scholarly journals Diurnal cortisol and mental well-being in middle and older age: evidence from four cohort studies

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e016085 ◽  
Author(s):  
Mai Stafford ◽  
Yoav Ben-Shlomo ◽  
Cyrus Cooper ◽  
Catharine Gale ◽  
Michael P Gardner ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Meta Analysis ◽  
Serum Cortisol ◽  
Well Being ◽  
Mental Wellbeing ◽  
Diurnal Cortisol ◽  
Morning Cortisol ◽  
Study Heterogeneity ◽  
Individual Participant

ObjectivesWe conducted an individual participant meta-analysis to test the hypothesis that cortisol patterns indicative of dysregulated hypothalamic–pituitary–adrenal axis functioning would be prospectively associated with poorer well-being at follow-up.SettingFour large UK-based cohort studies.ParticipantsThose providing valid salivary or serum cortisol samples (n=7515 for morning cortisol; n=1612 for cortisol awakening response) at baseline (age 44–82) and well-being data on the Warwick Edinburgh Mental Wellbeing Scale at follow-up (0–8 years) were included.ResultsWell-being was not associated with morning cortisol, diurnal slope or awakening response though a borderline association with evening cortisol was found. Adjusting for sex and follow-up time, each 1 SD increase in evening cortisol was associated with a −0.47 (95% CI −1.00 to 0.05) point lower well-being. This was attenuated by adjustment for body mass index, smoking and socioeconomic position. Between-study heterogeneity was low.ConclusionsThis study does not support the hypothesis that diurnal cortisol is prospectively associated with well-being up to 8 years later. However, replication in prospective studies with cortisol samples over multiple days is required.

scholarly journals Subclinical thyroid dysfunction and depressive symptoms: protocol for a systematic review and individual participant data meta-analysis of prospective cohort studies

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029716
Author(s):  
Lea Wildisen ◽  
Elisavet Moutzouri ◽  
Shanthi Beglinger ◽  
Lamprini Syrogiannouli ◽  
Anne R Cappola ◽  
...  
Keyword(s):  
Systematic Review ◽  
Depressive Symptoms ◽  
Cohort Studies ◽  
Prospective Cohort ◽  
Thyroid Dysfunction ◽  
Meta Analysis ◽  
Individual Participant Data ◽  
Prospective Cohort Studies ◽  
Individual Participant

IntroductionProspective cohort studies on the association between subclinical thyroid dysfunction and depressive symptoms have yielded conflicting findings, possibly because of differences in age, sex, thyroid-stimulating hormone cut-off levels or degree of baseline depressive symptoms. Analysis of individual participant data (IPD) may help clarify this association.Methods and analysisWe will conduct a systematic review and IPD meta-analysis of prospective studies on the association between subclinical thyroid dysfunction and depressive symptoms. We will identify studies through a systematic search of the literature in the Ovid Medline, Ovid Embase, Cochrane Central Register of Controlled Trials (CENTRAL) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases from inception to April 2019 and from the Thyroid Studies Collaboration. We will ask corresponding authors of studies that meet our inclusion criteria to collaborate by providing IPD. Our primary outcome will be depressive symptoms at the first available individual follow-up, measured on a validated scale. We will convert all the scores to the Beck Depression Inventory scale. For each cohort, we will estimate the mean difference of depressive symptoms between participants with subclinical hypothyroidism or hyperthyroidism and control adjusted for depressive symptoms at baseline. Furthermore, we will adjust our multivariable linear regression analyses for age, sex, education and income. We will pool the effect estimates of all studies in a random-effects meta-analysis. Heterogeneity will be assessed by I2. Our secondary outcomes will be depressive symptoms at a specific follow-up time, at the last available individual follow-up and incidence of depression at the first, last and at a specific follow-up time. For the binary outcome of incident depression, we will use a logistic regression model.Ethics and disseminationFormal ethical approval is not required as primary data will not be collected. Our findings will have considerable implications for patient care. We will seek to publish this systematic review and IPD meta-analysis in a high-impact clinical journal.PROSPERO registration numberCRD42018091627.

scholarly journals Height in relation to dementia death: individual participant meta-analysis of 18 UK prospective cohort studies

