膳食摄入n-3脂肪酸与结直肠癌发生风险的Meta分析

目的探讨n-3脂肪酸的膳食摄入量与结直肠癌发生风险的关系。 方法计算机检索PubMed、EMBASE、CNKI数据库和Cochrane图书馆已发表的相关研究文献。由2名评价者独立筛选文章、提取数据及评价纳入研究的质量,采用STATA11.0软件完成Meta分析。 结果最终共纳入7项病例对照研究和4项前瞻性队列研究,共253 479名研究对象。n-3脂肪酸膳食摄入最高量部分的人群相比摄入最低量部分的人群发生结直肠癌的风险是0.88（95% CI：0.68~1.13;P = 0.316,4分类,6项研究）和1.03（95% CI：0.92~1.16;P = 0.606,5分类,5项研究）。 结论n-3脂肪酸的摄入量与结直肠癌的发生没有显著相关性,膳食摄入n-3脂肪酸与结直肠癌的发生风险之间的关系尚需进一步研究证实。     

性别、吸烟与腰椎间盘突出症术后复发关系的Meta分析

目的探讨性别、吸烟与腰椎间盘突出症(lumbar disc herniation,LDH)术后复发的关系。方法通过中国生物医学文献数据库、中国期刊全文数据库、Cochrane Library数据库、PubMed、Ovid等数据库收集建库至2013年7月国内外公开发表的关于LDH术后复发危险因素的文献,采用Meta分析综合定量分析最终纳入的文献。结果共纳入8篇文献,其中性别与LDH术后复发关系的研究7篇,Meta分析结果差异无统计学意义[OR=1.34,95%CI(0.88,2.04),P=0.178];吸烟与LDH术后复发关系的研究4篇,Meta分析结果差异有统计学意义[OR=17.96,95%CI(1.96,164.32),P=0.011]。结论 Meta分析结果提示,吸烟是LDH术后复发的危险因素,性别尚不是LDH术后复发的危险因素。受纳入文献数量所限制,其结果尚需更多大样本的研究进一步证实。     

辅助生殖技术与子代先天性心脏病相关性队列研究的Meta分析

目的 系统评价辅助生殖技术(ART)助孕与子代先天性心脏病(CHD)发生的相关性。方法 计算机检索中国知网、万方数据库、维普中文数据库、中国生物医学文献数据库等国内数据库以及PubMed、Web of Science、Embase、Scopus等外文数据库，检索有关ART和子代CHD发生相关性的队列研究，检索时限均从建库至2022年3月，并通过人工阅读检索参考文献以避免文献漏检。2名研究者严格按照纳入、排除标准独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用Stata 10.1软件进行Meta分析。结果 共纳入8篇高质量队列研究，包括ART助孕子代82 214例。Meta分析结果显示，ART助孕子代CHD发生风险显著高于自然受孕子代[OR=1.21,95%CI(1.10,1.34),P<0.001]。亚组分析结果显示，不同数据来源、ART类型、ART样本量和未调整母亲糖尿病病史等是ART助孕子代CHD发生风险的显著影响因素(P<0.05)。结论 当前证据表明，与自然受孕子代相比，ART助孕子代CHD发生风险可能会增加；母亲有糖尿病病史可能是子代CHD发生风险增加的危险...     

血尿酸与骨质疏松性骨折的相关性

目的系统评价血尿酸与骨质疏松性骨折之间的关系。方法通过PubMed数据库、Cochrane Collaboration数据库、中国知识资源总库(CNKI)、万方数据知识服务平台和Sino Med数据库进行检索,查找关于高血尿酸与骨质疏松性骨折发生风险的相关文献。结果依纳入标准,共纳入7个研究,含30 855例患者。Meta分析结果显示:高血尿酸水平患者发生骨质疏松性骨折风险明显下降(HR=0.88,95%CI为0.83～0.93,P0.001)。发表偏倚及敏感性分析显示:漏斗图及Egg检验未见明显发表偏倚,敏感性分析提示结果较稳定。结论高血尿酸可降低骨质疏松性骨折发生风险。     

