Dose-Response Association Between Bilirubin and Cardiovascular Disease: A Systematic Review and Meta-analysis

Angiology ◽  
2022 ◽  
pp. 000331972110596
Author(s):  
Lei Zuo ◽  
Jun Huang ◽  
Hongyue Zhang ◽  
Bing Huang ◽  
Xiaoyi Wu ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Dose Response ◽  
Prospective Studies ◽  
Therapeutic Potential ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Fixed Effect Model ◽  
Effect Estimate ◽  
Effect Model

The association between bilirubin (BIL) and cardiovascular disease (CVD) remains controversial. We performed a meta-analysis of prospective studies to evaluate this association in the general population. We searched PubMed, EMBASE, Web of Science, Cochrane, and Scopus databases through to September 2021. The Newcastle-Ottawa Quality Assessment Scale was used to assess study quality. The pooled effect estimate was calculated by the fixed-effect model or random-effect model. We included 12 prospective studies (368 567 participants). The pooled risk ratio of CVD for the lowest vs highest groups of BIL levels was .75 (95% CI: .58-.97) with high heterogeneity (I2 = 87.5%, P < .001). Similar associations were observed for coronary heart disease and stroke. We further performed a “dose-response” meta-analysis, and a significant U-shaped relationship between circulating (most values were serum bilirubin, but a few were plasma bilirubin) BIL and CVD ( P < .01) was observed. The lowest risk of CVD events was observed in participants with a BIL of 17-20 µmol/L in serum and/or plasma. In conclusion, there was a U-shaped dose-response relationship between BIL and CVD, especially for men. Further studies are needed to confirm our findings and identify the mechanisms involved as well as any prognostic or therapeutic potential.

scholarly journals The Correlation of Glycemic Index, Glycemic Load, and Carbohydrates with the Risk of Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Long-Shan Yang ◽  
Guang-Xiao Meng ◽  
Zi-Niu Ding ◽  
Lun-Jie Yan ◽  
Sheng-Yu Yao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Glycemic Index ◽  
Hepatitis Virus ◽  
Meta Analysis ◽  
Glycemic Load ◽  
Random Effect ◽  
Random Effect Model ◽  
Fixed Effect Model ◽  
Case Control Studies ◽  
Effect Model

Abstract Background Glycemic index (GI), glycemic load (GL), and carbohydrates have been shown to be associated with a variety of cancers, but their correlation with hepatocellular carcinoma (HCC) remains controversial. The purpose of our study was to investigate the correlation of GI, GL and carbohydrate with risk of HCC.Methods Systematic searches were conducted in PubMed, Embase and Web of Science until November 2020. According to the size of heterogeneity, the random effect model or the fixed effect model was performed to calculate the pooled relative risks (RRs) and 95% confidence intervals (CIs) for the correlation of GI, GL, and carbohydrates with the risk of HCC.Results Seven cohort studies involving 1,193,523 participants and 1,004 cases, and 3 case-control studies involving 827 cases and 5,502 controls were eventually included. The pooled results showed no significant correlation of GI (RR=1.11, 95%CI 0.80-1.53, I2= 62.2%), GL (RR=1.09, 95%CI 0.76-1.55, I2 = 66%), and carbohydrate (RR=1.09, 95%CI 0.84-1.32, I2=0%) with the risk of HCC in general population. Subgroup analysis revealed that in hepatitis B virus (HBV) or/and hepatitis C virus (HCV)-positive group, GI was not correlated with the risk of HCC (RR=0.65, 95%CI 0.32-1.32, p=0.475, I2=0.0%), while GL was significantly correlated with the risk of HCC (RR=1.52, 95%CI 1.04-2.23, p=0.016, I2=70.9%). In contrast, in HBV and HCV-negative group, both GI (RR=1.23, 95%CI 0.88-1.70, p=0.222, I2=33.6%) and GL (RR=1.17, 95% CI 0.83-1.64, p=0.648, I2=0%) were not correlated with the risk of HCC. Conclusion A high GL diet is correlated with a higher risk of HCC in people with hepatitis virus. A low GL diet may be recommended for patients with viral hepatitis to reduce the risk of HCC.

