Proton pump inhibitor (PPI) exposure and risk of pancreatic cancer (PC): Meta-analysis.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15755-e15755
Author(s):  
Nasser Mubarak Al Khushaym ◽  
Abdulaali Almutairi ◽  
Saad Fallatah ◽  
Abdulhamid Althagafi ◽  
Mok Oh ◽  
...  

e15755 Background: PPIs are widely used in the treatment of various acid related disorders. Observational studies have raised concern about an association of PPI use and PC but findings have been inconsistent. This meta-analysis aimed to estimate from published studies the pooled PC risk among subjects exposed and not exposed to PPIs. Methods: We searched PubMed, EMBASE, Scopus, Cochrane Library and clinicaltrials.gov to identify relevant studies on the association of PPI exposure and PC risk. Three reviewers independently screened search results for eligibility and extracted data from retained studies. Our primary analysis quantified PC risk among subjects exposed vs not exposed to PPI, expressed as the pooled (adjusted) odds ratio (OR/aOR) and 95% confidence interval (95%CI) as estimated in a random effect model. We performed similar secondary analyses in selected subgroups. Results: Of the 2683 reports yielded by the search 1 randomized trial, 2 cohort, and 9 case-control studies with 1,093,766 subjects (123,214 cases; 970,552 controls) were retained. Our main analysis (exposed vs non exposed) revealed a significant overall association between PPI exposure and PC risk (OR 1.77, 95%CI 1.14-2.74). Secondary analyses showed higher risk estimates from high quality (NOS > 7) studies (OR 2.04, 95%CI 1.03-4.02), observational studies (aOR, 1.70 95%CI 1.08-2.68), and studies with PPI use and PC risk as main outcome (aOR 2.01, 95%CI 1.06-3.83). Subgroup analyses by comorbidities showed an association with diabetes (aOR 1.98, 95%CI 1.02-3.82) but not pancreatitis (aOR 1.77, 95%CI 0.93-3.35). PC risk was not associated with duration of PPI use longer 1 (aOR 1.36 95%CI 0.81-2.28 and > 3 yrs (aOR 1.21 95%CI 0.73-2.02). In addition to the overall PPI class effect in the primary analysis, rabeprazole was singularly associated with PC risk (aOR 5.40 95%CI 1.98-14.70). Conclusions: Pooled risk estimates suggest that the class of PPIs is associated with a general 1.77 fold increase in PC risk, independent of duration of PPI exposure. Diabetic patients are at a significant incremental risk over the base risk.

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Liyuan Han ◽  
Lina Zhang ◽  
Wenhua Xing ◽  
Renjie Zhuo ◽  
XiaLu Lin ◽  
...  

Aims. Published data on the associations of VEGF polymorphisms with diabetic retinopathy (DR) susceptibility are inconclusive. A systematic meta-analysis was undertaken to clarify this topic.Methods. Data were collected from the following electronic databases: PubMed, Embase, OVID, Web of Science, Elsevier Science Direct, Excerpta Medica Database (EMBASE), and Cochrane Library with the last report up to January 10, 2014. ORs and 95% CIs were calculated for VEGF–2578C/A (rs699947), –1154G/A (rs1570360), –460T/C (rs833061), −634G>C (rs2010963), and +936C/T (rs3025039) in at least two published studies. Meta-analysis was performed in a fixed/random effect model by using the software STATA 12.0.Results. A total of 11 studies fulfilling the inclusion criteria were included in this meta-analysis. A significant relationship between VEGF+936C/T (rs3025039) polymorphism and DR was found in a recessive model (OR = 3.19, 95% CI = 1.20–8.41, andP(z)=0.01) in Asian and overall populations, while a significant association was also found between –460T/C (rs833061) polymorphism and DR risk under a recessive model (OR = 2.12, 95% CI = 1.12–4.01, andP(z)=0.02).Conclusions. Our meta-analysis demonstrates that +936C/T (rs3025039) is likely to be associated with susceptibility to DR in Asian populations, and the recessive model of –460T/C (rs833061) is associated with elevated DR susceptibility.


PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2203 ◽  
Author(s):  
Dan Zhou ◽  
Weiwei Tang ◽  
Wenyi Wang ◽  
Xiaoyan Pan ◽  
Han-Xiang An ◽  
...  

Background.Adenomatous polyposis coli (APC) is widely known as an antagonist of the Wnt signaling pathway via the inactivation ofβ-catenin. An increasing number of studies have reported that APC methylation contributes to the predisposition to breast cancer (BC). However, recent studies have yielded conflicting results.Methods.Herein, we systematically carried out a meta-analysis to assess the correlation between APC methylation and BC risk. Based on searches of the Cochrane Library, PubMed, Web of Science and Embase databases, the odds ratio (OR) with 95% confidence interval (CI) values were pooled and summarized.Results.A total of 31 articles involving 35 observational studies with 2,483 cases and 1,218 controls met the inclusion criteria. The results demonstrated that the frequency of APC methylation was significantly higher in BC cases than controls under a random effect model (OR= 8.92, 95% CI [5.12–15.52]). Subgroup analysis further confirmed the reliable results, regardless of the sample types detected, methylation detection methods applied and different regions included. Interestingly, our results also showed that the frequency of APC methylation was significantly lower in early-stage BC patients than late-stage ones (OR= 0.62, 95% CI [0.42–0.93]).Conclusion.APC methylation might play an indispensable role in the pathogenesis of BC and could be regarded as a potential biomarker for the diagnosis of BC.


2020 ◽  
Author(s):  
Tesfaye Getachew Charkos ◽  
Yawen Liu ◽  
Kemal Sherefa Oumer ◽  
Ann M Vuong ◽  
Shuman Yang

Abstract Introduction The association between β-carotene intake and risk of fracture has been reported inconsistently. We conducted a meta-analysis to investigate the association between β-carotene intake and risk of fracture using a Bayesian approach. Methods We systematically searched PubMed, EMBASE and Cochrane library database for relevant articles until December 2019. We also performed a hand search based on reference lists from published articles. The Bayesian random effect model was used to synthesize data from individual studies. Results Nine studies with a total of 190,545 men and women were included in this meta-analysis. The participants' average age was 59.8 years old. For β-carotene intake, the pooled RR of any fracture was 0.67 (95% Credible Interval (CrI): 0.51-0.82; heterogeneity: P = 0.66, I 2 =0.00%) and 0.63 (95%CrI: 0.44-0. 82) for hip fracture. By study design, the pooled RRs were 0.55 (95% CrI: 0.14-0.96) for case-control studies and 0.82 (95% CrI: 0.58-0.99) for cohort studies. By geographic region, the pooled RRs were 0.58 (95% CrI: 0.28-0.89) for studies conducted in China, 0.86 (95% CrI: 0.35-0.1.37) in America and 0.91(95% CrI: 0.75-1.00) Europe. By gender: the pooled RRs were 0.88 (95% CrI: 0.73-0.99) for males and 0.76 (95% CrI: 0.44-1.07) for females. The probability that β-carotene intakes reduce the risk of any fracture and hip fracture by more than 20% was 95%. Conclusion The present meta-analysis suggests that β-carotene intake was inversely associated with fracture risk, consistently observed for case-control and cohort studies. Further randomized control trial is warranted to confirm this finding.


