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1.
目的探讨小于胎龄儿(small for gestational age,SGA)与未成年期注意缺陷多动障碍(attention deficit hyperactive disorder,ADHD)发生的相关性。方法计算机检索万方数据库、中国知网期刊全文数据库、维普中文科技期刊数据库等中文数据库及Pubmed、OVID、Cochrane databases等英文数据库,收集研究SGA在未成年期发生ADHD的队列研究或病例对照研究。经过文献筛选、资料提取和质量评价后,采用Stata 12. 0软件进行Meta分析。结果 9篇文献满足纳入标准,Meta分析提示SGA在未成年期发生ADHD风险高于对照人群,OR值为1. 63(95%CI:1. 25,2. 13)。亚组分析显示:未分型组临床研究Meta分析提示SGA在未成年期发生ADHD的风险高于对照人群,OR值为2. 55(95%CI:1. 42,4. 56),注意力缺陷组和多动/冲动组临床研究Meta分析结果不支持SGA在未成年期发生ADHD的风险高于对照人群,OR值分别为1. 34(95%CI:0. 98,1. 83)和1. 27(95%CI:0. 66,2. 44)。结论 SGA可能会导未成年期ADHD发生的风险增加,但仍需高质量的临床研究进一步证实。  相似文献   

2.
目的 系统评价钙摄入与脑卒中发生风险的相关性。方法 计算机检索电子数据库Cochrane Library、PubMed、Embase和中国期刊全文数据库、中文科技期刊全文数据库、万方数据库至2017年10月。纳入钙摄入与脑卒中发生风险的前瞻性队列研究。采用RevMan5.3进行Meta分析。结果 共纳入13篇队列研究,Meta分析显示:(1)钙摄入最高组与最低组脑卒中发病风险相对危险度合并效应量(RR = 0.92,95% CI: 0.83~1.01),差异无统计学意义,钙摄入量与脑卒中发生风险无明显相关性;(2)亚组分析发现膳食钙摄入最高组与最低组脑卒中发生风险合并效应值(RR = 0.82,95%CI:0.73~0.91,P<0.01)差异有统计学意义,即高膳食钙摄入可降低脑卒中发生风险;(3)在亚洲人群中,高钙摄入与低钙摄入相比,差异具有统计学意义,高钙摄入时脑卒中发生风险明显降低(RR = 0.78, 95%CI:0.65~0.94, P<0.01)。结论 钙摄入与脑卒中发生风险无明显相关性,但在亚洲人群或膳食钙摄入亚组中,钙摄入是脑卒中发生风险的保护因素。  相似文献   

3.
目的探讨环境双酚A(BPA)暴露与人群糖尿病的关系。方法以计算机检索中外期刊数据库[包括中国学术期刊全文数据库(CNKI)、万方数据知识服务平台全文数据库、维普中文科技期刊全文数据库(VIP)、Pub Med、EBSCO、Elsevier Science direct、Medical Evidence Matters Archive],收集各数据库从建库至2016年4月有关BPA暴露对糖尿病患病影响公开发表的文献。按照文献纳入排除标准筛选文献后进行meta分析。结果最终纳入9篇文献共10个研究。meta分析结果显示整体合并效应值OR为1.32(95%CI:1.15~1.52,P0.01);2型糖尿病、妊娠期糖尿病以及不区分糖尿病类型三组研究进行亚组分析,各自合并OR值分别为1.19(95%CI:0.99~1.42)、0.70(95%CI:0.27~1.79)以及1.80(95%CI:1.39~2.34),结合漏斗图和Egger回归分析(P=0.691)发现纳入文献不存在发表偏倚。结论较高BPA暴露可增加整体糖尿病的患病风险,但对不同类型糖尿病作用可能存在差异。  相似文献   