scholarly journals Cyp2C19*2 Polymorphism Related to Clopidogrel Resistance in Patients With Coronary Heart Disease, Especially in the Asian Population: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 11 ◽  
Author(s):  
Ying Sun ◽  
Qing Lu ◽  
Xuefei Tao ◽  
Biao Cheng ◽  
Guoxing Yang
Keyword(s):  
Gene Polymorphism ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Asian Population ◽  
Fixed Effect Model ◽  
Clopidogrel Resistance ◽  
Effect Model ◽  
The Relationship ◽  
Allele Model

In recent years, the relationship between Cyp2C19*2 gene polymorphism and clopidogrel resistance reflected by platelet function assay has been studied extensively, but there is no clear conclusion yet. In order to evaluate the relationship between Cyp2C19*2 gene polymorphism and clopidogrel resistance more accurately, meta-analysis was conducted in this study. The I2 value taking 50% as the limit, the heterogeneity is judged as high or low, and then a random effect model or a fixed effect model is selected for statistical analysis. PubMed, EMBASE, Web of Science, CNKI, and China Wanfang database were searched, and the related literatures from the establishment of the database to May 2020 were collected and analyzed by STATA 15.0 software. A total of 3,073 patients were involved in 12 studies, including 1,174 patients with clopidogrel resistance and 1,899 patients with non-clopidogrel resistance. The results of this study showed that allele model (A vs. G): OR = 2.42 (95%CI: 1.97–2.98); dominant model (AA+GA vs. GG): OR = 2.74 (95%CI: 2.09–3.59); recessive model (AA vs. GA+GG): OR = 4.07 (95%CI: 3.06–5.41); homozygous model (AA vs. GG): OR = 5.70 (95%CI: 4.22–7.71); heterozygote model (GA vs. GG): OR = 2.32 (95%CI: 1.76–3.07), the differences were statistically significant. Also, the analysis of the Ethnicity subgroup indicated that the Asian allele model and the other four gene models were statistically significant. In conclusion, Cyp2C19*2 gene polymorphism is strongly associated with clopidogrel resistance. Allele A, genotype GA, AA, and GG + GA can increase clopidogrel resistance, especially in the Asian population.

scholarly journals History and Spread of Viruses (COVID-19) and Associated Demographic and Clinical Parameters – A systematic review and meta-analysis

2021 ◽  
Vol 33 (1) ◽  
pp. 9-24
Author(s):  
Swambhavi Awasthi ◽  
Sunil Sharma ◽  
Saurav Attri ◽  
Sakshi Malik Attri ◽  
Rajesh Sharawat ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Fixed Effect Model ◽  
Primary Objective ◽  
Asymptomatic Patients ◽  
Effect Model ◽  
Co Morbidity ◽  
The Common ◽  
Meta Analyses

COVID-19 made a huge impact on the world due to its rapid transmission and no treatments being available for it. The virus affected more people and spread to various countries than what was predicted when COVID-19 initially began spreading. There have been numerous pandemics and epidemics in the 21st century yet COVID-19 has affected more people and spread widely. The primary objective of the study was to explore history, spread and associated parameters of existing viruses especially COVID-19. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for a systematic search to identify eligible published articles. Clinical data, regarding COVID-19 patients, was obtained from previously published articles. The main cause of COVID-19 spreading rapidly was noted to be due to a high percentage of asymptomatic patients, transmission being air-borne, and the lack of knowledge and preventative measures being implemented when the virus began spreading. The common co-morbidity that found in patients was Diabetes Mellitus, Hypertension, and Coronary Heart Disease. The common symptoms, found through the Meta-analysis, that the patients faced included cough (55.4%), fever (68.4%), fatigue (20.3%), and shortness of breath (18.1%). The proportion of asymptotic positive cases was measured 58.3% (95%CI: 24.7% – 87.9%) while mortality proportion was found to be 6.7% (fixed-effect model) and 13.4% (random-effect model). The Meta-analysis indicated that a higher percentage of males were affected by COVID-19 than females and more patients are found to be asymptomatic. Moreover, the mortality rate of patients that have had COVID-19 was found to be low. 