泡沫敷料预防高危风险患者压疮的Meta分析

目的评价使用泡沫敷料联合常规护理预防高危风险患者压疮的有效性。方法检索国内外数据库建库至2013年12月关于泡沫敷料用于预防高危风险患者压疮的随机对照试验(RCT)和类实验研究,文献的筛选与资料提取均由2名评价员独立进行,分歧通过协商或第三方解决。纳入文献的质量依据Jadad量表评价,提取资料用Revman5.0软件进行数据处理和分析。结果共纳入7篇文献,1 611例患者。所纳入研究的偏倚风险较低。Meta分析结果显示:对于存在压疮高危风险患者预防性使用泡沫敷料联合常规护理能有效降低压疮发生率(RR=0.22,95%CI=0.10~0.49,P0.05),但研究间存在一定程度的异质性,可能与预防部位、研究人群、泡沫敷料的来源不同有关。结论预防性使用泡沫敷料联合常规护理能更有效减少高危风险患者压疮的发生,但是由于纳入7篇研究存在一定程度的异质性,泡沫敷料的有效性、具体的使用方法和经济效益还需大样本多中心的RCT研究进一步验证。     

我国孕期风疹病毒IgM检测及其意义的Meta分析

目的 Meta分析我国孕期风疹病毒IgM检测阳性率、IgM阳性率与孕产次的关系,以及IgM阳性率与早期流产的相关性。方法通过计算机检索Cochrane Library、PubMed、CBMdisc、CNKI、维普、万方等数据库,时限从建库至2017年6月。选定关键词,查找孕期风疹病毒IgM检测相关研究。按照纳入与排除标准选择文献,提取资料,利用STATA数据处理软件进行Meta分析。结果最终纳入文献9篇,汇总后总样本量为53 270例,其中阳性例数为1 923例,总阳性率为3.61%。孕期风疹病毒IgM阳性与孕产次关系共纳入文献5篇,统计结果显示多次妊娠会增加孕妇风疹病毒IgM阳性率,OR及95%CI为[0.316(0.210,0.475)],且差异有统计学意义(P0.001)。孕期风疹病毒IgM阳性与早期流产关系共纳入文献4篇,结果显示IgM阳性者发生早期流产的风险要明显大于IgM阴性孕妇,OR及95%CI为[3.184(1.874,5.410)],且差异有统计学意义(P0.001)。结论应加强孕期风疹病毒筛查,预防出生缺陷及不良妊娠结局。     

尿石症与骨质疏松症发生关系的病例对照研究

目的:探讨尿石症与骨质疏松症两者之间的关系。方法:纳入2005~2014年在我院就诊的2 147例尿石症患者(尿石组)和同时随机选取同期的2 147例健康体检者(对照组),通过运用非条件logistic回归分析,对两者关系进行风险评估。结果:骨质疏松症患者发生尿石症的风险较正常者高1.91倍(P0.01)。进一步分析不同部位尿石症与骨质疏松症的风险关系,显示骨质疏松症患者发生肾结石的OR=2.10(95%CI:1.95~2.27),输尿管结石OR=1.68(95%CI:1.51~1.85),膀胱结石OR=1.49(95%CI:1.13~1.98),多发结石OR=1.89(95%CI:1.74~2.06)。提示骨质疏松症与不同部位结石的发生相关。结论:骨质疏松症患者发生尿石症的风险较正常人高,且不同部位结石的发生风险均增高,与总体结果一致。     

糖皮质激素对儿童紫癜性肾炎预防作用的Meta分析

目的评价糖皮质激素对儿童紫癜性肾炎(Henoch-Sch?nlein purprua,HSPN)的预防作用。方法检索 Cochrane Library、Embase、PubMed、Medline、Web of Science、Google Scholar、Springer、中国期刊全文数据库(CNKI)、中文科技期刊全文数据库库(VIP)、万方数据库等,收集随机对照试验文献,检索文献时间截止到2013年12月31日。对文献进行资料提取和文献质量评价,应用RevMan 5.2软件进行 Meta分析。结果6篇随机对照试验进入 Meta分析。其中多中心前瞻性随机对照试验研究(Ⅰa级)5篇,单中心前瞻性随机对照试验研究(Ⅰb 级)1篇。5篇文献描述了具体随机化方法,采用了充分的分配隐藏和盲法,1篇文献未提及具体随机化方法和分配隐藏,未采用盲法。纳入6篇文献均报道了失访和退出情况,5篇为低度偏倚风险,1篇为高度偏倚风险。Meta分析结果显示,诊断过敏性紫癜(Henoch-Sch?nlein purpura,HSP)后糖皮质激素预防组 HSPN 发生率为16.9%(89/527),对照组 HSPN发生率为15.9%(84/527),合并相对危险度 RR=1.07[95%可信区间(95%CI)：0.83~1.39],P=0.61,差异无统计学意义,进行敏感性分析,结果无改变。结论本Meta分析结果尚不支持糖皮质激素能预防儿童 HSPN 的发生,并有待于大规模、多中心、前瞻性随机对照试验进一步证实。     