4.
目的 通过meta分析探究中国人群慢性阻塞性肺病(COPD)的危险因素,为制定中国控烟政策及评估中国烟草带来的疾病负担提供必要的参数。方法 在PubMed、Web of science、Embase、中国知网、维普、万方数据库中检索从建库至2021年6月31日发表的所有吸烟相关疾病的中、英文队列或病例对照研究文献,筛选并提取相关信息。 使用Stata 16.0进行meta分析,探究吸烟与慢性阻塞性肺病发病/死亡的关联。结果 最终纳入16篇文献,其中队列研究10篇,病例对照6篇。Meta分析结果显示,吸烟是COPD的重要危险因素,曾吸烟者较不吸烟者COPD患病/死亡风险更大,RR值为2.64(95%CI:1.74~4.00),其中男性RR为1.74(95%CI:1.44~2.09),女性RR为4.06(95%CI:2.53~6.52),女性显著高于男性。亚组分析结果显示,除男性曾吸烟者病例对照研究(RR: 2.22,95%CI:1.68~2.95)和队列研究(RR:1.33,95%CI:1.19~1.49)RR可信区间无交叠,差异有统计学意义外,其他不同类别的各亚组间RR值差异没有统计学意义。结论 虽然与西方国家相比,中国人群RR值偏低,但吸烟仍是COPD的重要危险因素,其中女性较男性危险度更高。为减轻COPD造成的疾病负担,应进一步加强控烟相关措施。同时,作为一篇只针对于中国人群的研究,本篇文献将为制定中国控烟政策及评估中国烟草带来的疾病负担提供相关依据。  相似文献   

5.
目的 评价牙周病与冠心病的关联程度,为制定预防措施提供依据.方法 检索符合本研究分析条件的牙周病与冠心病相关性文献,采用Meta分析法,进行定量综合分析.运用Rev Man 4.2分析软件和SPSS 13.0统计软件计算相关危险因素OR或RR值及95%CI,并绘制森林图.结果 共筛选出相关文献13篇,其中10篇为病例-对照研究,合并OR值为2.21,95%CI为1.91~2.56,3篇为队列研究,合并RR值=1.40,95%CI为1.28~1.54.对所有研究进行异质性检验,各研究差别无统计学意义(X2=9.08,P=0.70),采用固定效应模型进行Meta分析,表明有无牙周病对患冠心病的危险性差别有统计学意义(RR=1.43,95%CI为1.35~1.52).结论 牙周病与冠心病呈显著相关性,且可能互为致病和加重病情的危险因素.  相似文献   

6.
目的 探讨含糖饮料摄入与2型糖尿病的关系,为制定糖尿病的预防控制措施提供依据。方法 计算机检索Pub Med、the Cochrane Library、ELSEVIER Science Direct、Ovid、Pro Quest、中国期刊全文数据库(CNKI)和万方数据库,收集国内外1997年1月至2014年7月公开发表的关于含糖饮料摄入与2型糖尿病关系的前瞻性队列研究。应用Stata 12软件进行Meta分析,计算合并效应量(RR)及其95%CI和剂量-反应关系,采用Egger’s检验评估发表偏倚。结果 共纳入9篇文献,累计402 901人。含糖饮料摄入与2型糖尿病关系的合并RR值为1.31(95%CI:1.19~1.43),每天每增加1份含糖饮料摄入,2型糖尿病发病风险增加28%。Egger’s检验的P值为0.86,所纳入分析的文献不存在发表偏倚。结论 增加含糖饮料摄入会增加2型糖尿病的发病风险。  相似文献   

7.
目的 索体力活动与结肠癌发生的病因学联系.方法 集和整理1979-2009年国内外公开发表的体力活动与结肠癌关系的队列研究文献,开展Meta分析.其中,各文献RR值的合并采用倒方差法或DerSimonian-Laird method(D-L)法,剂量-反应关系的评价采用方差加权的最小二乘法.结果 入Meta分析的文献共28篇.与低体力活动者相比,男、女性高体力活动者结肠癌RR值分别为0.75(95%CI:0.66~0.86)、0.85(95%CI:0.76~0.95).高质量文献分析显示体力活动与结肠癌,男性RR=0.74(95%CI:0.61~0.90)、女性接近统计学意义的RR=0.99(95%CI:0.95~1.02).男、女性中均未观察到明显的剂量-反应关系,趋势检验分别为P=0.142和P=0.417.结肠亚部位分析结果显示,增加体力活动与男性近端(右侧)结肠癌与远端(左侧)结肠癌发生均有关联,合并RR值分别为0.62(95%CI:0.45~0.85)和0.74(95%CI:0.56~0.99).结论 增加体力活动可以降低结肠癌发生的危险性.  相似文献   

