-
Obesity Reviews : An Official Journal... Jul 2015While the relationship between body mass index as an indicator of excess body weight and the risk of colorectal cancer (CRC) is well established, the association between... (Meta-Analysis)
Meta-Analysis Review
While the relationship between body mass index as an indicator of excess body weight and the risk of colorectal cancer (CRC) is well established, the association between body weight gain in adulthood and risk of CRC remains unresolved. We quantified this association in a meta-analysis of 12 observational studies published until November 2014 with a total of 16,151 incident CRC cases. Random effect models were used to obtain summary relative risks (RR) and 95% confidence intervals (95% CIs). Between-study heterogeneity was assessed using I(2) statistics. Overall, the summary RR (95% CI) was 1.22 (1.14-1.30) for high body weight gain (midpoint: 15.2 kg) compared with stable weight (P for heterogeneity = 0.182; I(2) = 21.2%). In a dose-response analysis, each 5 kg weight gain was associated with a 4% (95% CI: 2%-5%) higher risk of CRC. The association persisted after adjustment for body weight at younger age and was present for both men and women, as well as for colon and rectal cancer. Differences by sex were detected for colon cancer (P for interaction = 0.003, with higher risk for men than women), but not for rectal cancer (P for interaction = 0.613). In conclusion, these data underscore the importance of body weight management from early adulthood onwards for the prevention of CRC development.
Topics: Colorectal Neoplasms; Humans; Obesity; Observational Studies as Topic; Risk Assessment; Risk Factors; Risk Reduction Behavior; Sex Factors; Waist Circumference; Weight Gain
PubMed: 25925734
DOI: 10.1111/obr.12286 -
International Journal of Environmental... Jan 2022Hereditary cancer syndromes are inherited pathogenic genetic variants that significantly increase the risk of developing cancer. When individuals become aware of their... (Review)
Review
Hereditary cancer syndromes are inherited pathogenic genetic variants that significantly increase the risk of developing cancer. When individuals become aware of their increased probability of having cancer, the whole family is affected by this new reality and needs to adjust. However, adjustment to hereditary cancer syndromes has been mainly studied at an individual level, and research about familial adjustment remains dispersed and disorganized. To overcome this gap, this review aims to understand how families adjust to genetic testing and risk management, and to what extent the family's adjustment influences the psychological response and risk management behaviors of mutation carriers. We conducted searches on the PubMed/Med Line, PsycInfo, SCOPUS, and Google Scholar databases and used the Mixed Methods Appraisal Tool (MMAT-v2018) to assess the methodological quality of each selected study. Thirty studies met the inclusion criteria. Most results highlighted the interdependent nature of adjustment of pathogenic variant carriers and their families. The way carriers adjust to the syndrome is highly dependent on family functioning and related to how family members react to the new genetic information, particularly partners and siblings. Couples who share their worries and communicate openly about cancer risk present a better long-term adjustment than couples who use protective buffering (not talking about it to avoid disturbing the partner) or emotional distancing. Parents need help dealing with disclosing genetic information to their children. These findings reinforce the importance of adopting a family-centered approach in the context of genetic counseling and the necessity of involving family members in research.
Topics: Child; Family; Genetic Counseling; Genetic Testing; Humans; Neoplastic Syndromes, Hereditary; Risk
PubMed: 35162625
DOI: 10.3390/ijerph19031603 -
Atherosclerosis Nov 2006To determine the strength and consistency with which a low ankle brachial pressure index (ABI), measured in the general population, is associated with an increased risk... (Review)
Review
OBJECTIVE
To determine the strength and consistency with which a low ankle brachial pressure index (ABI), measured in the general population, is associated with an increased risk of subsequent death and/or cardiovascular events.
DESIGN
Systematic review.
DATA SOURCES
Medline, Embase, reference lists and grey literature were searched; studies known to experts were also retrieved.
MAIN OUTCOME MEASURES
All cause mortality, fatal and non-fatal coronary heart disease and stroke.
REVIEW METHODS
Longitudinal studies in which participants were representative of the general population (all ages, either sex) and which used any standard method for measurement and calculation of the ABI. Studies in which participants were selected according to presence of pre-existing disease or were post intervention (e.g. angioplasty or peripheral arterial grafting) were excluded.
RESULTS
11 studies comprising 44,590 subjects from six different countries were included. Despite clinical heterogeneity between studies, the findings were remarkably consistent in demonstrating an increased risk of clinical cardiovascular disease associated with a low ABI. A low ABI (<0.9) was associated with an increased risk of subsequent all cause mortality (pooled RR 1.60, 95% CI 1.32-1.95), cardiovascular mortality (pooled RR 1.96, 95% CI 1.46-2.64), coronary heart disease (pooled RR 1.45, 95% CI 1.08-1.93) and stroke (pooled RR 1.35, 95% CI 1.10-1.65) after adjustment for age, sex, conventional cardiovascular risk factors and prevalent cardiovascular disease.
