To which extent are per-and poly-fluorinated substances associated to metabolic syndrome?

Abstract Exposure to per- and polyfluoroalkyl substances (PFAS), ubiquitous persistent environmental contaminants, has led to substantial global concern due to their potential environmental and human health effects. Several epidemiological studies have assessed the possible association between PFAS exposure and risk of metabolic syndrome (MetS), however, the results are ambiguous. The aim of this study was to assess the current human epidemiologic evidence on the association between exposure to PFAS and MetS. We performed a systematic search strategy using three electronic databases (PubMed, Scopus, and Web of Science) for relevant studies concerning the associations of PFAS with MetS and its clinical relevance from inception until January 2021. We undertook meta-analyses where there were five or more studies with exposure and outcomes assessments that were reasonably comparable. The pooled odd ratios (ORs) were calculated using random effects models and heterogeneity among studies was assessed by I2 index and Q test. A total of 12 cross-sectional studies (10 studies on the general population and two studies in the occupational settings) investigated the association between PFAS exposure and MetS. We pooled data from seven studies on the general population for perfluorooctanoic acid (PFOA) and perfluorooctanesulfonate (PFOS) and five studies for perfluorohexanesulfonate (PFHxS) and perfluorononanoic acid (PFNA). Predominately, most studies reported no statistically significant association between concentrations of PFAS and MetS. In the meta-analysis, the overall measure of effect was not statistically significant, showing no evidence of an association between concentrations of PFOA, PFOS, PFNA, and PFHxS and the risk of MetS. Based on the results of the meta-analysis, current small body of evidence does not support association between PFAS and MetS. However, due to limited number of studies and substantial heterogeneity, results should be interpreted with caution. Further scrutinizing cohort studies are needed to evaluate the association between various and less well-known PFAS substances and their mixture with MetS and its components in both adults and children in different settings.

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Associations of Whole Grain and Refined Grain Consumption With Metabolic Syndrome. A Meta-Analysis of Observational Studies

Frontiers in Nutrition ◽

10.3389/fnut.2021.695620 ◽

2021 ◽

Vol 8 ◽

Author(s):

Hongbin Guo ◽

Jun Ding ◽

Jieyu Liang ◽

Yi Zhang

Keyword(s):

Metabolic Syndrome ◽

Cohort Studies ◽

Prospective Cohort ◽

Observational Studies ◽

Meta Analysis ◽

Epidemiological Studies ◽

Whole Grain ◽

Cross Sectional ◽

Prospective Cohort Studies ◽

Embase Database

Background: The associations of whole grain and refined grain consumption with metabolic syndrome (MetS) has been evaluated in several epidemiological studies with conflicting results. This meta-analysis was therefore employed to further investigate the above associations.Method: We searched the PubMed, Web of Science and Embase database until March 2021 (without restriction for inclusion time), for observational studies on the associations of whole grain and refined grain consumption with MetS. The pooled relative risk (RR) of MetS for the highest vs. lowest category of whole grain and refined grain consumption, as well as their corresponding 95% confidence interval (CI) were calculated.Results: A total of 14 observational studies, which involved seven cross-sectional and seven prospective cohort studies, were identified. Specifically, nine studies were related to whole grain consumption, and the overall multi-variable adjusted RR demonstrated that the whole grain consumption was inversely associated with MetS (RR = 0.80, 95%CI: 0.67–0.97; P = 0.021). With regard to refined grain consumption, 13 studies were included. The overall multi-variable adjusted RR indicated that refined grain consumption was positively associated with MetS (RR = 1.37, 95%CI: 1.02–1.84; P = 0.036).Conclusions: The existing evidence suggests that whole grain consumption is negatively associated with MetS, whereas refined grain consumption is positively associated with MetS. Our result might be helpful to better consider the diet effect on MetS. However, more well-designed prospective cohort studies are needed to elaborate the concerned issues further.

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The Association Between Coffee Consumption and Metabolic Syndrome in Adults: A Systematic Review and Meta-Analysis

Advances in Nutrition ◽

10.1093/advances/nmaa132 ◽

2020 ◽

Author(s):

Tommy H T Wong ◽

Chi Ho Wong ◽

Xiaoyu Zhang ◽

Yunpeng Zhou ◽

Jinfeng Xu ◽

...