2014 ◽  
Vol 205 (5) ◽  
pp. 348-354 ◽  
Author(s):  
Tom C. Russ ◽  
Mika Kivimäki ◽  
John M. Starr ◽  
Emmanuel Stamatakis ◽  
G. David Batty
Keyword(s):  
Cohort Studies ◽  
Early Life ◽  
Response Pattern ◽  
Meta Analysis ◽  
Dementia Risk ◽  
Multiple Covariates ◽  
General Population Cohort ◽  
Individual Participant ◽  
The Mean

BackgroundThat risk factors measured in middle age may not fully explain future dementia risk implicates exposures acting earlier in life. Height may capture early-life illness, adversity, nutrition and psychosocial stress.AimsTo investigate the little-explored association between height and dementia death.MethodIndividual participant meta-analysis using 18 prospective general population cohort studies with identical methodologies (1994–2008; n = 181 800).ResultsMean follow-up of 9.8 years gave rise to 426 and 667 dementia deaths in men and women respectively. The mean heights were 174.4cm (s.d. = 7.3) for men and 161.0cm (s.d. = 6.8) for women. In analyses taking into account multiple covariates, increasing height was related to lower rates of death from dementia in a dose–response pattern (P⩽0.01 for trend). There was evidence of a differential effect by gender (P = 0.016 for interaction). Thus, the association observed in men (hazard ratio per s.d. decrease in height 1.24, 95% CI 1.11–1.39) was markedly stronger than that apparent in women (HR = 1.13, 95% CI 1.03–1.24).ConclusionsEarly-life circumstances, indexed by adult height, may influence later dementia risk.

Abstract P209: Heterogeneity of Absolute/Relative Measures of Cardiovascular Mortality Among Cohorts in an Individual Participant Data Meta-Analysis: An EPOCH-JAPAN Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Yoshitaka Murakami ◽  
Tomonori Okamura ◽  
Katsuyuki Miura ◽  
Hirotsugu Ueshima ◽  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cohort Studies ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Individual Participant Data ◽  
Individual Participant ◽  
Rate Ratios ◽  
Meta Analyses

Introduction: Individual participant data (IPD) meta-analyses involve participant-level data from multiple cohort studies. However, these cohorts have different periods (years) of follow-up, target regions, and distributions of risk factors (including patient age). It remains unclear if these variations affect the heterogeneity of absolute/relative measures of mortality in cardiovascular disease (CVD), stroke, and coronary heart disease (CHD) among cohorts. Hypothesis: There is diverse heterogeneity in absolute measures of mortality, but negligible heterogeneity in relative measures among cohorts in IPD meta-analyses. Methods: The Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH-JAPAN) study is an IPD meta-analysis of cardiovascular epidemiology. This project comprises 14 cohort studies with 105,945 Japanese subjects (total CVD deaths: 5,314). First, we examined the correlation between the follow-up periods of the baseline surveys and multivariate-adjusted mortality rates (CVD, stroke, and CHD) among the cohorts. Next, we estimated the cohort-specific mortality rates that adjusted for the stated follow-up periods, regions, age, and other risk factors using Poisson regression. Finally, we explored the heterogeneity of multivariate-adjusted mortality rates, mortality rate ratios, and rate ratios of 10-mmHg increases in systolic blood pressure using Higgins’s I 2 , which measures heterogeneity in meta-analyses. Results: High correlations were observed between the stated follow-up periods of the cohorts and their mortality rates (CVD [men, -0.70; women, -0.79], stroke [men, -0.65; women, -0.73], CHD [men, -0.24; women, -0.89]). In the multivariate-adjusted mortality rates, we observed clear heterogeneity in mortality rates among the cohorts (CVD [I 2 : men, 98.6%; women, 99.3%], stroke [I 2 : men, 98.5%; women, 98.3%], and CHD [I 2 : men, 98.2%; women 92.4%]). In the rate ratio comparison of 10-mmHg increases in systolic blood pressure, no heterogeneity was detected among the cohorts (CVD [I 2 : men, 0.0%; women, 17.9%]). Our results indicated that the ratio measure, which shows the magnitude of each risk factor, was stable even in the heterogeneity of absolute measures. Conclusions: A clear heterogeneity in mortality was observed in absolute measures, but not in relative measures, among cohorts after adjusting for the periods of follow-up, regions, and other risk factors.

scholarly journals P34 Characteristics, diagnosis and management of Cushing’s disease - A systematic review and meta-analysis

