-
International Journal of Stroke :... Jun 2015Chinese populations are reported to have a different distribution of ischemic stroke subtypes compared with Caucasians. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Chinese populations are reported to have a different distribution of ischemic stroke subtypes compared with Caucasians.
AIMS
To understand this better, we aimed to evaluate the differences in prevalence of risk factors in ischemic stroke and their distributions among ischemic stroke subtypes in Chinese vs. Caucasians.
SUMMARY OR REVIEW
We systematically sought studies conducted since 1990 with data on frequency of risk factors among ischemic stroke subtypes in Chinese or Caucasians. For each risk factor, we calculated study-specific and random effects pooled estimates in Chinese and Caucasians separately for: prevalence among ischemic stroke; odds ratios, comparing prevalence for each ischemic stroke subtype vs. all others. We included seven studies among 16,199 Chinese, and eleven among 16,189 Caucasian ischemic stroke patients. Risk factors studied were hypertension, diabetes, atrial fibrillation, ischemic heart disease, hypercholesterolemia, smoking and alcohol. Chinese ischemic stroke patients had younger onset of stroke than Caucasians, similar prevalence of hypertension, diabetes, smoking and alcohol, and significantly lower prevalence of atrial fibrillation, ischemic heart disease and hypercholesterolemia. Risk factor associations with ischemic stroke subtypes were mostly similar among Chinese and Caucasian ischemic stroke patients. Compared with all other ischemic subtypes, diabetes was more common in large artery stroke, atrial fibrillation and ischemic heart disease in cardioembolic stroke, and hypertension and diabetes in lacunar stroke.
CONCLUSION
Our study showed a lower prevalence of atrial fibrillation, ischemic heart disease and hypercholesterolemia in Chinese, and mostly similar risk factor associations in Chinese and Caucasian ischemic stroke patients. Further analyses of individual patient data to allow adjustment for confounders are needed to confirm and extend these findings.
Topics: Asian People; Brain Ischemia; China; Humans; Risk Factors; Stroke; White People
PubMed: 25907735
DOI: 10.1111/ijs.12508 -
The Pediatric Infectious Disease Journal Dec 2012Mannose-binding lectin (MBL) can activate the complement system by binding to carbohydrates, such as those presented on the HIV virion surface. It is unclear whether... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Mannose-binding lectin (MBL) can activate the complement system by binding to carbohydrates, such as those presented on the HIV virion surface. It is unclear whether genetically determined MBL deficiency is related to vertical HIV transmission and disease progression in HIV-infected children.
METHODS
A literature search of Medline, Embase and Cochrane Central Register identified all relevant studies on MBL and HIV infection in children. We extracted information on the characteristics of the study group, method of MBL analysis, outcome definitions, follow-up and the risk estimates. The validity of each study was assessed.
RESULTS
Nine studies were retrieved. Most were of good validity, but risk adjustment for confounders was missing in 6 studies. Age, treatment and outcome definitions differed between the study groups. In most of the studies, MBL deficiency was associated with an increased frequency of vertical HIV transmission and an increased speed of disease progression. In the 2 most valid studies, carriers of variant genes had an increased odds ratio for transmission and an increased relative hazard for disease progression and central nervous system impairment, especially in children <2 years of age.
CONCLUSIONS
MBL deficiency is associated with an increased risk of vertical HIV transmission. How this risk relates to other factors that influence transmission is unclear. The association between HIV disease progression and MBL deficiency is most pronounced in children <2 years of age, probably due to immaturity of their adaptive immunity.
Topics: Child; Child, Preschool; Disease Progression; HIV Infections; Humans; Infant; Infectious Disease Transmission, Vertical; Mannose-Binding Lectin; Risk Assessment
PubMed: 22810018
DOI: 10.1097/INF.0b013e3182678bc4 -
Gastroenteritis exposure and the risk of schizophrenia onset: A systematic review and meta-analysis.Journal of Psychosomatic Research Jul 2020The association between gastroenteritis exposure and schizophrenia (SCZ) onset has been investigated, but the findings were inconsistent. This study aimed to determine... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The association between gastroenteritis exposure and schizophrenia (SCZ) onset has been investigated, but the findings were inconsistent. This study aimed to determine whether gastroenteritis would increase the risk of SCZ onset.