Keyword(s):

Metabolic Syndrome ◽

Longitudinal Studies ◽

Meta Analysis ◽

Random Effect ◽

Coffee Consumption ◽

Temporal Association ◽

Inverse Association ◽

Cross Sectional ◽

Consumption Level ◽

Meta Analyses

ABSTRACT Previous meta-analyses that found an inverse association between coffee consumption and metabolic syndrome pooled data from cross-sectional and longitudinal studies, which could lead to potentially misleading conclusions. Hence, this work aimed to reassess this association by analyzing data from the 2 types of studies separately and including recent studies. Online databases including PubMed, Scopus, Embase, The Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus, and Science Direct were searched for relevant studies published up to July 2020. Both cross-sectional and longitudinal studies were included if published after 1999, reported both effect estimates and CIs, and presented results adjusted for confounding variables. Data of the highest coffee consumption level in each study, as well as those of medium consumption levels in studies with ≥3 consumption categories, were pooled using random-effect models, with sex-stratified and sex-adjusted results being analyzed separately. Results were obtained based on data from 13 cross-sectional studies involving 280,803 participants and 2 longitudinal studies involving 17,014 participants. The overall sex-adjusted association of the highest consumption level was not significant (n = 9 studies; OR: 0.88; 95% CI: 0.70, 1.10; I2: 91.5%) and the 2 longitudinal studies both yielded no association. Subgroup analysis revealed inverse associations in both males and females, as well as in Caucasians with medium coffee consumption (n = 4 studies, OR: 0.88; 95% CI: 0.84, 0.93; I2: 0%). Although residual confounding could affect the results of this meta-analysis, our findings suggested with a low certainty that coffee consumption may not be associated with metabolic syndrome, a finding that is different from those of previous meta-analyses and could be due to variation in characteristics of study participants. More longitudinal studies are also needed to further assess the temporal association between coffee consumption and metabolic syndrome. This meta-analysis was registered at https://www.crd.york.ac.uk/prospero as CRD42018110650.

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Association between Metabolic Syndrome and Osteoporosis: A Systematic Review and Meta-Analysis

International Journal of Endocrinology ◽

10.1155/2021/6691487 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Weida Liu ◽

Chuangshi Wang ◽

Jun Hao ◽

Lu Yin ◽

Yang Wang ◽

...

Keyword(s):

Metabolic Syndrome ◽

Meta Analysis ◽

Cochrane Library ◽

Mineral Density ◽

Cross Sectional ◽

Random Effects Models ◽

Subgroup Analyses ◽

Study Population ◽

Definition Of ◽

Osteoporosis Risk

Background. Previous studies have reached mixed conclusions regarding the association between metabolic syndrome (MS) and osteoporosis. We aimed to perform a meta-analysis based on published studies that explored the association between osteoporosis and MS. Methods. To identify related literature, a systematic search of PubMed, Cochrane Library, and EMBASE databases from inception to June 2020 was performed. Original studies that reported the risk estimates of osteoporosis morbidity for two or three categories of bone mineral density (BMD) in patients with MS were selected. Two independent investigators screened and selected the articles. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects models. Results. Of 2632 identified studies, nine cross-sectional studies with 14 datasets were eligible for our meta-analysis. In seven studies (10 datasets), the summarized ORs of osteoporosis for MS were 0.72 (95% CI: 0.52–0.99). Subgroup analyses by gender showed that significant inverse associations were observed only in men (OR = 0.72, 95% CI: 0.55–0.96) but not in women (OR = 0.70, 95% CI: 0.41–1.22). The definition of MS, the source of the study population, and the adjustment of covariates affected the estimates. In two studies (4 datasets), there was no evidence for an association between MS and decreased BMD. Conclusions. Our findings demonstrated that MS was significantly associated with a lower osteoporosis risk. There might be gender differences in the association between MS and osteoporosis. In addition, the association was likely to relate to the definition of MS, the source of the study population, and the adjustment of covariates.

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Abstract 14945: Electronic Cigarettes Are Effective for Smoking Cessation: Evidence From a Systematic Review and Meta-analysis

Circulation ◽

10.1161/circ.130.suppl_2.14945 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Muhammad A Rahman ◽

Nicholas R Hann ◽

Andrew M Wilson ◽

George Mnatzaganian ◽

Linda Worrall-Carter

Keyword(s):

