scholarly journals Bayesian Meta-analysis of Multiple Continuous Treatments with Individual Participant-Level Data: An Application to Antipsychotic Drugs

2019 ◽  
Vol 39 (5) ◽  
pp. 583-592 ◽  
Author(s):  
Jacob Spertus ◽  
Marcela Horvitz-Lennon ◽  
Sharon-Lise T. Normand
Keyword(s):  
Clinical Trials ◽  
Weight Gain ◽  
Dose Response ◽  
Meta Analysis ◽  
Credible Interval ◽  
Continuous Treatment ◽  
Sample Population ◽  
Response Curves ◽  
Excessive Weight Gain ◽  
Excessive Weight

Modeling dose-response relationships of drugs is essential to understanding their safety effects on patients under realistic circumstances. While intention-to-treat analyses of clinical trials provide the effect of assignment to a particular drug and dose, they do not capture observed exposure after factoring in nonadherence and dropout. We develop a Bayesian method to flexibly model the dose-response relationships of binary outcomes with continuous treatment, permitting multiple evidence sources, treatment effect heterogeneity, and nonlinear dose-response curves. In an application, we examine the risk of excessive weight gain for patients with schizophrenia treated with the second-generation antipsychotics paliperidone, risperidone, or olanzapine in 14 clinical trials. We define exposure as total cumulative dose (daily dose × duration) and convert to units equivalent to 100 mg of olanzapine (OLZ doses). Averaging over the sample population of 5891 subjects, the median dose ranged from 0 (placebo randomized participants) to 6.4 OLZ doses (paliperidone randomized participants). We found paliperidone to be least likely to cause excessive weight gain across a range of doses. Compared with 0 OLZ doses, at 5.0 OLZ doses, olanzapine subjects had a 15.6% (95% credible interval: 6.7, 27.1) excess risk of weight gain; corresponding estimates for paliperidone and risperidone were 3.2% (1.5, 5.2) and 14.9% (0.0, 38.7), respectively. Moreover, compared with nonblack participants, black participants had a 6.8% (1.0, 12.4) greater risk of excessive weight gain at 10.0 OLZ doses of paliperidone. Nevertheless, our findings suggest that paliperidone is safer in terms of weight gain risk than risperidone or olanzapine for all participants at low to moderate cumulative OLZ doses.

Risk of childhood overweight or obesity associated with excessive weight gain during pregnancy: a meta-analysis

2013 ◽  
Vol 289 (2) ◽  
pp. 247-257 ◽  
Author(s):  
Hong-Tao Tie ◽  
Yi-Yin Xia ◽  
Yong-Sheng Zeng ◽  
Yong Zhang ◽  
Chia-Liang Dai ◽  
...  
Keyword(s):  
Weight Gain ◽  
Meta Analysis ◽  
Childhood Overweight ◽  
Excessive Weight Gain ◽  
Excessive Weight ◽  
Weight Gain During Pregnancy ◽  
Overweight Or Obesity

Excessive weight gain during pregnancy and risk of macrosomia: a meta-analysis

2015 ◽  
Vol 293 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Chaoqing Tian ◽  
Chengwen Hu ◽  
Xiujie He ◽  
Meng Zhu ◽  
Fengyun Qin ◽  
...  
Keyword(s):  
Weight Gain ◽  
Meta Analysis ◽  
Excessive Weight Gain ◽  
Excessive Weight ◽  
Weight Gain During Pregnancy

scholarly journals Impact of maternal education on response to lifestyle interventions to reduce gestational weight gain: individual participant data meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e025620 ◽  
Author(s):  
Eileen C O’Brien ◽  
Ricardo Segurado ◽  
Aisling A Geraghty ◽  
Goiuri Alberdi ◽  
Ewelina Rogozinska ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Educational Attainment ◽  
Meta Analysis ◽  
Individual Participant Data ◽  
Excessive Weight Gain ◽  
Excessive Weight ◽  
Individual Participant ◽  
Lower Education ◽  
Reduced Risk

ObjectivesTo identify if maternal educational attainment is a prognostic factor for gestational weight gain (GWG), and to determine the differential effects of lifestyle interventions (diet based, physical activity based or mixed approach) on GWG, stratified by educational attainment.DesignIndividual participant data meta-analysis using the previously established International Weight Management in Pregnancy (i-WIP) Collaborative Group database (https://iwipgroup.wixsite.com/collaboration). Preferred Reporting Items for Systematic reviews and Meta-Analysis of Individual Participant Data Statement guidelines were followed.Data sourcesMajor electronic databases, from inception to February 2017.Eligibility criteriaRandomised controlled trials on diet and physical activity-based interventions in pregnancy. Maternal educational attainment was required for inclusion and was categorised as higher education (≥tertiary) or lower education (≤secondary).Risk of biasCochrane risk of bias tool was used.Data synthesisPrinciple measures of effect were OR and regression coefficient.ResultsOf the 36 randomised controlled trials in the i-WIP database, 21 trials and 5183 pregnant women were included. Women with lower educational attainment had an increased risk of excessive (OR 1.182; 95% CI 1.008 to 1.385, p =0.039) and inadequate weight gain (OR 1.284; 95% CI 1.045 to 1.577, p =0.017). Among women with lower education, diet basedinterventions reduced risk of excessive weight gain (OR 0.515; 95% CI 0.339 to 0.785, p = 0.002) and inadequate weight gain (OR 0.504; 95% CI 0.288 to 0.884, p=0.017), and reduced kg/week gain (B −0.055; 95% CI −0.098 to −0.012, p=0.012). Mixed interventions reduced risk of excessive weight gain for women with lower education (OR 0.735; 95% CI 0.561 to 0.963, p=0.026). Among women with high education, diet based interventions reduced risk of excessive weight gain (OR 0.609; 95% CI 0.437 to 0.849, p=0.003), and mixed interventions reduced kg/week gain (B −0.053; 95% CI −0.069 to −0.037,p<0.001). Physical activity based interventions did not impact GWG when stratified by education.ConclusionsPregnant women with lower education are at an increased risk of excessive and inadequate GWG. Diet based interventions seem the most appropriate choice for these women, and additional support through mixed interventions may also be beneficial.