CONCLUSIONS
The ABI may help to identify asymptomatic individuals in the general population who are at increased risk of subsequent cardiovascular events. Evaluation is now required of the potential of incorporating ABI measurement into cardiovascular prevention programmes.
Topics: Blood Flow Velocity; Blood Pressure; Brachial Artery; Cardiovascular Diseases; Humans; Risk Factors; Survival Rate
PubMed: 16620828
DOI: 10.1016/j.atherosclerosis.2006.03.011 -
Nutrition, Metabolism, and... May 2020Results regarding the association between fish intake and risk of metabolic syndrome (MetS) are ambiguous. Therefore, this study aims to evaluate whether there is an... (Meta-Analysis)
Meta-Analysis
AIMS
Results regarding the association between fish intake and risk of metabolic syndrome (MetS) are ambiguous. Therefore, this study aims to evaluate whether there is an association between fish consumption and risk of MetS.
DATA SYNTHESIS
A comprehensive literature search was conducted of PubMed, Embase, ScienceDirect and Google Scholar up to August 2019. A random-effects model was used to pool the risk of MetS in the highest category of fish consumption compared with the lowest one. Subgroup analysis was conducted based on country of region, gender, dietary tool, MetS definition, energy adjustment and sample size. A dose-response of analysis of fish intake and risk of MetS was also conducted. Twelve studies with a total of 16 effect sizes (10 cross-sectional and six cohort) were included. An inverse association was observed between fish intake and risk of MetS in cohort (OR = 0.80, 95% CI: 0.66, 0.96; P = 0.017, I = 62.9%) but not cross-sectional studies (OR = 0.80, 95% CI: 0.70, 1.02; P = 0.085, I = 50.1%). Subgroup analysis suggested that the results were influenced by all the included variables but sample size. A significant non-linear association was observed between fish intake levels and risk of MetS (P-value for non-linearity = 0.010).
CONCLUSION
An inverse association existed between fish intake and risk of MetS when combining data from prospective cohort studies. Further studies are needed to confirm such an effect.
Topics: Adolescent; Adult; Aged; Animals; Diet, Healthy; Female; Fishes; Humans; Male; Metabolic Syndrome; Middle Aged; Nutritive Value; Protective Factors; Recommended Dietary Allowances; Risk Assessment; Risk Factors; Risk Reduction Behavior; Seafood; Young Adult
PubMed: 32127332
DOI: 10.1016/j.numecd.2020.02.001 -
PLoS Medicine Jun 2015According to WHO Global Health Estimates, tuberculosis (TB) is among the top ten causes of global mortality and ranks second after cardiovascular disease in most... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
According to WHO Global Health Estimates, tuberculosis (TB) is among the top ten causes of global mortality and ranks second after cardiovascular disease in most high-burden regions. In this systematic review and meta-analysis, we investigated the role of second-hand smoke (SHS) exposure as a risk factor for TB among children and adults.
METHODS AND FINDINGS
We performed a systematic literature search of PubMed, Embase, Scopus, Web of Science, and Google Scholar up to August 31, 2014. Our a priori inclusion criteria encompassed only original studies where latent TB infection (LTBI) and active TB disease were diagnosed microbiologically, clinically, histologically, or radiologically. Effect estimates were pooled using fixed- and random-effects models. We identified 18 eligible studies, with 30,757 children and 44,432 adult non-smokers, containing SHS exposure and TB outcome data for inclusion in the meta-analysis. Twelve studies assessed children and eight studies assessed adult non-smokers; two studies assessed both populations. Summary relative risk (RR) of LTBI associated with SHS exposure in children was similar to the overall effect size, with high heterogeneity (pooled RR 1.64, 95% CI 1.00-2.83). Children showed a more than 3-fold increased risk of SHS-associated active TB (pooled RR 3.41, 95% CI 1.81-6.45), which was higher than the risk in adults exposed to SHS (summary RR 1.32, 95% CI 1.04-1.68). Positive and significant exposure-response relationships were observed among children under 5 y (RR 5.88, 95% CI 2.09-16.54), children exposed to SHS through any parent (RR 4.20, 95% CI 1.92-9.20), and children living under the most crowded household conditions (RR 5.53, 95% CI 2.36-12.98). Associations for LTBI and active TB disease remained significant after adjustment for age, biomass fuel (BMF) use, and presence of a TB patient in the household, although the meta-analysis was limited to a subset of studies that adjusted for these variables. There was a loss of association with increased risk of LTBI (but not active TB) after adjustment for socioeconomic status (SES) and study quality. The major limitation of this analysis is the high heterogeneity in outcomes among studies of pediatric cases of LTBI and TB disease.
