酒精摄入与女性乳腺癌发病风险的Meta分析

目的 探讨酒精摄入与女性乳腺癌发病风险的关联性。方法 通过Stata 12.0软件对国内外发表的有关酒精摄入与女性乳腺癌发病风险的队列研究和病例对照研究进行Meta分析。结果 共纳入16项病例对照研究和15项队列研究,包括50 519例患者和973 216例对照者。病例对照研究Meta分析提示,酒精暴露可明显增加女性个体发生乳腺癌的风险,合并OR值为1.18,95％置信区间为1.05～1.32;以绝经状态为亚组的Meta分析提示,酒精暴露可增加绝经后女性个体发生乳腺癌的风险,合并OR值为1.26,95％置信区间为1.08～1.46。队列研究Meta分析提示,有酒精暴露者女性乳腺癌的发生率是非饮酒者的1.1倍,合并RR值为1.10,95％置信区间为1.06～1.15;以绝经状态为亚组的Meta分析提示,有酒精暴露的绝经后女性乳腺癌的发生率是非饮酒者的1.1倍,合并RR值为1.14,95％置信区间为1.10～1.19。结论 酒精摄入可显著提高女性尤其绝经后乳腺癌的发病风险。     

Association between domains of physical activity and all-cause,cardiovascular and cancer mortality

Few studies have investigated the independent effects of domain-specific physical activity on mortality. We sought to investigate the association of physical activity performed in different domains of daily living on all-cause, cardiovascular (CVD) and cancer mortality. Using a prospective cohort design, 4,672 men and women, aged 25–74 years, who participated in the baseline examination of the MONICA/KORA Augsburg Survey 1989/1990 were classified according to their activity level (no, light, moderate, vigorous). Domains of self-reported physical activity (work, transportation, household, leisure time) and total activity were assessed by the validated MOSPA (MONICA Optional Study on Physical Activity) questionnaire. After a median follow-up of 17.8 years, a total of 995 deaths occurred, with 452 from CVD and 326 from cancer. For all-cause mortality, hazard ratios and 95% confidence interval (HR, 95% CI) of the highly active versus the inactive reference group were 0.69 (0.48–1.00) for work, 0.48 (0.36–0.65) for leisure time, and 0.73 (0.59–0.90) for total activity after multivariable adjustments. Reduced risks of CVD mortality were observed for high levels of work (0.54, 0.31–0.93), household (0.80, 0.54–1.19), leisure time (0.50, 0.31–0.79) and total activity (0.75, 0.55–1.03). Leisure time (0.36, 0.23–0.59) and total activity (0.62, 0.43–0.88) were associated with reduced risks of cancer mortality. Light household activity was related to lower all-cause (0.82, 0.71–0.95) and CVD (0.72, 0.58–0.89) mortality. No clear effects were found for transportation activities. Our findings suggest that work, household, leisure time and total physical activity, but not transportation activity, may protect from premature mortality.     

Association between physical activity and patient-reported outcome measures in patients with lung cancer: a systematic review and meta-analysis

Quality of Life Research - The aim of this systematic review was to examine the association between physical activity (PA) and Health-Related Quality of Life (HRQoL) as well as other...     

Metabolic syndrome and all-cause mortality: a meta-analysis of prospective cohort studies

To synthesize the available data on the association between metabolic syndrome and all-cause mortality, we conducted a meta-analysis of prospective cohort studies. We performed a literature search using Medline, EMBASE and Cochrane Library from 2001 to December 2009, with no restrictions. We included studies if they were prospective, had an assessment of metabolic syndrome at baseline and risk of all-cause mortality. We recorded several characteristics for each study. We extracted relative risks (RR) and 95% confidence intervals (CI) and pooled them using fixed or random effects models. We performed sensitivity analysis, and assessed heterogeneity and publication bias. A total of 21 studies including 372,411 participants were included in our meta-analysis. 18,556 deaths from any cause occurred during a mean follow-up of 11.5 years. Individuals with the metabolic syndrome, compared to those without, had an increased mortality from all causes (pooled RR 1.46; 95% CI 1.35–1.57). The RR of all-cause mortality associated with metabolic syndrome was higher in studies using the National Cholesterol Education Program Adult Treatment Panel (NCEP) than the revised NCEP criteria (RR: 1.45 vs. 1.25; P = 0.0002). Metabolic syndrome is an important risk factor for all-cause mortality. The diagnosis and treatment of the underlying risk factors for the metabolic syndrome should be an important strategy for the reduction of all-cause mortality associated with metabolic syndrome in the general population.     