半机械吻合与手工吻合对食管癌切除食管胃吻合口并发症发生率影响的系统评价与Meta分析

目的分析食管癌切除术后患者行食管胃半机械吻合与手工吻合对患者术后吻合口并发症发生率影响的差异。方法计算机检索PubMed、OVID数据库、中国期刊全文数据库（CNKI）、中国生物医学文献数据（CBM）,检索时间均从建库至2013年12月,并手工检索相关杂志,纳入比较半机械吻合与手工吻合对食管癌术后患者吻合口并发症发生率影响的随机对照研究或观察性研究。评价纳入文献质量、提取数据,采用RevMan 5.2软件进行Meta分析。结果共纳入12篇文献,包括随机对照试验3篇,观察性研究9篇,共1 271例患者。各研究间无统计学异质性,故采用固定效应模型进行Meta分析。结果显示两组患者术后吻合口瘘发生率差异有统计学意义[随机对照研究RR=0.34,95%CI（0.12,0.97）,P〈0.05;观察性研究OR=0.40,95%CI（0.26,0.62）,P〈0.05]。12篇文献均报道了患者术后吻合口狭窄发生率,Meta分析结果显示两组患者术后吻合口狭窄发生率差异有统计学意义[随机对照研究RR=0.14,95%CI（0.04,0.47）,P〈0.05;观察性研究OR=0.22,95%CI（0.15,0.34）,P〈0.000 1]。结论与手工吻合比较,食管癌切除术后患者食管胃半机械吻合能降低吻合口瘘和吻合口狭窄的发生率。由于纳入研究数量偏小,质量不高,上述结论仍需大样本、高质量的随机或非随机对照试验进一步验证。     

男性骨密度与冠状动脉粥样硬化关系的Meta分析

目的从循证医学的角度探究男性骨密度改变与冠状动脉粥样硬化之间的关系。方法首先根据研究的目的制定检索策略,利用Pubmed、Embase、Cochrane图书馆、中国生物医学文献数据库(CBM)、维普信息资源系统、中国期刊全文数据库(CNKI)、万方数据库等检索截至目前已发表的相关文献,对符合纳入标准的文献进行数据的提取,利用Review Manager 5.3Meta分析软件对提取的数据进行分析。结果本研究最终纳入5篇文献,包含骨密度降低组(骨量减少和骨质疏松)325名患者,对照组259名患者。Meta分析显示5项研究之间的异质性检验结果为I~2=62%,Chi~2=10.56,P=0.03,说明各研究之间存有异质性,因此采用随机效应模型进行分析,合并后的效应量为OR=1.79,95%CI为(0.79,4.03),P=0.16;经灵敏度分析剔除1篇样本量较小的研究后,异质性检验结果显示I~2=35%,Chi~2=4.64,P=0.20,表明各研究之间的异质性较小并且可以接受,因此采用固定效应模型进行分析,合并后的效应量为OR=1.22,95%CI为(0.76,1.96),P=0.41,最后所得的合并效应量与样本量较小的研究删除之前的合并效应量相比,结果基本一致,说明此次Meta分析的结果比较稳定。结论男性骨密度的降低与冠状动脉粥样硬化之间没有显著的相关性。     

Meta-analysis for combining relative risks of alcohol consumption and prostate cancer