scholarly journals A Bayesian Model-Averaged Meta-Analysis of the Power Pose Effect with Informed and Default Priors: The Case of Felt Power

2017 ◽  
Author(s):  
Quentin Frederik Gronau ◽  
Sara van Erp ◽  
Daniel W. Heck ◽  
Joseph Cesario ◽  
Kai Jonas ◽  
...  
Keyword(s):  
Bayesian Model ◽  
Bayesian Model Averaging ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Model Averaging ◽  
Fixed Effect Model ◽  
Body Postures ◽  
Effect Model ◽  
Meta Analyses

Carney, Cuddy, and Yap (2010) found that --compared to participants who adopted constrictive body postures-- participants who adopted expansive body postures reported feeling more powerful, showed an increase in testosterone and a decrease in cortisol, and displayed anincreased tolerance for risk. However, these power pose effects have recently come under considerable scrutiny. Here we present a Bayesian meta-analysis of six preregistered studies from this special issue, focusing on the effect of power posing on felt power. Our analysisimproves on standard classical meta-analyses in several ways. First and foremost, we considered only preregistered studies, eliminating concerns about publication bias. Second, the Bayesian approach enables us to quantify evidence for both the alternative and the null hypothesis. Third, we use Bayesian model-averaging to account for the uncertainty with respect to the choice for a fixed-effect model or a random-effect model. Fourth, based on a literature review we obtained an empirically informed prior distribution for the between-studyheterogeneity of effect sizes. This empirically informed prior can serve as a default choice not only for the investigation of the power pose effect, but for effects in the field of psychology more generally. For effect size, we considered a default and an informed prior. Our meta-analysis yields very strong evidence for an effect of power posing on felt power. However, when the analysis is restricted to participants unfamiliar with the effect, the meta-analysis yields evidence that is only moderate.

scholarly journals The risk of smoking with stroke in Asia : meta-analysis

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Fadhilatul Hasnah ◽  
Yuniar Lestari ◽  
Abdiana Abdiana
Keyword(s):  
Ischemic Stroke ◽  
Publication Bias ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Haemorrhagic Stroke ◽  
Fixed Effect Model ◽  
Stroke Subtype ◽  
Effect Model ◽  
Trim And Fill

This study uses a systematic method of review and meta-analysis to look at the risk of smoking with stroke in Asia. Further analysis based on the stroke subtype (ischemic stroke and haemorrhagic stroke was also carried out. Literature search was carried out in the PubMed, EBSCO and Google Scholar databases. Q tests were performed to determine the heterogeneity of included studies. Funnel plot, Egger regression test and trim and fill methods were used to identified publication bias and with the transformation of the model between the fixed effect model and the random effect model for sensitivity analysis A total of 12 articles were included consisting of 9 studies with case control design studies and 3 studies with cohort designs. The meta-analysis results showed that people who smoke have risks pooled OR 2.04 times (95% CI 1.57-2.65) for having a stroke Analysis of the type of stroke, smokers had 2.3 times the risk of having an ischemic stroke or 2.77 times for having a haemorrhagic stroke. Eggers test showed no influence of publication bias on the meta-analysis of smoking with stroke to. From this meta-analysis, it can be concluded that smoking increasing risk for stroke. This study found the risk of smokers to have a haemorrhagic stroke is higher than ischemic stroke.

scholarly journals Therapeutic potential of ivermectin as add on treatment in COVID 19: A systematic review and meta-analysis

2020 ◽  
Vol 23 ◽  
pp. 462-469
Author(s):  
Biswa Mohan Padhy ◽  
Rashmi Ranjan Mohanty ◽  
Smita Das ◽  
Bikash Ranjan Meher
Keyword(s):  
Systematic Review ◽  
Therapeutic Potential ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Symptomatic Treatment ◽  
Effect Model ◽  
Usual Therapy