8.
目的 通过Meta分析研究水果摄入对胃癌发生的影响.方法 通过Medline、Pubmed、Ovid数据库及万方数据库、中国期刊全文数据库、重庆维普数据库等工具检索2001年1月至2012年10月国内外发表的关于水果摄入与胃癌关系的队列研究,收集文献资料.采用Meta分析的方法对数据进行分析,根据异质性采用不同的模型对检索文献的相对危险度(RR)值及其95%可信区间(CI)值进行合并,并根据地区、随访时间、调整因素进行亚组分析.结果 共纳入队列研究文献7篇,随访人数1 173 859例,其中胃癌患者3679例;总合并效应量为0.89(95% CI:0.78 ~ 1.01),提示水果摄入对胃癌的发生保护性作用不具有独立性;亚组分析结果表明,随访时间≥10年的合并效应量为0.94(95% CI:0.85 ~0.99),调整了年龄、吸烟、饮酒等生活习惯因素的效应量为0.81(95%CI:0.54 ~0.99),提示排除了不良生活习惯等因素的影响,水果的摄入对胃癌的发生具有保护作用.结论 水果摄入对胃癌发生具有抑制作用,建议在饮食中适当增加水果以预防胃癌的发生.  相似文献   

9.
目的通过meta分析系统评价血液中miR-21对乳腺癌的诊断价值。方法检索国内外多个数据库,收集2008年1月—2018年7月公开发表的关于miR-21用于乳腺癌诊断的研究数据,按照纳入标准筛选文献、提取资料和质量评价,采用metadisc 1.4对纳入研究进行meta分析。结果共纳入8篇文献,累计502例乳腺癌患者和272例对照。Meta分析结果显示,合并敏感度为0.78(95%CI:0.74~0.81),特异度为0.86(95%CI:0.81~0.90);阳性似然比(PLR值)为4.72(95%CI:3.51~6.34),阴性似然比(NLR值)为0.26(95%CI:0.18~0.38),诊断比值比(DOR值)为19.09(95%CI:10.09~36.09)。亚组分析显示,亚洲人群对照亚组的诊断准确性优于非亚洲人群对照亚组[曲线下面积(AUC):0.894 vs 0.877,P0.05]。敏感性分析显示meta分析结果并未过分依赖于某个研究,其结论稳定。结论 miR-21用于乳腺癌诊断具有一定的价值。  相似文献   

10.
了解中国中小学生龋齿流行态势,为学校龋齿防治工作提供科学依据.方法 系统检索PubMed, Web of Science,Embase 和CNKI 等数据库.英文检索词为"Dental caries""School student""China""Prevalence",中文检索词为龋齿、中小学生、中国、患病率.同时辅以人工检索参考文献.检索范围为2010年1月至2018年2月.应用随机效应模型计算合并龋患率及其95%CI,按学段、性别、城乡进行亚组分组.结果 纳入文献49 篇,总人数4 526 031 人,龋患人数997 208 例,纳入的研究调查覆盖19 省份,调查时间为2010—2016年.龋患率的中位数为21.56%,P25 ~ P75为15.46%~37.78%.各地龋患率差异较大,其中最低为3.44%,最高为75.80%,各研究间表现为异质性.Meta 分析显示,中国中小学生龋患率为27.11% (95%CI = 24.63%~ 29.59%).亚组分析中,中学生龋患率为20.67%(95%CI = 17.39%~ 23.94%) 低于小学生的28.82%(95%CI = 25.16%~ 32.48%) (RR= 0.73,95%CI = 0.57 ~ 0.93,P<0.01).男生龋患率为27.18%(95%CI = 23.36%~ 31.01%),低于女生的31.60%(95%CI = 27.28%~ 35.91%) (RR = 0.83,95%CI = 0.81 ~ 0.86,P<0.01).城市学生龋患率为32.41%(95%CI = 24.04% ~ 40.78%),低于农村的35.07%(95%CI = 22.46% ~ 47.69%) (RR = 0.90,95%CI = 0.76 ~ 1.06,P= 0.20).结论 龋齿是影响中小学生的主要疾病.应加强中小学生龋齿防治工作,有针对性地进行宣传教育和开展早期预防与干预.  相似文献   