2020 ◽  
Author(s):  
Hai-bo Gong ◽  
Shu-tao Gao ◽  
Xiong-Ming Pu ◽  
Xiao-jing Kang ◽  
Xiu-juan Wu

Abstract Background: To date, The pathological mechanisms underlying the occurrence and development of psoriasis are still unanswered questions. Genome-wide association surveys have revealed that TNFAIP3 and TNIP1 were key biomarkers for psoriasis. This study aimed to investigate the association between TNFAIP3 and TNIP1 gene polymorphisms with psoriasis susceptibility. Methods: Comprehensive literature search was undertook across four online databases—PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure (CNKI) up to August 25, 2019. Allele model of inheritance was used to analyze the original data. Newcastle–Ottawa scale (NOS) was used to evaluate the risk bias of each study. Pooled odds ratios and 95% confidence intervals were calculated using the RevMan 5.3 software. Results: In all, 13 case-control studies comprising 13,908 psoriasis patients and 20,051 controls were identified and included in this meta-analysis. The results demonstrated that rs610604 in TNFAIP3 polymorphism was significantly associated with psoriasis risk using random effect model (G vs. T, OR = 1.19, 95 % CI: 1.09–1.31, P = 0.0002), and a significant association between rs17728338 in TNIP1 polymorphism and psoriasis vulnerability using fixed effect model (A vs. G, OR = 1.69, 95% CI:1.58–1.80, P < 0.00001). Conclusions: This meta-analysis indicated that rs610604 in TNFAIP3 and rs17728338 in TNIP1 gene polymorphisms were associated with psoriasis susceptibility.


2019 ◽  
Author(s):  
Hai-bo Gong ◽  
Shu-tao Gao ◽  
Xiong-ming Pu ◽  
Xiao-jing Kang ◽  
Xiu-juan Wu

Abstract Background: To date, The pathological mechanisms underlying the occurrence and development of psoriasis are still unanswered questions. Genome-wide association surveys have revealed that TNFAIP3 and TNIP1 were key biomarkers for psoriasis. This study aimed to investigate the association between TNFAIP3 and TNIP1 gene polymorphisms with psoriasis susceptibility.Methods Comprehensive literature search was undertook across four online databases—PubMed, Embase, Cochrane Library, and China National Knowledge Infrastructure (CNKI) up to August 25, 2019. Allele model of inheritance was used to analyze the original data. Newcastle–Ottawa scale (NOS) was used to evaluate the risk bias of each study. Pooled odds ratios and 95% confidence intervals were calculated using the RevMan 5.3 software.Results In all, 13 case-control studies comprising 13,908 psoriasis patients and 20,051 controls were identified and included in this meta-analysis. The results demonstrated that rs610604 in TNFAIP3 polymorphism was significantly associated with psoriasis risk using random effect model (G vs. T, OR = 1.19, 95% CI: 1.09–1.31, P = 0.0002), and a significant association between rs17728338 in TNIP1 polymorphism and psoriasis vulnerability using fixed effect model (A vs. G, OR = 1.69, 95% CI:1.58–1.80, P < 0.00001).Conclusions This meta-analysis indicated that rs610604 in TNFAIP3 and rs17728338 in TNIP1 gene polymorphisms were associated with psoriasis susceptibility.


2020 ◽  
Author(s):  
Hai-bo Gong ◽  
Shu-tao Gao ◽  
Xiong-ming Pu ◽  
Xiao-jing Kang ◽  
Xiu-juan Wu

Abstract Background: To date, the fundamental pathophysiology underlying the occurrence and progression of psoriasis are still unanswered questions. Genome-wide association surveys have revealed that TNFAIP3 and TNIP1 were key biomarkers for psoriasis. Here, we intended to conduct a survey on the association between TNFAIP3 and TNIP1 gene polymorphisms and psoriasis risk.Methods: A comprehensive search of four online databases—China National Knowledge Infrastructure (CNKI), PubMed, Embase, and Cochrane Library was undertaken up to August 25, 2019. We chose allele genetic model to deal with the original data. Newcastle–Ottawa scale (NOS) was used to evaluate the risk bias of each study. The RevMan 5.3 software was used to calculate the combined odds ratio and 95% confidence interval.Results: In total, we included 13 case-control studies consist of 13,908 psoriasis patients and 20,051 controls in this work. Our results demonstrated that rs610604 in TNFAIP3 polymorphism was significantly associated with psoriasis risk using random-effect model (G vs. T, OR = 1.19, 95 % CI: 1.09–1.31, P = 0.0002), and a significant association between rs17728338 in TNIP1 polymorphism and psoriasis vulnerability using fixed-effect model (A vs. G, OR = 1.69, 95% CI:1.58–1.80, P < 0.00001).Conclusions: Our findings indicated that rs610604 in TNFAIP3 and rs17728338 in TNIP1 gene polymorphisms were associated with psoriasis susceptibility.