BACKGROUND: Prostate cancer has become the most common cancer among men in the United States, but little is known about factors associated with prostate cancer incidence. METHODS: A meta-analysis of studies published prior to July 1998 was conducted to pool relative risk (RR) estimates from the existing literature on the association between prostate cancer and alcohol consumption, in an attempt to determine whether there is an association, and if so, what its magnitude is. RESULTS: The overall pooled RR estimate was 1. 05 for both fixed and random effects models, based on six cohort studies and 27 case-control studies. The RR estimate varied little by study design. Among types of consumption, the highest risk was found for beer (RR = 1.27), but this was based on only eight studies that reported type of alcohol consumed. A linear dose-response was fit to the 15 studies reporting amount of alcohol consumed, finding a RR of 1.05 (95% confidence interval (CI), 0.91-1.20) for each additional drink of alcohol per day or a RR of 1.21 for 4 drinks per day. When the average drinks per day consumed in the 15 studies were used to estimate the overall risk for all 33 studies, a RR of 1.02 was found for each additional drink of alcohol per day. CONCLUSIONS: Overall, no association between prostate cancer and alcohol consumption was seen. While some categories of consumption showed an increased risk, the studies reporting such categories appeared to be biased towards reporting a positive association among the categories.     

Coffee consumption and risk of type 2 diabetes mellitus in Asians: A meta-epidemiological study of population-based cohort studies

BACKGROUNDPrevious systematic reviews have consistently reported that coffee consumption has a preventive effect on the occurrence of type 2 diabetes mellitus (T2DM). However, further evaluations between coffee consumption and the risk of T2DM in Asian populations are needed.AIMTo conduct a meta-epidemiological study on systematic reviews evaluating the association between coffee consumption and the risk of T2DM in Asian people. METHODSThe selection criterion was defined as a population-based prospective cohort study evaluating the association between coffee consumption and the risk of T2DM in Asian populations, reporting the adjusted relative risk (RR) and its 95% confidence interval (CI) for potential confounders. A fixed-effect model meta-analysis was applied to calculate the summary RR and its 95%CI in less than 50% of the I² value indicating the level of heterogeneity. A two-stage fixed-effects dose-response meta-analysis (DRMA) was performed to calculate the risk per unit dose (a cup per day). RESULTSA total of seven studies were selected in this meta-epidemiological study. The risk of T2DM in Asian populations was significantly reduced in the highest to the lowest dose group (summary RR = 0.73, 95%CI: 0.66-0.82; I² value = 0.0%). The DRMA showed that drinking one cup of coffee per day reduced the risk of T2DM in Asian populations by 8% (RR = 0.92, 95%CI: 0.90-0.95). CONCLUSIONThese findings support the conclusion that coffee consumption has a protective effect on the occurrence of T2DM in Asian men and women.     

Coffee consumption and risk of prostate cancer: a meta‐analysis of epidemiological studies

OBJECTIVE To evaluate the association between coffee consumption and the risk of prostate cancer. METHODS We searched PubMed, EMBASE, and the bibliographies of relevant articles in August 2009. Two evaluators independently reviewed and selected articles based on predetermined selection criteria. RESULTS Twelve epidemiological studies (eight case‐control studies and four cohort studies) were included in the final analysis. In a meta‐analysis of all included studies, when compared with the lowest level of coffee consumption, the overall relative risk (RR) of prostate cancer for the highest level of coffee consumption was 1.16 (95% confidence interval [CI] 1.01–1.33). In subgroup meta‐analyses by study design, there was a significant positive (harmful) association between coffee consumption and prostate cancer risk in seven case‐control studies using both crude and adjusted data (RR 1.20, 95% CI 1.02–1.40; and RR 1.21, 95% CI 1.03–1.43, respectively), whereas there was no significant association in four cohort studies using crude or adjusted data (RR 0.97, 95% CI 0.68–1.38; and RR 1.06, 95% CI 0.83–1.35, respectively). CONCLUSION Given that a cohort study gives a higher level of evidence than a case‐control study, there is no evidence to support a harmful effect of coffee consumption on prostate cancer risk. Further prospective cohort studies are required.     

The association between diabetes and thoracic aortic aneurysms

Objective

The negative correlation between diabetes mellitus (DM) and abdominal aortic aneurysms (AAAs) is well described. The etiologic similarities and differences between AAAs and thoracic aortic aneurysms (TAAs) have also been documented. We aimed to evaluate the relationship between DM and TAA by performing a meta-analysis of contemporary clinical studies.