The role of antenatal education for the prevention of excessive weight gain during pregnancy

2020 ◽  
Vol 71 (6) ◽  
Author(s):  
Roberta Amadori ◽  
Carmela Melluzza ◽  
Alessia Motta ◽  
Alberto De Pedrini ◽  
Daniela Surico
Keyword(s):  
Weight Gain ◽  
Excessive Weight Gain ◽  
Antenatal Education ◽  
Excessive Weight ◽  
Weight Gain During Pregnancy

Screening for celiac disease among children with overweight and obesity: toward exploring celiac iceberg

2020 ◽  
Vol 33 (8) ◽  
pp. 995-1002
Author(s):  
Valeria Calcaterra ◽  
Corrado Regalbuto ◽  
Matteo Manuelli ◽  
Catherine Klersy ◽  
Gloria Pelizzo ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Weight Gain ◽  
Autoimmune Diseases ◽  
Medical History ◽  
Unknown Origin ◽  
Overweight And Obesity ◽  
Excessive Weight Gain ◽  
Familial Predisposition ◽  
Excessive Weight ◽  
Hla Dq2

AbstractObjectivesThe coexistence of celiac disease (CD) and obesity/overweight is not unusual. We investigate the prevalence and clinical presentation of CD, detected by screening, among children with excessive weight gain.MethodsWe enrolled 200 children referred for overweight/obesity to our outpatient clinic. Medical history during pregnancy and childhood and lifestyle variables were recorded. Patients were screened for CD with total immunoglobulin A (IgA), IgA anti-transglutaminase (tTG-IgA) and IgA anti-endomysial antibodies (EMA-IgA). In subjects with positive autoantibodies, esophagogastroduodenoscopy (EGDS) was performed and genetic testing for HLA DQ2 and/or DQ8 haplotypes was tested.ResultsCD positive antibodies (tTg-IgA and EMA-IgA) were detected in eight patients (4%); in all subjects CD diagnosis was confirmed by HLA-DQ2 and/or DQ8 compatibility and EGDS. No association between CD and medical history during pregnancy and childhood or lifestyle variables was noted; however, a dietary difference was identified with those testing positive for CD also reporting a lower weekly consumption of fruits and vegetables (p=0.04). Headache was reported more frequently in patients with than without CD (p=0.04). Familiar positivity for autoimmune diseases was revealed in CD patients (p=0.01).ConclusionCD should be considered in children with excessive weight gain. Familial predisposition to other autoimmune diseases may represent a risk factor for development of CD. Even though the relationship between headache and CD is not well defined, the patients with headache of unknown origin should be screened for CD.

scholarly journals Family sociodemographic characteristics as correlates of children’s breakfast habits and weight status in eight European countries. The ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project

2014 ◽  
Vol 18 (5) ◽  
pp. 774-783 ◽  
Author(s):  
Yannis Manios ◽  
George Moschonis ◽  
Odysseas Androutsos ◽  
Christina Filippou ◽  
Wendy Van Lippevelde ◽  
...  
Keyword(s):  
Weight Gain ◽  
Energy Balance ◽  
Weight Status ◽  
Educational Status ◽  
European Countries ◽  
Sociodemographic Characteristics ◽  
Excessive Weight Gain ◽  
Breakfast Consumption ◽  
Mediation Analyses ◽  
Excessive Weight

AbstractObjectiveThe purpose of the present study was to investigate the associations of family sociodemographic characteristics with children’s weight status and whether these potential associations are mediated by children’s breakfast habits.DesignA school-based survey among 10–12-year-old children was conducted in eight European countries. Children’s weight and height were measured and breakfast habits and family sociodemographic characteristics were self-reported by 5444 children and their parents. International Obesity Task Force cut-off points were used to categorize children as overweight/obese or normal weight. Mediation analyses were used to test the potential mediating effect of children’s breakfast consumption on the associations between family sociodemographic characteristics and children’s overweight/obesity.SettingSchools in eight European countries participating in the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project.SubjectsChildren aged 10–12 years and their parents (n 5444).ResultsChildren’s reported daily breakfast consumption varied from 56 % in Slovenia to 92 % in Spain on weekdays and from 79 % in Greece to 93 % in Norway on weekends. Children of native parents, with both parents employed and with at least one parent having more than 14 years of education were more likely to consume breakfast daily and less likely to be overweight/obese. Finally, mediation analyses revealed that the association of parental nationality and parental educational status with children’s overweight/obesity was partially mediated by children’s daily breakfast consumption.ConclusionsThe study shows that the lower likelihood of being overweight/obese among 10–12-year-old children of native background and higher parental educational status was partially mediated by children’s daily breakfast consumption.

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