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Chan Hee Koh ◽  
Danyal Z Khan ◽  
Ronneil Digpal ◽  
Hugo Layard Horsfall ◽  
Hani J Marcus ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cushing’S Disease ◽  
Meta Analysis ◽  
A Priori ◽  
Pituitary Surgery ◽  
Serum Cortisol ◽  
Cushing's Disease ◽  
Diagnosis And Management ◽  
Over Time

Abstract Introduction The clinical practice and research in the diagnosis and management of Cushing’s disease remains heterogeneous and challenging to this day. We sought to establish the characteristics of Cushing’s disease, and the trends in diagnosis, management and reporting in this field. Methods Searches of PubMed and Embase were conducted. Study protocol was registered a-priori. Random-effects analyses were conducted to establish numerical estimates. Results Our screening returned 159 papers. The average age of adult patients with Cushing’s disease was 39.3, and 13.6 for children. The male:female ratio was 1:3. 8% of patients had undergone previous transsphenoidal resection. The ratio of macroadenomas: microadenomas:imaging-undetectable adenomas was 18:53:29. The most commonly reported preoperative biochemical investigations were serum cortisol (average 26.4µg/dL) and ACTH (77.5pg/dL). Postoperative cortisol was most frequently used to define remission (74.8%), most commonly with threshold of 5µg/dL (44.8%). Average remission rates were 77.8% with recurrence rate of 13.9%. Median follow-up was 38 months. Majority of papers reported age (81.9%) and sex (79.4%). Only 56.6% reported whether their patients had previous pituitary surgery. 45.3% reported whether their adenomas were macroadenoma, microadenoma or undetectable. Only 24.1% reported preoperative cortisol, and this did not improve over time. 60.4% reported numerical thresholds for cortisol in defining remission, and this improved significantly over time (p = 0.004). Visual inspection of bubbleplots showed increasing preference for threshold of 5µg/dL. 70.4% reported the length of follow up. Conclusion We quantified the characteristics of Cushing’s disease, and analysed the trends in investigation and reporting. This review may help to inform future efforts in forming guidelines for research and clinical practice.

scholarly journals Alcohol use and personality trait change: pooled analysis of six cohort studies

2018 ◽  
Vol 49 (2) ◽  
pp. 224-231 ◽  
Author(s):  
Christian Hakulinen ◽  
Markus Jokela
Keyword(s):  
Alcohol Use ◽  
Cohort Studies ◽  
Personality Traits ◽  
Personality Trait ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Emotional Stability ◽  
Risky Alcohol ◽  
Average Alcohol

AbstractBackgroundPersonality has been associated with alcohol use, but less is known about how alcohol use may influence long-term personality trait change.MethodsThe present study examines associations between alcohol use and change in the five major personality traits across two measurement occasions (mean follow-up of 5.6 years). A total of 39 722 participants (54% women) were pooled from six cohort studies for an individual-participant meta-analysis. Alcohol use was measured as (1) average alcohol consumption, (2) frequency of binge drinking, (3) symptoms of alcohol use disorder, and (4) a global indicator of risky alcohol use. Changes in the five major personality traits (extraversion, emotional stability, agreeableness, conscientiousness, and openness to experience) were used as outcomes.ResultsRisky alcohol use was associated with increasing extraversion [0.25 T-scores over the mean follow-up of 5.6 years; 95% confidence interval (CI) 0.07–0.44] and decreasing emotional stability (−0.28; 95% CI −0.48 to −0.08), agreeableness (−0.67; 95% CI −0.87 to −0.36), and conscientiousness (−0.58; 95% CI −0.79 to −0.38). Except the association between alcohol use and extraversion, these associations were consistent across cohort studies and across different measures of alcohol use.ConclusionsThese findings suggest that alcohol use is associated with personality trait changes in adulthood.

scholarly journals Prevalence of All-Cause Mortality and Suicide among Bariatric Surgery Cohorts: A Meta-Analysis

2018 ◽  
Vol 15 (7) ◽  
pp. 1519 ◽  
Author(s):  
Russell Lim ◽  
Melvyn Zhang ◽  
Roger Ho
Keyword(s):  
Bariatric Surgery ◽  
Analytical Study ◽  
Meta Analysis ◽  
Well Being ◽  
Mortality Rates ◽  
Pooled Prevalence ◽  
All Cause Mortality ◽  
Bariatric Patients ◽  
Post Bariatric Surgery