Proton pump inhibitors linked to hypomagnesemia: a systematic review and meta-analysis of observational studies

Abstract

Background: The reported risk of hypomagnesemia in patients with proton pump inhibitor (PPI) use is conflicting. The objective of this meta-analysis was to assess the association between the use of PPIs and the risk of hypomagnesemia. Methods: A literature search of observational studies was performed using MEDLINE, EMBASE and Cochrane Database of Systematic Reviews from inception through September 2014. Studies that reported odd ratios or hazard ratios comparing the risk of hypomagnesemia in patients with PPI use were included. Pooled risk ratios (RRs) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. Results: Nine observational studies (three cohort studies, five cross-sectional studies and a case-control study) with a total of 109,798 patients were identified and included in the data analysis. The pooled RR of hypomagnesemia in patients with PPI use was 1.43 (95% CI, 1.08–1.88). The association between the use of PPIs and hypomagnesemia remained significant after the sensitivity analysis including only studies with high quality score (Newcastle–Ottawa scale score?≥?8) with a pooled RR of 1.63 (95% CI, 1.14–2.23). Conclusions: Our study demonstrates a statistically significant increased risk of hypomagnesemia in patients with PPI use. The finding of this meta-analysis of observational studies suggests that PPI use is associated with hypomagnesemia and may impact clinical management of patients who are taking PPIs and at risk for hypomagnesemia related cardiovascular events.     

Caffeine intake and the risk of incident kidney stones: a systematic review and meta-analysis

Background

Kidney stone disease is increasingly common in the general population, with a high recurrence rate after stone removal. It has been proven that caffeine consumption can reduce the risk of diseases, such as stroke and dementia. However, the effect of caffeine intake on the incidence of kidney stones has not been determined. This systematic review and meta-analysis were performed to evaluate the association of caffeine intake with the risk of incident kidney stones.

Methods

PubMed, Web of Science, Scopus, Cochrane and Google Scholar were searched using terms related to coffee, caffeine and kidney stones to find eligible articles up to December 2021. Articles with clear diagnostic criteria for kidney stone disease and the exact intake dose of caffeine were included. The incidence of kidney stone disease was the main outcome. Summarized risk estimates and 95% CIs for the highest and lowest categories of caffeine intake were calculated using a random effects model.

Results

Seven studies were included in the final meta-analysis, with 9707 cases of kidney stones and a total of 772,290 cohort members. Compared with the lowest category of caffeine intake, the pooled relative risk (RR) was 0.68 ([95% CI 0.61–0.75], I²?=?57%) for the highest category of caffeine intake. Subgroup analyses showed that caffeine intake had an inverse relationship with the incidence of kidney stones in all subgroups.

Conclusion

This study suggests that a higher caffeine intake may be associated with a lower risk of incident kidney stones.

     

Bisphosphonate treatment and risk of esophageal cancer: a meta-analysis of observational studies

Summary

The use of bisphosphonates and the risk of esophageal cancer have recently received increasing concern and related studies have yielded controversial results. The present meta-analysis of observational studies shows that no clear association between bisphosphonate treatment and risk of esophageal cancer was observed.

Introduction

Epidemiological evidence suggests that bisphosphonate treatment can increase the risk of esophageal cancer. However, data on this issue are unstable and controversial. We conducted a meta-analysis to provide a quantitative assessment of the association between use of bisphosphonates and risk of esophageal cancer.

Methods

We searched the Medline and Embase databases up to May 2012 to identify studies related to bisphosphonates and esophageal cancer. Summary effect estimates with 95 % confidence intervals (CI) were derived using a fixed or random effects model, depending on the heterogeneity of the included studies.

Results

Seven epidemiologic studies that consisted of four cohort studies and three case–control studies were included in this meta-analysis. In our primary analysis, bisphosphonate treatment was not associated with risk of esophageal cancer in both cohort studies [pooled relative risk (RR) 1.23, 95 % CI 0.79–1.92] and case–control studies [pooled odds ratio (OR) 1.24, 95 % CI 0.98–1.57]. Evidence for the presence of significant heterogeneity was found in cohort studies (p?=?0.009, I ²?=?74 %) but not in case–control studies (p?=?0.338, I ²?=?7.8 %). In our secondary analysis, no significant increased risk of esophageal cancer was found in alendronate users (pooled RR 1.08, 95 % CI 0.67–1.75 in cohort studies; pooled OR 1.16, 95 % CI 0.82–1.63 in case–control studies).