11.
The association between anthropometric indices and the risk of breast cancer was analyzed using pooled data from seven prospective cohort studies. Together, these cohorts comprise 337,819 women and 4,385 incident invasive breast cancer cases. In multivariate analyses controlling for reproductive, dietary, and other risk factors, the pooled relative risk (RR) of breast cancer per height increment of 5 cm was 1.02 (95% confidence interval (CI): 0.96, 1.10) in premenopausal women and 1.07 (95% CI: 1.03, 1.12) in postmenopausal women. Body mass index (BMI) showed significant inverse and positive associations with breast cancer among pre- and postmenopausal women, respectively; these associations were nonlinear. Compared with premenopausal women with a BMI of less than 21 kg/m2, women with a BMI exceeding 31 kg/m2 had an RR of 0.54 (95% CI: 0.34, 0.85). In postmenopausal women, the RRs did not increase further when BMI exceeded 28 kg/m2; the RR for these women was 1.26 (95% CI: 1.09, 1.46). The authors found little evidence for interaction with other breast cancer risk factors. Their data indicate that height is an independent risk factor for postmenopausal breast cancer; in premenopausal women, this relation is less clear. The association between BMI and breast cancer varies by menopausal status. Weight control may reduce the risk among postmenopausal women.  相似文献   

12.
This meta-analysis was conducted to assess the association between coffee consumption and prostate cancer risk. Thirteen cohort studies with 34,105 cases and 539,577 participants were included in the meta-analysis. The summary relative risks (RRs) with 95% confidence intervals (CIs) for different coffee intake levels were calculated. Dose-response relationship was assessed using generalized least square trend estimation. The pooled RR for the highest vs. lowest coffee intake was 0.90 (95% CI: 0.85–0.95), with no significant heterogeneity across studies (P = 0.267; I2= 17.5%). The dose-response analysis showed a lower cancer risk decreased by 2.5% (RR = 0.975; 95% CI: 0.957–0.995) for every 2 cups/day increment in coffee consumption. Stratifying by geographic region, there was a statistically significant protective influence of coffee on prostate cancer risk among European populations. In subgroup analysis of prostate cancer grade, the summary RRs were 0.89 (95% CI: 0.83–0.96) for nonadvanced, 0.82 (95% CI: 0.61–1.10) for advanced and 0.76 (95% CI: 0.55–1.06) for fatal diseases. Our findings suggest that coffee consumption may be associated with a reduced risk of prostate cancer and it also has an inverse association with nonadvanced prostate cancer. Because of the limited number of studies, more prospective studies with large sample size are needed to confirm this association.  相似文献   

13.
In this study, we examined the available evidence and sources of heterogeneity for studies of dairy products, calcium, and vitamin D intake and the risk of prostate cancer. We pooled data from 45 observational studies using a general variance-based, meta-analytic method employing CIs. Summary relative risks (RRs) were calculated for specific dairy products such as milk and dairy micronutrients. Sensitivity analyses were performed to test the robustness of these summary measures of effect. Cohort studies showed no evidence of an association between dairy [RR = 1.06; 95% confidence interval (CI) = 0.92-1.22] or milk intake (RR = 1.06; 95% CI = 0.91-1.23) and risk of prostate cancer. This was supported by pooled results of case-control analyses (RR = 1.14; 95% CI = 1.00-1.29), although studies using milk as the exposure of interest were heterogeneous and could not be combined. Calcium data from cohort studies were heterogeneous. Case-control analyses using calcium as the exposure of interest demonstrated no association with increased risk of prostate cancer (RR = 1.04; 95% CI = 0.90-1.15). Dietary intake of vitamin D also was not related to prostate cancer risk (RR = 1.16; 95% CI = 0.98-1.38). The data from observational studies do not support an association between dairy product use and an increased risk of prostate cancer.  相似文献   