The current management of COVID-19 is mostly limited to general supportive care and symptomatic treatment. Ivermectin is a broad-spectrum anti-parasitic drug used widely for the treatment of onchocerciasis and lymphatic filariasis. Apart from its anti-parasitic effect it also exhibits antiviral activity against a number of viruses both in vitro and in vivo. Hence, we conducted this systematic review and meta-analysis to assess the currently available data on the therapeutic potential of ivermectin for the treatment of COVID‐19 as add on therapy. A total of 629 patients were included in the 4 studies and all were COVID-19 RT-PCR positive. Among them, 397 patients received ivermectin along with usual therapy. The random effect model showed the overall pooled OR to be 0.53 (95%CI: 0.29 to0.96) for the primary outcome (all-cause mortality) which was statistically significant (P=0.04). Similarly, the random effect model revealed that adding ivermectin led to significant clinical improvement compared to usual therapy (OR=1.98, 95% CI: 1.11 to 3.53, P=0.02).  However, this should be inferred cautiously as the quality of evidence is very low. Currently, many clinical trials are on-going, and definitive evidence for repurposing this drug for COVID-19 patients will emerge only in the future.

scholarly journals A Bayesian Model-Averaged Meta-Analysis of the Power Pose Effect with Informed and Default Priors: The Case of Felt Power

2017 ◽  
Author(s):  
Quentin Frederik Gronau ◽  
Sara van Erp ◽  
Daniel W. Heck ◽  
Joseph Cesario ◽  
Kai Jonas ◽  
...  
Keyword(s):  
Bayesian Model ◽  
Bayesian Model Averaging ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Model Averaging ◽  
Fixed Effect Model ◽  
Body Postures ◽  
Effect Model ◽  
Meta Analyses

Carney, Cuddy, and Yap (2010) found that --compared to participants who adopted constrictive body postures-- participants who adopted expansive body postures reported feeling more powerful, showed an increase in testosterone and a decrease in cortisol, and displayed an increased tolerance for risk. However, these power pose effects have recently come under considerable scrutiny. Here we present a Bayesian meta-analysis of six preregistered studies from this special issue, focusing on the effect of power posing on felt power. Our analysis improves on standard classical meta-analyses in several ways. First and foremost, we considered only preregistered studies, eliminating concerns about publication bias. Second, the Bayesian approach enables us to quantify evidence for both the alternative and the null hypothesis. Third, we use Bayesian model-averaging to account for the uncertainty with respect to the choice for a fixed-effect model or a random-effect model. Fourth, based on a literature review we obtained an empirically informed prior distribution for the between-study heterogeneity of effect sizes. This empirically informed prior can serve as a default choice not only for the investigation of the power pose effect, but for effects in the field of psychology more generally. For effect size, we considered a default and an informed prior. Our meta-analysis yields very strong evidence for an effect of power posing on felt power. However, when the analysis is restricted to participants unfamiliar with the effect, the meta-analysis yields evidence that is only moderate.

Survival benefit from maintenance therapy after first-line chemotherapy in advanced non-small cell lung cancer: A meta-analysis.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e18003-e18003
Author(s):  
Kader Chouahnia ◽  
Gaetan Des Guetz ◽  
Bernard Uzzan ◽  
Patrick Nicolas ◽  
Jean F. Morere
Keyword(s):  
Lung Cancer ◽  
Maintenance Therapy ◽  
Survival Benefit ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Fixed Effect Model ◽  
Small Cell ◽  
Small Cell Lung ◽  
Effect Model