Conclusions

Based on current evidences, bisphosphonate treatment was not significantly associated with excess risk of esophageal cancer.     

Does physical activity reduce the risk of prostate cancer? A systematic review and meta-analysis

Context

Numerous observational epidemiologic studies have evaluated the association between physical activity and prostate cancer (PCa); however, the existing results are inconsistent.

Objective

To determine the association between physical activity and risk of PCa.

Evidence acquisition

A systematic search was performed using the Medline, Embase, and Web of Science databases through 15 May 2011 to identify all English-language articles that examined the effect of physical activity on the risk of PCa. This meta-analysis was conducted according to the guidelines for the meta-analysis of observational studies in epidemiology.

Evidence synthesis

This meta-analysis consisted of 88 294 cases from 19 eligible cohort studies and 24 eligible case-control studies. When data from both types of studies were combined, total physical activity (TPA) was significantly associated with a decreased risk of PCa (pooled relative risk [RR]: 0.90; 95% confidence interval [CI], 0.84-0.95). The pooled RR for occupational physical activity (OPA) and recreational physical activity (RPA) were 0.81 (95% CI, 0.73-0.91) and 0.95 (95% CI, 0.89-1.00), respectively. Notably, for TPA, we observed a significant PCa risk reduction for individuals between 20 and 45 yr of age (RR: 0.93; 95% CI, 0.89-0.97) and between 45 and 65 yr of age (RR: 0.91; 95% CI, 0.86-0.97) who performed activities but not for individuals <20 yr of age or >65 yr of age.

Conclusions

There appears to be an inverse association between physical activity and PCa risk, albeit a small one. Given that increasing physical activity has numerous other health benefits, men should be encouraged to increase their physical activity in both occupational and recreational time to improve their overall health and potentially decrease their risk of PCa.     

Alcohol Drinking and Risk of Breast Cancer

Abstract: Using a case-control design, the authors studied female residents of five Massachusetts towns between 1983 and 1986. The objective was to measure the association between breast cancer occurrence and drinking alcohol. Cohort and case-control studies have often observed an association between drinking alcohol and breast cancer risk. In this study, women with any history of drinking alcohol had a risk of breast cancer 1.2-fold greater than women who never drank alcohol (95% confidence interval 0.7–1.8). The relative risk of breast cancer did not depend on the usual number of drinks per day or drinking history relative to time of diagnosis. Women who reported ever having a period of 6 months or more during which they drank more than average had an adjusted relative risk of breast cancer equal to 2.6 (95% confidence interval 1.1–5.8). The estimates of effect are consistent with the positive dose-response trends reported in a pooled analysis of large cohort studies and a meta-analysis of a broader spectrum of studies. Alcohol drinking remains one of the few risk factors for breast cancer amenable to intervention.     

Vasectomy and the risk of prostate cancer: a meta-analysis examining vasectomy status,age at vasectomy,and time since vasectomy

The aim of this study was to conduct a quantitative review of prostate cancer studies to pool relative risk (RR) estimates on the association between prostate cancer and vasectomy, in an attempt to determine whether there is an association, and if so, its magnitude. Random-effects models were examined along with a linear model for time since vasectomy. The pooled RR estimate was 1.37 (95% CI=1.15-1.62) based on five cohort studies and 17 case-control studies. The RR estimate varied by study design with the lowest risk for population-based case-control studies. No difference was seen in risk by age at vasectomy. A linear trend based on the 16 studies reporting time since vasectomy suggested an 10% increase for each additional 10 y or a RR of 1.32 (95% CI=1.17-1.50) for 30 y since vasectomy. When null effects were assumed for the six studies not reporting information, the linear RR for the 22 studies was 1.07 (1.03-1.11) and 1.23 (1.11-1.37) for 10 and 30 y since vasectomy, respectively. These results suggest that men with a prior vasectomy may be at an increased risk of prostate cancer, however, the increase may not be causal since potential bias cannot be discounted. The overall association was small and therefore could be explained by bias. The latency effect shown here for time since vasectomy should be examined further.