Systematic Review ◽

Smoking Cessation ◽

Electronic Cigarettes ◽

Meta Analysis ◽

Publication Date ◽

Cross Sectional ◽

Random Effects Models ◽

Effective Interventions ◽

Randomised Controlled ◽

Meta Analyses

Introduction: Smoking is the leading cause of preventable death worldwide. Finding effective interventions for smoking cessation has proven difficult and existing interventions have limited consumer appeal. Electronic cigarettes (e-cigarettes) are becoming increasingly popular and a possible role for them in smoking cessation is being debated. Our objective was therefore to analyse existing research to investigate whether use of e-cigarettes is an effective smoking cessation method. Hypothesis: We assessed the hypothesis that use of e-cigarettes is an effective smoking cessation method. Methods: A systematic review of articles in English of any publication date was conducted by searching PubMed, Web of Knowledge and Scopus databases. Published studies investigating the effectiveness of e-cigarettes for smoking cessation among current smokers were included. Studies were systematically reviewed, and meta-analyses were conducted using the Mantel-Haenszel fixed-effect and random-effects models. Heterogeneity and quality of the selected studies were also evaluated. Results: Six studies were selected, including two randomised controlled trials, two cohort studies and two cross-sectional studies, and included 7,551 participants. Meta-analyses included 1,242 participants on whom complete smoking cessation data was available. Of these, 224 (18%) reported smoking cessation after using nicotine-enriched e-cigarettes for a minimum period of six months. Use of such e-cigarettes was positively associated with smoking cessation with a pooled Effect Size of 0.20 (95%CI 0.11-0.28). Nicotine filled e-cigarettes were more effective in achieving cessation compared to those without nicotine (pooled Risk Ratio 2.29, 95%CI 1.05-4.97). Use of e-cigarettes was also effective in reducing smokers’ daily cigarette consumption. The studies included were heterogeneous, (I 2 =93%, p<0.001). A meta-regression model showed that 98% of this heterogeneity was caused by study design and gender variation. Conclusions: In conclusion, available literature suggests that the use of e-cigarettes may be an effective alternate smoking cessation method. Further research is required to investigate this among both genders.

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Asthma and metabolic syndrome: a comprehensive systematic review and meta-analysis of observational studies

Journal of Cardiovascular and Thoracic Research ◽

10.34172/jcvtr.2020.20 ◽

2020 ◽

Vol 12 (2) ◽

pp. 120-128

Author(s):

Nahid Karamzad ◽

Neda Izadi ◽

Sarvin Sanaie ◽

Elham Ahmadian ◽

Aziz Eftekhari ◽

...

Keyword(s):

Metabolic Syndrome ◽

Observational Studies ◽

Meta Analysis ◽

Insulin Resistance Syndrome ◽

Case Control ◽

Healthy Controls ◽

Case Control Studies ◽

Prevalence Odds Ratio ◽

Cross Sectional ◽

Random Effects Models

Introduction : This study aimed to perform a meta-analysis on the prevalence of metabolic syndrome (MetS) among patients with asthma and to measure the association asthma has with MetS. Methods: The Web of Science, Medline, Scopus, Embase and Google Scholar were searched using the "Asthma", "Metabolic Syndrome", "Dysmetabolic Syndrome", "Cardiovascular Syndrome", "Insulin Resistance Syndrome", "Prevalence", "Odds Ratio", "Cross-Sectional Studies", and "Case-Control Studies" keywords. All observational studies reporting the prevalence of MetS among people with and without asthma were included in the study. In the presence of heterogeneity, random-effects models were used to pool the prevalence and odds ratios (OR), as measures of association in cross-sectional and case-control/ cohort studies, respectively. Results: The prevalence of MetS among patients with asthma (8 studies) and the OR comparing the prevalence of MetS among patients with and without asthma (5 studies) were pooled separately. The pooled prevalence of MetS among patients with asthma was found to be 25% (95% confidence interval (CI): 13%–38%). In contrast, the overall pooled OR for MetS in patients with asthma, compared to healthy controls, was 1.34 (95% CI: 0.91–1.76), which was not statistically significant. Conclusion: The prevalence of MetS was relatively high in patients with asthma. Furthermore, the odds of MetS was higher in patients with asthma, compared to healthy controls, although this difference was not statistically significant. More original studies among different populations are needed in order to more accurately examine the association between asthma and MetS, as well as the relationship asthma has with the individual components of MetS.

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Dietary Patterns and Metabolic Syndrome in Adult Subjects: A Systematic Review and Meta-Analysis

Nutrients ◽

10.3390/nu11092056 ◽

2019 ◽

Vol 11 (9) ◽

pp. 2056 ◽

Cited By ~ 13

Author(s):

Roberto Fabiani ◽

Giulia Naldini ◽

Manuela Chiavarini

Keyword(s):