CONCLUSIONS
We found that SHS exposure is associated with an increase in the relative risk of LTBI and active TB after controlling for age, BMF use, and contact with a TB patient, and there was no significant association of SHS exposure with LTBI after adjustment for SES and study quality. Given the high heterogeneity among the primary studies, our analysis may not show sufficient evidence to confirm an association. In addition, considering that the TB burden is highest in countries with increasing SHS exposure, it is important to confirm these results with higher quality studies. Research in this area may have important implications for TB and tobacco control programs, especially for children in settings with high SHS exposure and TB burden.
Topics: Adult; Child; Humans; Risk Factors; Tobacco Smoke Pollution; Tuberculosis, Pulmonary
PubMed: 26035557
DOI: 10.1371/journal.pmed.1001835 -
Cancer Treatment Reviews May 2005To evaluate the existing evidence regarding the long-term risk of cardiovascular disease (CVD) after radiotherapy for childhood cancer. (Review)
Review
PURPOSE
To evaluate the existing evidence regarding the long-term risk of cardiovascular disease (CVD) after radiotherapy for childhood cancer.
PATIENTS AND METHODS
MEDLINE and EMBASE were searched for articles reporting on radiation-induced CVD after childhood cancer published between 1966 and October 2002. Information about study design, population, treatment, outcome and risk factors were abstracted and the quality of each study was assessed.
RESULTS
Fourteen articles met all the eligibility criteria. Ten studies evaluated clinical cardiovascular events (CVE) and 11 cardiovascular mortality (CVM) after cardiac irradiation for childhood cancer. Four studies, all in survivors of Hodgkin's disease, showed a significantly increased standardised mortality ratio; a 22- to 68-fold increase compared to the general population. No study compared the risk of CVE with the general population. Three studies examined the risk of CVD (both CVM and CVE) after radiotherapy compared to an unexposed control group, and two showed a significantly increased relative risk. Many studies had important methodological limitations, related to completeness of follow-up, adjustment for other risk factors and outcome assessment in CVE studies.
CONCLUSIONS
This systematic review demonstrates that the risk of CVM after cardiac irradiation for childhood cancer is increased compared to the general population and to unexposed patients. The risk of developing clinical CVE and the precise risk factors for developing CVE or CVM after radiotherapy remain unclear. New well-designed studies are needed to reliably evaluate the long-term risk of CVD following radiotherapy and associated risk factors.
Topics: Cardiovascular Diseases; Child; Humans; Neoplasms; Radiation Injuries; Radiotherapy; Reproducibility of Results; Risk Assessment; Risk Factors
PubMed: 15896910
DOI: 10.1016/j.ctrv.2005.03.008 -
Clinical Rehabilitation Sep 2010This systematic review explored the potential impact of parental multiple sclerosis on their offspring. It considered adjustment to parental multiple sclerosis at... (Review)
Review
OBJECTIVE
This systematic review explored the potential impact of parental multiple sclerosis on their offspring. It considered adjustment to parental multiple sclerosis at different developmental stages and the factors associated with good versus poor adjustment.
DATA SOURCES
MEDLINE, EMBASE, PsycINFO, CINAHL and Web of Science were searched for studies on children with a parent with multiple sclerosis. Inclusion and exclusion criteria were formulated. Hand-searching journals and reference lists, contacting authors and multiple sclerosis societies for additional unpublished papers complemented the searches.
REVIEW METHODS
Twenty studies that satisfied the inclusion criteria were included. The research articles were ranked according to a quality assessment checklist and were categorized as good, medium or poor quality.
RESULTS
The review found good evidence to suggest that parental multiple sclerosis has a negative impact on children's social and family relationships and their psychological well-being. The review also identified potential factors associated with poor adjustment. These factors included parental negative emotions, increased illness severity, family dysfunction, children's lack of knowledge about the illness and lack of social support. Adolescent children also seemed to be more at risk for psychosocial problems than school-age children.
CONCLUSIONS
There is good evidence that parental multiple sclerosis has a negative psychosocial impact on children, especially on adolescents.
Topics: Adaptation, Psychological; Adjustment Disorders; Adolescent; Child; Family Characteristics; Female; Humans; Male; Multiple Sclerosis; Parents
PubMed: 20685724
DOI: 10.1177/0269215510367982 -
Journal of the American Heart... Oct 2016The possibility that lifestyle factors such as diet, specifically potassium intake, may modify the risk of stroke has been suggested by several observational cohort... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The possibility that lifestyle factors such as diet, specifically potassium intake, may modify the risk of stroke has been suggested by several observational cohort studies, including some recent reports. We performed a systematic review and meta-analysis of existing studies and assessed the dose-response relation between potassium intake and stroke risk.
