women. Although identifying patients at risk could facilitate preventive strategies, guide therapy, and help in clinical research, no prior systematic review of this literature exploring the validity of risk prediction models for maternal mortality exists. Therefore, we have systematically reviewed and meta-analyzed risk prediction models for maternal mortality.
METHODS
Search strategy: MEDLINE, EMBASE and Scopus, from inception to May 2017. Selection criteria: Trials or observational studies evaluating risk prediction models for maternal mortality. Data collection and analysis: Two reviewers independently assessed studies for eligibility and methodological quality, and extracted data on prediction performance.
RESULTS
Thirty-eight studies that evaluated 12 different mortality prediction models were included. Mortality varied across the studies, with an average rate 10.4%, ranging from 0 to 41.7%. The Collaborative Integrated Pregnancy High-dependency Estimate of Risk (CIPHER) model and the Maternal Severity Index had the best performance, were developed and validated from studies of obstetric population with a low risk of bias. The CIPHER applies to critically ill obstetric patients (discrimination: area under the receiver operating characteristic curve (AUC) 0.823 (0.811-0.835), calibration: graphic plot [intercept-0.09, slope 0.92]). The Maternal Severity Index applies to hospitalized obstetric patients (discrimination: AUC 0.826 [0.802-0.851], calibration: standardized mortality ratio 1.02 [0.86-1.20]).
CONCLUSIONS
Despite the high heterogeneity of the study populations and the limited number of studies validating the finally eligible prediction models, the CIPHER and the Maternal Severity Index are recommended for use among critically ill and hospitalized pregnant and postpartum women for risk adjustment in clinical research and quality improvement studies. Neither index has sufficient discrimination to be applicable for clinical decision making at the individual patient level.
Topics: Area Under Curve; Critical Illness; Databases, Factual; Delivery, Obstetric; Female; Humans; Maternal Mortality; Pregnancy; ROC Curve; Risk
PubMed: 30513118
DOI: 10.1371/journal.pone.0208563 -
JAMA Dec 2008Low birth weight is implicated as a risk factor for type 2 diabetes. However, the strength, consistency, independence, and shape of the association have not been... (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Low birth weight is implicated as a risk factor for type 2 diabetes. However, the strength, consistency, independence, and shape of the association have not been systematically examined.
OBJECTIVE
To conduct a quantitative systematic review examining published evidence on the association of birth weight and type 2 diabetes in adults.
DATA SOURCES AND STUDY SELECTION
Relevant studies published by June 2008 were identified through literature searches using EMBASE (from 1980), MEDLINE (from 1950), and Web of Science (from 1980), with a combination of text words and Medical Subject Headings. Studies with either quantitative or qualitative estimates of the association between birth weight and type 2 diabetes were included.
DATA EXTRACTION
Estimates of association (odds ratio [OR] per kilogram of increase in birth weight) were obtained from authors or from published reports in models that allowed the effects of adjustment (for body mass index and socioeconomic status) and the effects of exclusion (for macrosomia and maternal diabetes) to be examined. Estimates were pooled using random-effects models, allowing for the possibility that true associations differed between populations.
DATA SYNTHESIS
Of 327 reports identified, 31 were found to be relevant. Data were obtained from 30 of these reports (31 populations; 6090 diabetes cases; 152 084 individuals). Inverse birth weight-type 2 diabetes associations were observed in 23 populations (9 of which were statistically significant) and positive associations were found in 8 (2 of which were statistically significant). Appreciable heterogeneity between populations (I(2) = 66%; 95% confidence interval [CI], 51%-77%) was largely explained by positive associations in 2 native North American populations with high prevalences of maternal diabetes and in 1 other population of young adults. In the remaining 28 populations, the pooled OR of type 2 diabetes, adjusted for age and sex, was 0.75 (95% CI, 0.70-0.81) per kilogram. The shape of the birth weight-type 2 diabetes association was strongly graded, particularly at birth weights of 3 kg or less. Adjustment for current body mass index slightly strengthened the association (OR, 0.76 [95% CI, 0.70-0.82] before adjustment and 0.70 [95% CI, 0.65-0.76] after adjustment). Adjustment for socioeconomic status did not materially affect the association (OR, 0.77 [95% CI, 0.70-0.84] before adjustment and 0.78 [95% CI, 0.72-0.84] after adjustment). There was no strong evidence of publication or small study bias.
CONCLUSION
In most populations studied, birth weight was inversely related to type 2 diabetes risk.
Topics: Adult; Aged; Birth Weight; Diabetes Mellitus, Type 2; Humans; Middle Aged; Risk
PubMed: 19109117
DOI: 10.1001/jama.2008.886 -
Association of Malnutrition with Risk of Acute Kidney Injury: A Systematic Review and Meta-Analysis.International Journal of Clinical... 2023Acute kidney injury (AKI) is a complex clinical syndrome of hospitalization that may be affected by undernutrition and metabolic changes. The aim of this meta-analysis... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Acute kidney injury (AKI) is a complex clinical syndrome of hospitalization that may be affected by undernutrition and metabolic changes. The aim of this meta-analysis was to systematically assess the association between malnutrition and the risk of prevalent AKI.
MATERIALS AND METHODS
We searched PubMed, Embase, Ovid MEDLINE, Web of Science, and Chinese databases (WANFANG, VIP, and CKI) from database inception until May 1, 2023, for studies evaluating the association of malnutrition with the risk of AKI. Summary odds ratios (ORs) were estimated using a random-effects model.
RESULTS
We identified 17 observational studies, which included 273,315 individuals. Compared with patients with normal nutritional status, those with malnutrition had a 125% increased risk of prevalent AKI (pooled ORs, 2.25; 95% confidence interval, 1.80-2.82). Malnutrition was also significantly associated with prevalent AKI across all subgroups when subgroup analyses were performed on covariates such as region, study design, age, sample size, malnutrition assessment method, patient characteristics, covariate adjustment degree, and risk of bias. Meta-regression models demonstrated no significant differences in AKI risk between patients with malnutrition and without malnutrition.
CONCLUSIONS
Our results suggest that malnutrition may be a potential target for AKI prevention. However, well-designed studies with ethnically or geographically diverse populations are needed to evaluate strategies and interventions to prevent or slow the development and progression of AKI in malnourished individuals.
Topics: Humans; Acute Kidney Injury; Malnutrition; Nutritional Status
PubMed: 37795077
DOI: 10.1155/2023/9910718