Diabetes mellitus and incidence and mortality of colorectal cancer: a systematic review and meta-analysis of cohort studies

Increasing evidence suggests that a history of diabetes mellitus (DM) may be associated with an increased risk of colorectal cancer (CRC). To provide a quantitative assessment of the association between DM and risk of CRC, We evaluated the relation between DM and incidence and mortality of CRC in a systematic review of cohort studies. Full publications of cohort studies were identified in MEDLINE, EMBASE and Science Citation Index Expanded, through February 28, 2011. Summary relative risks (SRRs) with 95% confidence intervals (CIs) were summarized using a random-effects model. Between-study heterogeneity was assessed using the Cochran’s Q and I² statistics. A total of 41 cohort studies (35 articles) were included in this systematic review. Combining 30 cohort studies which presented results on diabetes and CRC incidence, diabetes was associated with an increased incidence of CRC (SRRs 1.27, 95% CI: 1.21–1.34), with evident heterogeneity among studies (P = 0.002, I² = 48.4%). Subgroup analysis and meta-regression analysis by controlling the confounders showed that the increased incidence of CRC was independent of geographic locations, sex, family history of colorectal cancer, smoking, physical activity and body mass index. Diabetes was also positively associated with CRC mortality (SRR 1.20, 95% CI: 1.03–1.40), with evidence of heterogeneity between studies (P < 0.001, I² = 81.4%). Results from this systematic review support that compared to non-diabetic individuals, diabetic individuals have an increased risk of CRC.     

我国大气PM_(10)污染对人群死亡率影响的meta分析

目的综合相关文献,建立我国PM_(10)与居民死亡率之间的暴露-反应关系。方法通过各数据库和文献检索平台收集2005—2015年发表的符合纳入标准的我国大气PM_(10)污染与居民每日总死亡率、呼吸系统及心脑血管疾病死亡率关系的文献,共纳入20篇共37组相关数据。采用Stata 12.0软件进行meta分析,提取PM_(10)与人群死亡的暴露-反应系数,利用随机或固定效应模型合并效应值,对结果进行敏感性分析、发表偏倚检验及校正。结果建立了我国大气PM_(10)与居民每日死亡之间的暴露-反应关系,我国大气PM_(10)每上升10μg/m3,人群每日总死亡率、呼吸系统疾病和心脑血管疾病死亡率的相对危险度(RR)及95%CI分别为1.001 4(95%CI:1.000 8~1.002 0),1.001 6(95%CI:0.999 9~1.003 3),1.002 5(95%CI:1.001 4~1.003 6)。结论大气PM_(10)浓度上升可导致我国居民总死亡率、呼吸系统疾病和心脑血管疾病死亡率增加。     

我国大气可吸入颗粒物污染对人群死亡率的影响

目的 综合相关文献并以暴露-反应关系的形式探讨中国可吸入颗粒物( PM10)污染对人群死亡率的影响.方法 收集符合纳入标准的中国大气颗粒物污染与居民总死亡率、心脑血管疾病死亡率、呼吸系统疾病死亡率关系的文献,共纳入21篇文献.采用Stata9.0软件进行统计分析,提取PM10与人群死亡率的暴露-反应系数,利用固定或随机效应模型合并效应值,并对结果进行敏感性分析、发表偏倚检验与校正.结果 我国大气PM10每上升10 μg/m3,人群每日总死亡率、心脑血管疾病和呼吸系统疾病死亡率的相对危险度(RR)分别为1.0033(95％ CI:1.0022～1.0044)、1.0045(95％ CI:1.0029 ～1.0062)和1.0056(95％CI:1.0033～1.0079);校正发表偏倚后,人群每日总死亡率、心脑血管疾病和呼吸系统疾病死亡率的RR值降为1.0012(95％CI:1.0002～1.0022)、1.0011(95％ CI:0.9996～1.0026)和1.0023(95％ CI:1.0001～1.0045).结论 大气中PM10浓度的上升会导致我国人群每日总死亡率、心脑血管疾病死亡率和呼吸系统疾病死亡率的增加.     