2019 ◽  
Author(s):  
Xiao-ce Dai ◽  
Xin-xin Yang ◽  
Lan Ma ◽  
Guan-min Tang ◽  
Yan-yun Pan ◽  
...  

Abstract Background Our aim was to find possible risk associated between fluoroquinolones and aortic diseases.Methods PubMed, Embase and the Web of Science were searched from inception to July 6, 2019 to identify observational studies that evaluated the risk for aortic diseases associated with users of fluoroquinolones compared with non-users or users of other antibiotics. Primary outcome was the first occurrence of aortic diseases. We used Newcastle Ottawa Scale to assess quality among cohort and case-control studies and the GRADE approach was used for rating strength of evidence and used inverse variance method random-effect model to estimate odds risks (ORs) with 95% CIs and statistical heterogeneity were assessed by the I 2 statistic.Results Five observational studies that enrolled 2,829,385 patients were reported the relationship between fluoroquinolones and the risk for aortic diseases. Compared with non-users or users of other antibiotics, current fluoroquinolone use had association with a significantly increased risk of occurrence of aortic diseases (adjusted OR, 2.15; 95% CI, 1.66-2.64; P=.000). The risk of past fluoroquinolone use remained high in aortic dissection (adjusted OR, 1.98; 95% CI, 0.97-2.99; P=.000) and aortic aneurysm (adjusted OR, 1.77; 95% CI, 0.98-2.57; P=.000). The quality of evidence was moderate and the Number Need to Treat to Harm (NNTH) for aortic diseases among elderly patients above the age of 50 were current users of fluoroquinolones was estimated to be 1245.Conclusions The current fluoroquinolones use within elderly patients significantly increased the risk for the first occurrence of aortic diseases. Clinicians need to pay attention to these severe adverse events when considering fluoroquinolone use.


2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Xiaoli Li ◽  
Lianju Li ◽  
Yuling Xing ◽  
Tiantian Cheng ◽  
Shaohui Ren ◽  
...  

Aims. Although several epidemiological studies have investigated the relationship between diabetes mellitus (DM) and the risk of gout, the results are inconsistent. Therefore, we systematically retrospected available observational studies to clarify the impact of DM on the risk of gout. Methods. Embase, PubMed, Cochrane Library, Scopus, Web of Science, and China National Knowledge Infrastructure were searched for relevant articles from inception to 2 March 2020. The quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. The multivariate adjusted relative risks (aRR) and corresponding 95% confidence intervals (CI) were pooled based on a random-effect model. Cochran’s Q test and I2 were used to evaluate heterogeneity. Results. Five studies involving 863,755 participants were included in our meta-analysis. DM was associated with a lower risk of gout (aRR: 0.66; 95% CI: 0.59 to 0.73) but had a high heterogeneity (I2=89.2%). Metaregression analysis revealed that the types of DM were the source of heterogeneity. Subgroup analysis by types of DM showed that the risk of gout was significantly lower in type 1 DM (T1DM) (aRR: 0.42; 95% CI: 0.28 to 0.63) than in type 2 DM (T2DM) (aRR: 0.72; 95% CI: 0.70 to 0.74). Furthermore, when stratified according to gender in DM, sex-specific association was found. The inverse association was observed in males only (aRR: 0.57; 95% CI: 0.43 to 0.77) and not in females (aRR: 0.96; 95% CI: 0.87 to 1.05). Further stratified based on glycated hemoglobin (HbA1c) levels in DM, raised A1C levels were associated with a reduced risk of gout in patients with DM. Conclusions. This meta-analysis indicated that DM was related to a lower risk of gout, and the protective effect of DM on the risk of gout was stronger in males, T1DM, or DM with high HbA1c levels. However, more prospective cohort studies are required to confirm these results.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4546-4546
Author(s):  
Alexei Shimanovsky ◽  
Juliet Appiah ◽  
Basile M. Njei ◽  
Jessica Mary Clement