14.
BACKGROUND: Carotenoids may reduce lung carcinogenesis because of their antioxidant properties; however, few studies have examined the relation between intakes of individual carotenoids and lung cancer risk. OBJECTIVE: The aim of this study was to examine the relation between lung cancer risk and intakes of alpha-carotene, beta-carotene, lutein, lycopene, and beta-cryptoxanthin in 2 large cohorts. DESIGN: During a 10-y follow-up period, 275 new cases of lung cancer were diagnosed in 46924 men; during a 12-y follow-up period, 519 new cases were diagnosed in 77283 women. Carotenoid intakes were derived from the reported consumption of fruit and vegetables on food-frequency questionnaires administered at baseline and during follow-up. The data were analyzed separately for each cohort and the results were pooled to compute overall relative risks (RRs). RESULTS: In the pooled analyses, alpha-carotene and lycopene intakes were significantly associated with a lower risk of lung cancer; the association with beta-carotene, lutein, and beta-cryptoxanthin intakes were inverse but not significant. Lung cancer risk was significantly lower in subjects who consumed a diet high in a variety of carotenoids (RR: 0.68; 95% CI: 0.49, 0.94 for highest compared with lowest total carotenoid score category). Inverse associations were strongest after a 4-8-y lag between dietary assessment and date of diagnosis. In subjects who never smoked, a 63% lower incidence of lung cancer was observed for the top compared with the bottom quintile of alpha-carotene intake (RR: 0.37; 95% CI: 0.18, 0.77). CONCLUSION: Data from 2 cohort studies suggest that several carotenoids may reduce the risk of lung cancer.  相似文献   

15.
As several epidemiological studies on the association of coffee consumption with gastric cancer risk have produced inconsistent results, this meta-analysis was designed to synthesize current evidence of this potential relationship. We searched PubMed, EMBASE, and the Cochrane Library up to September 2014 to retrieve relevant articles. Prospective cohort studies were included if the relative risks (RRs) or hazard ratios and 95% confidence intervals (CIs) for gastric cancer according to coffee consumption were reported. Fixed- or random-effects models were used based on heterogeneity. The search yielded 13 eligible cohort studies of 3484 incident gastric cancer patients from among 1,324,559 participants. A significantly increased risk was found between gastric cardia cancer and coffee consumption (RR = 1.50, 95% CI: 1.09–2.07). Compared with Europeans (RR = 1.12, 95% CI: 0.86–1.46) and Asians (RR = 0.96, 95% CI: 0.72–1.27), Americans (RR = 1.36, 95% CI: 1.06–1.74) demonstrated a significantly positive association. However, the significant differences of the pooled results vanished after adjusting for smoking or body mass index. Our meta-analysis results suggest that a high level of coffee consumption is a risk factor for gastric cancer. However, these results should not be overinterpreted because residual confounding effects of other factors could exist.  相似文献   

16.
Alcohol drinking increases the risk of several types of cancer, but studies of the relation between alcohol and lung cancer risk are complicated by smoking. The authors carried out meta-analyses for four study designs and conducted sensitivity analyses to assess the results. Pooled smoking-unadjusted relative risks (RRs) for brewery workers and alcoholics were 1.17 (95% confidence interval (CI): 0.99, 1.39) and 1.99 (95% CI: 1.66, 2.39), respectively, relative to population rates. For cohort and case-control studies, the authors conducted dose-specific meta-analyses for ethanol consumption of 1-499, 500-999, 1,000-1,999, and > or = 2,000 g/month, relative to nondrinking. Smoking-adjusted RRs for ascending dose groups in cohort studies were 0.98 (95% CI: 0.79, 1.21), 0.92 (95% CI: 0.81, 1.04), 1.04 (95% CI: 0.88, 1.22), and 1.53 (95% CI: 1.04, 2.25), respectively. Smoking-adjusted odds ratios for ascending groups in case-control studies were 0.63 (95% CI: 0.51, 0.78), 1.30 (95% CI: 0.98, 1.70), 1.13 (95% CI: 0.46, 2.75), and 1.86 (95% CI: 1.39, 2.49), respectively. Elevated odds ratios were seen for hospital-based case-control studies but not for population-based case-control studies. Sensitivity analyses indicated that smoking explained the elevated RRs in studies of alcoholics and that strong misclassification of smoking status could produce an elevated smoking-adjusted RR in cohort and case-control studies. Overall, evidence for a smoking-adjusted association between alcohol and lung cancer risk is limited to very high consumption groups in cohort and hospital-based case-control studies. At lower levels, any associations observed appear to be explained by confounding.  相似文献   