Association between fruit and vegetable consumption and oral cancer: a meta-analysis of observational studies

BACKGROUND: Oral cancer ranks as the seventh most common form of cancer worldwide. Recent reports have examined the effect of fruit and vegetable intake on the risk of oral cancer, but results are controversial. OBJECTIVE: A meta-analysis was performed to arrive at quantitative conclusions about the contribution of fruit and vegetable intakes to the occurrence of oral cancer. DESIGN: A comprehensive, systematic bibliographic search of medical literature published up to September 2005 was conducted to identify relevant studies. Separate meta-analyses were conducted for fruit and vegetable consumption. The effect of portion or daily intake of fruit or vegetables on the risk of oral cancer was calculated. A multivariate meta-regression analysis was performed to explore heterogeneity. This multivariate meta-regression analysis examined the effect of quality score, the type of cancers included, citrus fruit and green vegetable consumption, and the time interval for dietary recall of the studies on the role of fruit or vegetable consumption in the risk of oral cancer. The presence of publication bias was assessed with a funnel plot for asymmetry. RESULTS: Sixteen studies (15 case-control studies and 1 cohort study) met the inclusion criteria and were included in the meta-analysis. The combined adjusted odds ratio (OR) estimates showed that each portion of fruit consumed per day significantly reduced the risk of oral cancer by 49% (OR: 0.51; 95% CI: 0.40, 0.65). For vegetable consumption, the meta-analysis showed a significant reduction in the overall risk of oral cancer of 50% (OR: 0.50; 95% CI: 0.38, 0.65). The multivariate meta-regression showed that the lower risk of oral cancer associated with fruit consumption was significantly influenced by the type of fruit consumed and by the time interval of dietary recall. CONCLUSION: The consumption of fruit and vegetables is associated with a reduced risk of oral cancer.     

The relation between dietary flavonol intake and coronary heart disease mortality: a meta-analysis of prospective cohort studies

OBJECTIVE: To assess the association of dietary flavonol intake with the subsequent risk of coronary heart disease (CHD) mortality. DESIGN: Meta-analysis of prospective cohort studies published before September 2001. Studies were identified by MEDLINE and EMBASE searches and by scanning relevant reference lists. The following information was extracted from published reports: size of cohort, mean age, mean duration of follow-up, number of fatal CHD events, mean flavonol intake, main sources of flavonol intake, degree of adjustment for potential confounders, and the relation of CHD mortality to dietary flavonol intake measured at baseline. RESULTS: Seven prospective cohorts of men and women were identified including a total of 2087 fatal CHD events. Comparison of individuals in the top third with those in the bottom third of dietary flavonol intake yielded a combined risk ratio of 0.80 (95% CI 0.69-0.93) after adjustment for known CHD risk factors and other dietary components. CONCLUSION: This overview of prospective cohort studies indicates that high dietary intake of flavonols from a small number of fruits and vegetables, tea and red wine may be associated with a reduced risk from CHD mortality in free-living populations.     

2,3,7,8-Tetrachlorodibezo-p-dioxin exposure and prostate cancer: a meta-analysis of cohort studies

Objective

To perform a meta-analysis of cohort studies and evaluate the association between exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and prostate cancer quantitatively.

Study design

Publications before April 2012 about populations exposed to TCDD were searched in PubMed. Only cohort studies were included. Extraction and quality assessment of included articles was performed independently by two authors using the MOOSE guidelines.

Methods

A total of 17 cohort studies on prostate cancer with information about standardized mortality ratios (SMR), risk ratio (RR), standardized incidence ratios (SIR) and TCDD exposure were included. SMRs and RRs were pooled separately after weighing each study by calculating the inverse of the estimated variance.

Results

Based on the 13 reported SMRs or SIRs, the meta-analysis yielded a meta-SMR of 1.26 (95% confidence interval 1.00–1.57, P = 0.046). The meta-RR, based on four reported RR from four cohorts, was 1.04 (95% confidence interval 0.85–1.28). Begg's funnel plot showed little evidence of publication bias (Egger's test P-value = 0.817).

Conclusion

This meta-analysis suggests that exposure to TCDD is associated with increased risk of prostate cancer.     