Introduction: Prior meta-analysis has reported mortality rates among post-operative bariatric patients, but they have not considered psychiatric factors like suicide contributing to mortality. Objectives: The current meta-analysis aims to determine the pooled prevalence for mortality and suicide amongst cohorts using reported suicides post bariatric surgery. It is also the aim of the current meta-analytical study to determine moderators that could account for the heterogeneity found. Results: In our study, the pooled prevalence of mortality in the studies which reported suicidal mortality was 1.8% and the prevalence of suicide was 0.3%. Mean body mass index (BMI) and the duration of follow-up appear to be significant moderators. Conclusions: Given the prevalence of suicide post bariatric surgery, it is highly important for bariatric teams to consider both the medical and psychiatric well-being of individuals pre- and post-operatively.

scholarly journals Association between metabolic syndrome and venous thromboembolism after total joint arthroplasty: a meta-analysis of cohort studies

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yipei Yang ◽  
Ziyue Li ◽  
Haifeng Liang ◽  
Jing Tian
Keyword(s):  
Metabolic Syndrome ◽  
Cohort Studies ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Joint Arthroplasty ◽  
Effect Model ◽  
Increased Risk ◽  
Subgroup Analyses

Abstract Objective Metabolic syndrome (MetS) has been associated with hypercoagulative status. However, previous studies evaluating the association between MetS and incidence of venous thromboembolism (VTE) after total joint arthroplasty (TJA) showed inconsistent results. We performed a meta-analysis to evaluate the influence of MetS on the risk of VTE following TJA. Methods Cohort studies were identified by the search of PubMed, Embase, and the Cochrane’s Library databases. A random-effect model was used if considerable heterogeneity was detected; otherwise, a fixed-effect model was used. Subgroup analyses according to the category of VTE, definition of MetS, category of procedure, and follow-up durations were performed. Results Seven cohort studies with 1,341,457 patients that underwent TJA were included, with 118,060 MetS patients (8.8%) at baseline. With a follow-up duration up to 3 months after surgery, 9788 patients had VTE. Pooled results with a random-effect model showed that MetS was not associated with increased overall VTE after TJA (adjusted risk ratio [RR] = 1.24, 95% confidence interval [CI] 0.89 ~ 1.72, p = 0.20; I2 = 69%). The results were not significantly affected by the diagnostic criteria of MetS, category of the procedure, and follow-up durations. Subgroup analyses showed that MetS was not associated with an increased the risk of pulmonary embolism ([PE], RR 1.06, 95% CI 0.37 ~ 3.02, p = 0.91), but an increased risk of deep vein thrombosis (DVT) after TJA (RR 3.38, 95% CI 1.83 ~ 6.24, p < 0.001). Conclusions Current evidence from observational studies suggests MetS might be associated with an increased risk of DVT but not PE after TJA.

scholarly journals Are Community Gardening and Horticultural Interventions Beneficial for Psychosocial Well-Being? A Meta-Analysis

2020 ◽  
Vol 17 (10) ◽  
pp. 3584
Author(s):  
Giuseppina Spano ◽  
Marina D’Este ◽  
Vincenzo Giannico ◽  
Giuseppe Carrus ◽  
Mario Elia ◽  
...  
Keyword(s):  
Human Health ◽  
Effect Size ◽  
Meta Analysis ◽  
Well Being ◽  
City Management ◽  
Community Gardening ◽  
Quantitative Studies ◽  
Bibliographic Records ◽  
Study Heterogeneity ◽  
Meta Analyses

Recent literature has revealed the positive effect of gardening on human health; however, empirical evidence on the effects of gardening-based programs on psychosocial well-being is scant. This meta-analysis aims to examine the scientific literature on the effect of community gardening or horticultural interventions on a variety of outcomes related to psychosocial well-being, such as social cohesion, networking, social support, and trust. From 383 bibliographic records retrieved (from 1975 to 2019), seven studies with a total of 22 effect sizes were selected on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Meta-analytic findings on 11 comparisons indicate a positive and moderate effect of horticultural or gardening interventions on psychosocial well-being. Moderation analysis shows a greater effect size in individualistic than collectivistic cultures. A greater effect size was also observed in studies involving community gardening compared to horticultural intervention. Nevertheless, an effect of publication bias and study heterogeneity has been detected. Despite the presence of a large number of qualitative studies on the effect of horticulture/gardening on psychosocial well-being, quantitative studies are lacking. There is a strong need to advance into further high-quality studies on this research topic given that gardening has promising applied implications for human health, the community, and sustainable city management.

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