4546 Background: There is evidence suggesting that PZD use may be a risk factor for BC, yet these reports are controversial. The aim of this meta-analysis is to review available data and evaluate the association between PZD and BC. Methods: Two independent reviewers conducted a systematic search of the Cochrane Library, OvidSP and PubMed for articles published January 1970 to April 2012. MeSH search terms included PZD, Actos, thiazolidinediones, diabetes mellitus (DM), and BC. Only studies reporting an effect measure for the association between PZD and BC were included. Subgroup analyses by study design and country were performed. Analysis was done using a random effect model after a preliminary review showed evidence of study heterogeneity. This was then assessed using the Cochrane’s Q and I2 statistics. Publication bias was evaluated using the Begg’s and Egger’s tests, and funnel plots. All analyses were performed using REVMAN 5.1. Results: A total of 6 studies (3 cohort and 3 case control) met the inclusion criteria. The overall pooled risk ratio (RR) for the association between PZD and BC was 1.12 (95% CI 1.09, 1.15; P <0.001). The summary RR for cohort and case control studies were 1.13(95% CI 1.07, 1.19; P <0.001) and 1.11(95% CI 1.07, 1.15; P <0.001), respectively. The subgroup analysis showed a significant association with BC in the USA and Europe, but not in Asia (RR 0.98, 95% CI 0.71, 1.34; P = 0.88). The association of PZD and BC was more sensitive for treatment duration (>12 month). Conclusions: Our study analyzed 1,214,071 patients, demonstrating a weak association between PZD and BC. The results were significant with increase in treatment duration, which corresponds to previous studies. This meta-analysis has limitations. Not all studies reported known variables associated with BC, such as smoking or occupational exposure. They did not address patient BMI, time from DM diagnosis or previous drug therapy. These parameters reflect severity of disease and level of insulin-resistance. Future studies should evaluate markers of insulin-resistance with PZD use and correlate with BC. Understanding the link between PZD and BC in the context of DM may allow physicians to determine a more accurate risk of PZD use.


2020 ◽  
Vol 8 (1) ◽  
pp. e001370
Author(s):  
Fan Ping ◽  
Ning Jiang ◽  
Yuxiu Li

Background and aimsAging becomes a growing global concern with an increased risk of neurodegenerative diseases (NDs) that mainly consist of cognitive decline and Parkinson disease (PD). As the most commonly prescribed antidiabetic drug, metformin has been shown to have inconsistent roles in the incidence of NDs. We performed a systematic review and meta-analysis of observational studies to evaluate the effect of metformin exposure on onset of NDs.MethodsThe observational studies that investigated the associations between metformin and the incidence of NDs were searched in MEDLINE, Embase and Cochrane Library databases. A random-effect model was performed using STATA to calculate the combined ORs.ResultsIn total, 23 comparisons out of 19 studies with 285 966 participants were included. Meta-analysis found there was no significant effect on incidence of all the subtypes of NDs with metformin exposure (OR 1.04, 95% CI 0.92 to 1.17). However, metformin monotherapy was associated with a significantly increased risk of PD incidence compared with non-metformin users or glitazone users (OR 1.66, 95% CI 1.14 to 2.42).ConclusionMetformin has failed to demonstrate a beneficial effect on NDs. In addition, it may increase the risk of PD development. In light of current results, how metformin would impact NDs, especially the potential risk of PD, needs to be scrutinized. The underlying mechanisms are vital to achieve some more profound understanding on the regimen.Trial registration numberCRD 42019133285.


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