METHODS
We performed a systematic literature search in PubMed, Cochrane Library and the Web of Science database up to 23 November 2019. The pooled relative risk (RR) with 95% confidence interval (CI) was used to estimate the effect of gastroenteritis on SCZ. Stratified analysis was conducted by study design, diagnostic criteria, region, adjustment for confounders, gastroenteritis sub-classification and data source.
RESULTS
This meta-analysis included nine published articles with 13,830,871 subjects. Overall, there was no significant relationship between gastroenteritis and SCZ onset (N [number of studies] = 11, RR = 1.06, 95% CI: 0.81-1.39). However, pooled results from cohort studies suggested that gastroenteritis significantly increased the risk of SCZ (N = 7, RR = 1.27, 95% CI = 1.05-1.53). Increased risk of SCZ was observed in America (N = 3) and Australia (N = 2), whereas no association was found in Europe (N = 1) and Asia (N = 5). The pooled RR, adjusting for ≥2 confounders (N = 5), was higher than those adjusting for <2 confounders (N = 6). The effects also varied in diagnostic criteria, gastroenteritis sub-classification and data source.
CONCLUSION
Based on current research evidence, it is not yet certain that gastroenteritis is a risk factor for SCZ, and more research on the association between specific gastroenteritis and SCZ is needed.
Topics: Cohort Studies; Gastroenteritis; Humans; Risk Factors; Schizophrenia
PubMed: 32417692
DOI: 10.1016/j.jpsychores.2020.110136 -
American Journal of Ophthalmology Apr 2008To review systematically the evidence currently available on alcohol consumption and the risk of age-related macular degeneration (AMD). (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To review systematically the evidence currently available on alcohol consumption and the risk of age-related macular degeneration (AMD).
DESIGN
Systematic review and meta-analysis of observational studies.
METHODS
Seven databases were searched systematically with no limits on the year or language of publication for prospective cohort studies. References identified from pertinent reviews and articles also were retrieved. Two reviewers independently searched the above databases and selected the studies using prespecified standardized criteria. These criteria included appropriate adjustment for age and smoking in the analysis. Of the 441 studies identified initially, five cohort studies met the selection criteria. Data extraction and study quality evaluation were performed independently by two reviewers and results were pooled quantitatively using meta-analytic methods.
RESULTS
The five cohort studies included 136,946 people, among whom AMD developed in 1923 (1,513 early and 410 late). Pooled results showed that heavy alcohol consumption was associated with an increased risk of early AMD (pooled odds ratio, 1.47; 95% confidence interval, 1.10 to 1.95), whereas the association between heavy alcohol consumption and risk of late AMD was inconclusive. There were insufficient data to evaluate a dose-response association between alcohol consumption and AMD or the association between moderate alcohol consumption and AMD.
CONCLUSIONS
Heavy alcohol consumption (more than three standard drinks per day) is associated with an increased risk of early AMD. Although this association seems to be independent of smoking, residual confounding effects from smoking cannot be excluded completely.
Topics: Alcohol Drinking; Databases, Factual; Humans; Macular Degeneration; Odds Ratio; Risk Factors
PubMed: 18242575
DOI: 10.1016/j.ajo.2007.12.005 -
Journal of Nutritional Science 2017Pregnancy and lactation deplete nutrients essential to the neurotransmission system. This may be one reason for the increased risk of depression during the perinatal... (Review)
Review
Pregnancy and lactation deplete nutrients essential to the neurotransmission system. This may be one reason for the increased risk of depression during the perinatal period. The objective of the present review was to systematically review the literature and summarise evidence on whether blood nutrient levels influence the risk of perinatal depression. PubMed, EMBASE and CINAHL databases were searched for studies of any design. A total of twenty-four articles of different designs were included, representing 14 262 subjects. We extracted data on study population, depression prevalence, nutrients examined, deficiency prevalence, timing of assessment, reporting, analysis strategy and adjustment factors. In all, fourteen studies found associations of perinatal depression with lower levels of folate, vitamin D, Fe, Se, Zn, and fats and fatty acids, while two studies found associations between perinatal depression and higher nutrient levels, and eight studies found no evidence of an association. Only ten studies had low risk of bias. Given the methodological limitations and heterogeneity of study approaches and results, the evidence for a causal link between nutritional biomarkers and perinatal depression is still inconclusive. High-quality studies in deficient populations are needed.