METHODS AND RESULTS
We reviewed the observational cohort studies addressing the relation between potassium intake, and incidence or mortality of total stroke or stroke subtypes published through August 6, 2016. We carried out a meta-analysis of 16 cohort studies based on the relative risk (RR) of stroke comparing the highest versus lowest intake categories. We also plotted a pooled dose-response curve of RR of stroke according to potassium intake. Analyses were performed with and without adjustment for blood pressure. Relative to the lowest category of potassium intake, the highest category of potassium intake was associated with a 13% reduced risk of stroke (RR=0.87, 95% CI 0.80-0.94) in the blood pressure-adjusted analysis. Summary RRs tended to decrease when original estimates were unadjusted for blood pressure. Analysis for stroke subtypes yielded comparable results. In the spline analysis, the pooled RR was lowest at 90 mmol of potassium daily intake (RRs=0.78, 95% CI 0.70-0.86) in blood pressure-adjusted analysis, and 0.67 (95% CI 0.57-0.78) in unadjusted analysis.
CONCLUSIONS
Overall, this dose-response meta-analysis confirms the inverse association between potassium intake and stroke risk, with potassium intake of 90 mmol (≈3500 mg)/day associated with the lowest risk of stroke.
Topics: Humans; Incidence; Potassium, Dietary; Protective Factors; Risk; Stroke
PubMed: 27792643
DOI: 10.1161/JAHA.116.004210 -
Obesity Reviews : An Official Journal... Sep 2021Body mass index (BMI) at child and adolescent ages is positively associated with adult coronary heart disease (CHD) whereas height at these ages may be inversely... (Meta-Analysis)
Meta-Analysis Review
Associations between body mass index and height during childhood and adolescence and the risk of coronary heart disease in adulthood: A systematic review and meta-analysis.
Body mass index (BMI) at child and adolescent ages is positively associated with adult coronary heart disease (CHD) whereas height at these ages may be inversely associated with CHD. However, potential effects of age, sex, and socioeconomic status on associations between BMI and CHD are less investigated. We conducted a systematic review and meta-analysis of BMI and height at ages 2-19 years in relation to adult CHD and examined effects of age, sex, socioeconomic status, and other factors. Twenty-two studies on BMI and five on height were included, comprising 5,538,319 individuals and 69,830 CHD events. Random effects meta-analyses were conducted. Child and adolescent BMI were positively associated with CHD (hazard ratio = 1.12; 95% confidence interval [CI] [1.01, 1.25] per standard deviation [SD]), and categorical analyses supported these findings. The associations did not significantly differ by age, sex, or by adjustment for socioeconomic status. Child and adolescent height were inversely associated with CHD (hazard ratio = 0.87; 95% CI [0.81, 0.93] per SD), and categorical analyses agreed. Insufficient studies on height precluded subgroup analyses. Heterogeneity was generally high in all analyses. We found that BMI in youth is positively associated with adult CHD regardless of sex or adjustment for socioeconomic status whereas height is inversely associated with later risk of CHD.
Topics: Adolescent; Adult; Birth Weight; Body Height; Body Mass Index; Child; Child, Preschool; Coronary Disease; Humans; Risk Factors; Young Adult
PubMed: 33960625
DOI: 10.1111/obr.13276 -
Journal of Psychiatric Research May 2021Mental disorders (MDs) are known risk factors for suicide. This systematic review updates the evidence base for this association and improves upon analytic approaches by...
BACKGROUND
Mental disorders (MDs) are known risk factors for suicide. This systematic review updates the evidence base for this association and improves upon analytic approaches by incorporating study-level and methodological variables to account for measurement error in pooled suicide risk estimates.
METHODS
A systematic review was conducted to review studies on MDs as risk factors for suicide. Relevant studies were searched using PubMed, Embase, PsychINFO, and existing reviews from 2010 to 19. Studies were eligible if they were longitudinal/case-control studies, representative of the general population, used diagnostic instruments, and quantified suicide risk. The outcome assessed was relative risks (RRs) for suicide due to MDs. A multi-level meta-regression approach was used to obtain pooled RRs adjusted for covariates and between-study effects.
FINDINGS
We identified 20 eligible studies yielding 69 RRs. Disorder type, age, sex, use of psychological autopsy, study design, and adjustment for confounders were tested as predictors of pooled suicide risk. Overall, all disorders were significant predictors of suicide with predicted adjusted RRs ranging from 4·11 [2·09, 8·09] for dysthymia to 7·64 [4·3, 13·58] for major depressive disorder.
INTERPRETATION
Our results indicate that MDs are important risk factors for suicide. This systematic review provides pooled RRs that have been adjusted for methodological sources of bias. Findings from our paper may inform suicide prevention strategies as part of national health agendas.
Topics: Case-Control Studies; Depressive Disorder, Major; Humans; Mental Disorders; Regression Analysis; Risk Factors; Suicide
PubMed: 33714076
DOI: 10.1016/j.jpsychires.2021.02.053