17.
Objectives: We performed a meta-analysis to assess the association and possible dose–response relationship between dietary inflammation index (DII)? and colorectal cancer (CRC). Methods: A literature search was performed in PubMed, Web of Science and Chinese National Knowledge Infrastructure (CNKI) database for all relevant studies. The pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated by random effects model. Results: A total of eight studies were included in this meta-analysis. The pooled RRs of CRC, colon and rectal cancer for the highest versus lowest DII categories were 1.43 (95% CI 1.25–1.63), 1.37 (95% CI 1.16–1.62) and 1.44 (95% CI 1.23–1.69), respectively. A significant positive association was observed both in cohort studies (RR = 1.26, 95% CI 1.14–1.38) and case–control studies (RR = 1.81, 95% CI 1.48–2.22). Nonlinear associations between DII scores and the risk of CRC, colon and rectal cancer were found in the dose–response analyses, the results showed that the risks of CRC, colon and rectal cancer increased slowly when the DII score was above 1.30, 2.21, and 1.30, respectively. Conclusion: Higher DII scores might increase CRC risk. Thus, people should adopt more anti-inflammatory diets such as those high in vegetables, fruits, whole grains, herbs, and spices.  相似文献   

18.
BACKGROUND: Although smoking is the primary cause of lung cancer, much is unknown about lung cancer etiology, including risk determinants for nonsmokers and modifying factors for smokers. OBJECTIVE: We hypothesized that alcohol consumption contributes to lung cancer risk. DESIGN: We conducted a pooled analysis using standardized exposure and covariate data from 7 prospective studies with 399,767 participants and 3137 lung cancer cases. Study-specific relative risks (RRs) and CIs were estimated and then combined to calculate pooled multivariate RRs by using a random-effects model. RESULTS: We found a slightly greater risk for the consumption of > or = 30 g alcohol/d than for that of 0 g alcohol/d in men (RR: 1.21; 95% CI: 0.91, 1.61; P for trend = 0.03) and in women (RR: 1.16; 95% CI: 0.94, 1.43; P for trend = 0.03). In male never smokers, the RR for consumption of > or = 15 g alcohol/d rather than 0 g alcohol/d was 6.38 (95% CI: 2.74, 14.9; P for trend < 0.001). In women, there were few never-smoking cases and no evidence of greater risk (RR: 1.35; 95% CI: 0.64, 2.87). Because of possible residual confounding by smoking, we performed sensitivity analyses by reclassifying the never smokers in the highest drinking category as former smokers. Resulting associations for alcohol consumption were somewhat attenuated, but P for trend = 0.05 for men, which was near the original P = 0.03. CONCLUSIONS: A slightly greater risk of lung cancer was associated with the consumption of > or = 30 g alcohol/d than with no alcohol consumption. Alcohol consumption was strongly associated with greater risk in male never smokers. Residual confounding by smoking may explain part of the observed relation.  相似文献   

19.
In this study, we examined the available evidence and sources of heterogeneity for studies of dairy products, calcium, and vitamin D intake and the risk of prostate cancer. We pooled data from 45 observational studies using a general variance-based, meta-analytic method employing CIs. Summary relative risks (RRs) were calculated for specific dairy products such as milk and dairy micronutrients. Sensitivity analyses were performed to test the robustness of these summary measures of effect. Cohort studies showed no evidence of an association between dairy [RR = 1.06; 95% confidence interval (CI) = 0.92–1.22] or milk intake (RR = 1.06; 95% CI = 0.91–1.23) and risk of prostate cancer. This was supported by pooled results of case-control analyses (RR = 1.14; 95% CI = 1.00–1.29), although studies using milk as the exposure of interest were heterogeneous and could not be combined. Calcium data from cohort studies were heterogeneous. Case-control analyses using calcium as the exposure of interest demonstrated no association with increased risk of prostate cancer (RR = 1.04; 95% CI = 0.90–1.15). Dietary intake of vitamin D also was not related to prostate cancer risk (RR = 1.16; 95% CI = 0.98–1.38). The data from observational studies do not support an association between dairy product use and an increased risk of prostate cancer.  相似文献   

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