PubMed: 29296279
DOI: 10.1017/jns.2017.58 -
Nutrition Reviews Sep 2014A systematic review of the evidence for an association between sugar-sweetened beverages and risk of obesity was conducted. This review focused specifically on the role... (Review)
Review
A systematic review of the evidence for an association between sugar-sweetened beverages and risk of obesity was conducted. This review focused specifically on the role of sugar-sweetened beverages in obesity risk, taking into account energy balance. For the purpose of this review, scientific conclusions could not be drawn from the intervention studies that evaluated the relationship between sugar-sweetened beverage intake and obesity risk. Results of observational studies that examined the relationship between sugar-sweetened beverage intake and obesity risk that were adjusted for energy intake and physical activity were inconsistent for each of the three age groups evaluated (children, adolescents, and adults). From this review, evidence for an association between sugar-sweetened beverage intake and obesity risk is inconsistent when adjustment for energy balance is made.
Topics: Adolescent; Adult; Aged; Beverages; Carbohydrate Metabolism; Child; Cohort Studies; Energy Intake; Exercise; Humans; Middle Aged; Obesity; Risk; Sweetening Agents
PubMed: 25091794
DOI: 10.1111/nure.12128 -
Schizophrenia (Heidelberg, Germany) Mar 2024This systematic review provides a comprehensive overview of the association between premorbid adjustment and social cognition in people with psychotic spectrum disorder.... (Review)
Review
This systematic review provides a comprehensive overview of the association between premorbid adjustment and social cognition in people with psychotic spectrum disorder. Obtaining evidence of this association will facilitate early detection and intervention before the onset of psychosis. Literature searches were conducted in Scopus, PubMed and PsycINFO. Studies were eligible if they included patients with a psychotic disorder or at a high-risk state; social cognition and premorbid adjustment were measured; and the relationship between premorbid adjustment and social cognition was analysed. The authors independently extracted data from all included articles, and discrepancies were resolved through discussion. Literature searches were conducted in Scopus, PubMed and PsycINFO. Studies were eligible if they included patients with a psychotic disorder or at a high-risk state; social cognition and premorbid adjustment were measured; and the relationship between premorbid adjustment and social cognition was analysed. The authors independently extracted data from all included articles, and discrepancies were resolved through discussion. Of 229 studies identified, 23 met the inclusion criteria. Different methods of assessment were used to measure premorbid adjustment, such as the Premorbid Adjustment Scale or premorbid IQ, among others. Social cognition was assessed as a global measure or by domains using different instruments. A total of 16 articles found a relationship between social cognition (or its domains) and premorbid adjustment: general social cognition (n = 3); Theory of Mind (n = 12); Emotional Recognition and Social Knowledge (n = 1). This review shows evidence of a significant relationship between social cognition and premorbid adjustment, specifically between Theory of Mind and premorbid adjustment. Social cognition deficits may already appear in phases prior to the onset of psychosis, so an early individualized intervention with stimulating experiences in people with poor premorbid adjustment can be relevant for prevention. We recommend some future directions, such as carrying out longitudinal studies with people at high-risk of psychosis, a meta-analysis study, broadening the concept of premorbid adjustment, and a consensual assessment of social cognition and premorbid adjustment variables. PROSPERO registration number: CRD42022333886.
PubMed: 38491028
DOI: 10.1038/s41537-023-00428-y -
Experimental Diabetes Research 2011We systematically reviewed research examining the association between gestational diabetes (GDM) and childhood overweight and obesity. We identified studies from three... (Review)
Review
We systematically reviewed research examining the association between gestational diabetes (GDM) and childhood overweight and obesity. We identified studies from three sources: (1) a PubMed search of articles published between January 1990-January 2011, (2) reference lists of publications from the PubMed search, and (3) reference lists of review articles. We included studies that examined GDM separately from pregestational diabetes and childhood overweight or obesity defined as BMI > 85th or 95th percentile. A total of 12 studies were included in the systematic review. Crude odds ratios for the relationship between GDM and childhood overweight or obesity ranged from 0.7 to 6.3; in 8 studies, the associations were not statistically significant. In only 3 studies were results adjusted for any confounders; in the 2 that adjusted for prepregnancy obesity, the GDM and childhood overweight or obesity associations were attenuated and not statistically significant after adjustment. This paper demonstrates inconsistent evidence of an association between GDM and offspring overweight and obesity due to the methodological limitations of existing studies. Recommendations for future research are presented, which address methodological challenges.