e18003 Background: Maintenance therapy corresponds to a prolonged treatment after induction chemotherapy (CT) for patients with advanced non-small cell lung cancer (NSCLC). Several recent randomized controlled trials (RCTs) showed a survival benefit for maintenance therapy, especially for EGFR tyrosine-kinase inhibitors (TKIs), but conflicting results have been published. We performed a meta-analysis of all RCTs published either as articles or in abstract form. Since its presentation at ESMO 2011, this meta-analysis has been updated with one additional study (AVAPERL) and the preliminary data of PARAMOUNT on Overall Survival (OS). Methods: A PubMed query using several keywords simultaneously (NSCLC, maintenance, RCT, survival) found 79 references. Abstracts from ASCO and ESMO proceedings were also reviewed. References were cross-checked. Outcomes were OS and PFS (Progression Free Survival). We used a fixed-effect model when heterogeneity was absent and a random-effect model when present. We used EasyMA software. Results: Thirteen RCTs were included with IFCT-GFPC trial used twice since it assessed 2 maintenance therapies in parallel, gemcitabine and erlotinib. These 13 RCTs included 5251 patients (median age 61 years, 4261 stage IV, 913 stage III diseases, 2929 adenocarcinomas, 983 squamous cell carcinomas). For OS (14 sub-studies), the overall HR was 0.85 (95 % Confidence Interval or CI 0.80-0.91; fixed effect model). For PFS (13 sub-studies), the overall HR was 0.65 (CI 0.58-0.73; random effect model). Both continuation maintenance (6 RCTs, HR 0.87, CI 0.76-0.99) and switch maintenance (3 RCTs, HR 0.85, CI 0.75-0.98) significantly improved OS. Targeted therapies also significantly increased OS (5 RCTs, HR 0.85, CI 0.77-0.93). Anaemia, thrombocytopenia and neutropenia were significantly more frequent after maintenance chemotherapy, and skin rashes and diarrhoea after biotherapies. Conclusions: Maintenance therapy with either continuation or switch chemotherapy or EGFR TKIs significantly improved OS and PFS. The benefit-to-risks ratios of these 3 types of maintenance should be compared more precisely thanks to additional RCTs.

scholarly journals Circular RNAs Serve as Prognostic, Diagnostic and Clinicopathological Markers in Lung Cancer: An Updated Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Zhuozheng Liang ◽  
Cui Chen ◽  
Cheng Guo ◽  
Ping Meng ◽  
Manman Zou ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Clinical Application ◽  
Clinical Characteristics ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Fixed Effect Model ◽  
Circular Rnas ◽  
Diagnosis And Prognosis ◽  
Effect Model

Abstract Background: In recent years, the roles of circular RNAs (circRNAs) in the biogenesis and clinical application have gradually garnered much interest in the field of cancer research. However, high-quality studies evaluating the roles of circRNAs in clinicopathological features and clinical application of lung cancer are still unrevealed. Herein, we aimed to elucidate the functions of circRNAs in the association with clinicopathology, diagnosis and prognosis in lung cancer. Methods: Comprehensive and reasonable search strategies were used in four databases up to Nov. 24th, 2019. The odds ratio (OR) was used to analyze the risks of circRNAs in lung cancer. Sensitivity (Sen), specificity (Spe) and area under curve (AUC) were used to assess the diagnostic value. What’s more, the hazard ratio (HR) was used for the analysis of survival outcomes. A fixed-effect model was firstly used in data analysis. If I2 >50% in heterogeneity, the random-effect model was chosen. Results: A total of 50 studies with 3815 samples were incorporated into our meta-analysis, in which 40 focused on clinical characteristics, 10 related to diagnosis and 31 were aimed at prognosis. In terms of clinical characteristics, both OR and 95% confidence interval (95%CI) were shown that circRNAs were significantly associated with TNM, tumor differentiation, lymph node metastasis, distal metastasis and tumor size in lung cancer. For diagnosis, both upregulated and downregulated circRNAs distinguished patients with lung cancer from healthy people with pooled Sen, Spe and AUC, of which the values were 0.78, 0.76 and 0.81 respectively. In the section of prognosis, circRNAs can better predict the survival time of patients with lung cancer (overall survival, OS: HR=0.46, 95%Cl: 0.33–0.65 in downregulated circRNAs; HR=2.23, 95%CI: 1.97-2.53 in upregulated circRNAs). Conclusions: The results presented here suggested that circRNAs were the potential cancer biomarkers in clinicopathology, diagnosis and prognosis of lung cancer patients, which deserve further application in clinical practice.

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