The association between physical activity and gastroesophageal cancer: systematic review and meta-analysis

Physical activity may decrease gastroesophageal cancer risk through a reduction of oxidative stress and decreased chronic inflammation, yet few epidemiologic studies have been able to report a clear inverse association between physical activity and gastroesophageal cancer. Because no meta-analysis has investigated the relation of physical activity to gastroesophageal cancer, we conducted a comprehensive systematic review and meta-analysis according to the PRISMA guidelines based on 24 studies with a total of 15,745 cases. When we compared high versus low physical activity levels and summarized associations according to anatomic site and tumor histology, risk reductions were evident for esophageal adenocarcinoma [relative risk (RR) = 0.79, 95 % confidence interval (CI) = 0.66–0.94], gastric cardia adenocarcinoma (RR = 0.83, 95 % CI = 0.69–0.99) and gastric non-cardia adenocarcinoma (RR = 0.72, 95 % CI = 0.62–0.84). The risk reduction for esophageal squamous cell carcinoma (RR = 0.94, 95 % CI = 0.41–2.16) became statistically significant (RR = 0.66, 95 % CI = 0.46–0.96) after excluding an influential study. The test for heterogeneity by gastroesophageal cancer subtype was statistically non-significant (p-difference = 0.71). The RR of total gastroesophageal cancer for high versus low physical activity was 0.82 (95 % CI = 0.74–0.90). A dose–response analysis of frequency of physical activity and total gastroesophageal cancer risk revealed that the greatest risk reduction was achieved among those engaging in moderate to vigorous physical activity five times per week (RR = 0.67, 95 % CI = 0.58–0.79). Our results provide support for an inverse relation of physical activity, in particular exercise frequency, to gastroesophageal cancer risk.     

Association between dietary fiber and endometrial cancer: a meta-analysis

Abstract

To explore a potential relationship between dietary fiber consumption and risk of endometrial cancer (EC), eligible studies published up to 30 June 2018 were retrieved via computer searches and manual review of references. Random-effects models were used to calculate summary relative risk (RR) estimates based on contrasting high- and low-fiber intake values. Sensitivity analysis was conducted, and heterogeneity among study results was explored through stratified analyses by study design, geographic region, Newcastle-Ottawa Scale (NOS) score, impact factor, and adjustment for several confounders (age, body mass index, smoking, energy intake, and education). We extracted data from 16 studies (involving 6,563 cases). There was a significant association between dietary fiber intake and EC (RR?=?0.86, 95% confidence interval [CI]: 0.78, 0.93). In stratified analysis, this trend was more pronounced in the case–control studies, and in studies conducted in the Americas and Asia. The relationship was further confirmed after adjusting for education level (RR?=?0.74; 95% CI: 0.60, 0.88) and age (RR?=?0.70; 95% CI: 0.57, 0.83), and NOS scores of 6 (RR?=?0.81; 95% CI: 0.67, 0.95) and 7 (RR?=?0.75; 95% CI: 0.62, 0.88). In conclusion, our meta-analysis revealed an inverse association between dietary fiber consumption and EC risk. Further efforts should be made to confirm these findings.     

Determining the association between physical activity prior to conception and pregnancy rate: A systematic review and meta-analysis of prospective cohort studies

Abstract

We investigated the association between physical activity (PA) before pregnancy and pregnancy rate according to intensity and amount of exercise. Eleven prospective cohort studies were included in this meta-analysis. Any amount of moderate-intensity PA was associated with a statistically higher rate of pregnancy compared to that in patients with no PA (p < .05). Any amount of vigorous PA was associated with decreased pregnancy rate; regular PA was associated with decreased infertility (p > .05). In contrast, vigorous PA was associated with increased infertility (p > .05). Therefore, women who are preparing for pregnancy are recommended to perform regular, moderate-intensity PA.     

体育锻炼与高血压间关联强度的剂量-反应关系研究

目的 探讨体育锻炼强度与高血压之间的剂量-反应关系。方法 采用多阶段分层随机整群抽样的方法,于2014年3至6月,在淄博市张店区18-69岁人群进行问卷调查和体格测量。采用logistic回归模型和限制性立方样条模型,分析体育锻炼频率和时间与高血压的剂量反应关系。结果 单因素分析结果显示,参加体育锻炼与高血压之间存在相关关系(OR=0.67,95%CI:0.55-0.83);调整年龄、性别、婚姻状况、教育水平、吸烟、饮酒及体质指数后,多因素logistic回归分析显示,体育锻炼与高血压病存在负相关(OR=0.86,95%CI:0.68-0.97)。限制性立方样条模型分析显示,每周锻炼次数及每次锻炼时间均与高血压病之间呈非线性剂量-反应关系(非线性检验,P<0.05)。结论 随着体育锻炼频率和时间的增加,高血压发病风险逐渐降低。