Topics: Adolescent; Child; Child, Preschool; Diabetes, Gestational; Female; Humans; Hyperglycemia; Male; Maternal-Fetal Exchange; Obesity; Overweight; Pregnancy; Prenatal Exposure Delayed Effects; Risk Factors
PubMed: 21960991
DOI: 10.1155/2011/541308 -
Journal of Endocrinological... Mar 2020The aim of this study was to systematically investigate whether, and to what extent, the detection of thyroid autoimmunity during pregnancy and in the weeks after... (Meta-Analysis)
Meta-Analysis
PURPOSE
The aim of this study was to systematically investigate whether, and to what extent, the detection of thyroid autoimmunity during pregnancy and in the weeks after childbirth is associated with an increased risk of developing post-partum depression (PPD), a condition associated with possible adverse outcomes for both mother and offspring. We performed a systematic review and meta-analysis of longitudinal studies, assessing the incidence of PPD in women with and without anti-thyroperoxidase antibody (TPOAb) positivity.
METHODS
We searched MEDLINE, EMBASE, Web of Science, Cochrane Library, and CINAHL. Methodological quality of the studies was assessed by the Newcastle-Ottawa Scale. In the presence of even modest between-studies heterogeneity, assessed by Cochrane Q and I tests, risk ratios (RRs) for PPD were combined using a random effects model. Funnel plot and trim-and-fill analysis were used to assess publication bias.
RESULTS
Five included studies provided information on 449 women with TPOAb-positive and 2483 TPOAb-negative women. Pooled RR indicated a significantly increased risk to develop PPD in TPOAb-positive group (RR 1.49, 95% CI 1.11-2.00; P = 0.008; I = 47%, P = 0.11). Consistent with a possible publication bias, the trim-and-fill test detected two putative missing studies in the funnel plot. Nevertheless, the adjustment for publication bias produced a negligible effect on the pooled estimate (adjusted RR 1.41, 95% CI 1.18-1.68, P = 0.0002).
CONCLUSIONS
Thyroid autoimmunity during pregnancy and in the weeks after childbirth is associated with an increased risk of developing PPD. Further well-designed studies are warranted to confirm this association and elucidate underlying pathophysiological mechanisms.
PROSPERO REGISTRATION
CRD42019129643.
Topics: Autoantibodies; Autoimmunity; Depression, Postpartum; Female; Humans; Iodide Peroxidase; Pregnancy; Risk Factors; Thyroid Gland
PubMed: 31552596
DOI: 10.1007/s40618-019-01120-8 -
Cardiology in Review 2020Intensive glycemic control significantly increases the risk of hypoglycemia in patients with diabetes mellitus. Recent data have shown that hypoglycemia may also be a... (Meta-Analysis)
Meta-Analysis
Intensive glycemic control significantly increases the risk of hypoglycemia in patients with diabetes mellitus. Recent data have shown that hypoglycemia may also be a marker of cardiovascular disease in these patients. We performed a systemic review and a meta-analysis to evaluate the relationship between severe hypoglycemic events (SHEs) and the subsequent risk of mortality and major adverse cardiovascular events (MACE) in patients with diabetes mellitus. PubMed, Cochrane library, and Embase were searched for randomized controlled trials between January 2006 and December 17, 2018 that reported cardiovascular outcomes in diabetic patients with a history of SHEs. The primary outcomes of interest were all-cause mortality, cardiovascular mortality, and MACE. Other outcomes assessed included myocardial infarction and hospitalization for unstable angina or heart failure. Data from 9 RCTs and 3,462 randomized patients were available. Patients who suffered an SHE were found to have a significantly increased risk of subsequent all-cause mortality (hazard ratio [HR] 2.24; 95% confidence interval [CI] 1.70, 2.95; P-value <0.01), cardiovascular mortality (HR 2.32; 95% CI 1.67, 3.22; P-value <0.01), and MACE (HR 1.66; 95% CI 1.35, 2.06; P-value <0.01) compared to the patients without an SHE. The increased risks of subsequent stroke and arrhythmic death (P-value<0.05) were also found. There was no significant association between SHE and the risk of subsequent myocardial infarction or hospitalization for unstable angina or heart failure. In conclusion, the occurrence of an SHE in patients with diabetes mellitus was associated with a significantly increased risk for subsequent cardiovascular morbidity and mortality.
Topics: Cardiovascular Diseases; Diabetes Mellitus; Humans; Hypoglycemia; Hypoglycemic Agents; Mortality; Randomized Controlled Trials as Topic; Risk Adjustment
PubMed: 31868770
DOI: 10.1097/CRD.0000000000000276