Systematic Review ◽

Metabolic Syndrome ◽

Dietary Patterns ◽

Meta Analysis ◽

Geographic Area ◽

Cross Sectional ◽

Random Effects Models ◽

Public Health Burden ◽

Study Characteristics ◽

Stratified Analysis

Metabolic Syndrome (MetS) constitutes a relevant public health burden. Several studies have demonstrated the association between diet and MetS. We performed a systematic review and meta-analysis to provide an estimate of the association between dietary patterns defined through a posteriori methods and MetS. A literature search on PubMed, Web of Science, and Scopus databases, up to March 2019, was conducted to identify all eligible case-control, prospective, or cross-sectional studies involving adult subjects of both sexes. Random-effects models were used. Heterogeneity and publication bias were evaluated. Stratified analyses were conducted on study characteristics. Forty observational studies were included in the meta-analysis, which identified the “Healthy” and the “Meat/Western” dietary patterns. The “Healthy” pattern was associated with reduced MetS risk (OR = 0.85; 95% confidence interval (CI): 0.79–0.91) and significantly decreased the risk in both sexes and in Eastern countries, particularly in Asia. Adherence to the “Meat/Western” pattern increased MetS risk (OR = 1.19; 95% CI: 1.09–1.29) and the association persisted in the stratified analysis by geographic area (Asia, Europe, America) and study design. Lifestyle is linked to risk of developing MetS. The “Healthy” and “Meat/Western” patterns are significantly associated with reduced and increased MetS risk, respectively. Nutrition represents an important modifiable factor affecting MetS risk.

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Factors associated with psychological distress during the coronavirus disease 2019 (COVID-19) pandemic on the predominantly general population: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0244630 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0244630

Author(s):

Yeli Wang ◽

Monica Palanichamy Kala ◽

Tazeen H. Jafar

Keyword(s):

Psychological Distress ◽

General Population ◽

Urban Areas ◽

Meta Analysis ◽

World Health ◽

Cochrane Library ◽

Anxiety And Depression ◽

Cross Sectional ◽

Random Effects Models ◽

Factors Associated

Background The Coronavirus Disease 2019 (COVID-19) outbreak has escalated the burden of psychological distress. We aimed to evaluate factors associated with psychological distress among the predominantly general population during the COVID-19 pandemic. Methods We searched PubMed, EMBASE, Scopus, Cochrane Library, PsycINFO, and World Health Organization COVID-19 databases (Dec 2019–15 July 2020). We included cross-sectional studies that reported factors associated with psychological distress during the COVID-19 pandemic. Primary outcomes were self-reported symptoms of anxiety and depression. Random-effects models were used to pool odds ratios (OR) and 95% confidence intervals (CI). The protocol was registered in PROSPERO (#CRD42020186735). Findings We included 68 studies comprising 288,830 participants from 19 countries. The prevalence of anxiety and depression was 33% (95% CI: 28%-39%) and 30% (26%-36%). Women versus men (OR: 1.48 [95% CI: 1.29–1.71; I2 = 90.8%]), younger versus older (< versus ≥35 years) adults (1.20 [1.13–1.26]; I2 = 91.7%), living in rural versus urban areas (1.13 [1.00–1.29]; I2 = 82.9%), lower versus higher socioeconomic status (e.g. lower versus higher income: 1.45 [1.24–1.69; I2 = 82.3%]) were associated with higher anxiety odds. These factors (except for residential area) were also associated with higher depression odds. Furthermore, higher COVID-19 infection risk (suspected/confirmed cases, living in hard-hit areas, having pre-existing physical or mental conditions) and longer media exposure were associated with higher odds of anxiety and depression. Interpretation One in three adults in the predominantly general population have COVID-19 related psychological distress. Concerted efforts are urgently needed for interventions in high-risk populations to reduce urban-rural, socioeconomic and gender disparities in COVID-19 related psychological distress.

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Occupational Exposure to Talc Increases the Risk of Lung Cancer: A Meta-Analysis of Occupational Cohort Studies

Canadian Respiratory Journal ◽

10.1155/2017/1270608 ◽

2017 ◽

Vol 2017 ◽

pp. 1-12 ◽

Cited By ~ 2

Author(s):

Che-Jui Chang ◽

Yu-Kang Tu ◽

Pau-Chung Chen ◽

Hsiao-Yu Yang

Keyword(s):

Lung Cancer ◽

Cohort Studies ◽

Meta Analysis ◽

Epidemiological Studies ◽

Industrial Applications ◽

Lung Cancer Death ◽

Random Effects Models ◽

Significant Difference ◽

Asbestos Contamination ◽

Meta Analyses

Objective. Talc is widely used in industrial applications. Previous meta-analyses of carcinogenic effects associated with inhaled talc included publications before 2004, with a lack of data in China, the largest talc-producing country. The safety of workers exposed to talc was unclear due to limited evidence. The objective of this study was to reevaluate the association between inhaled talc and lung cancer. Setting, Participants, and Outcome Measures. A meta-analysis was performed to calculate the meta-SMR of lung cancer. We searched the MEDLINE, EMBASE, CNKI, and Wanfang Data databases through March 2017. Data from observational studies were pooled using meta-analysis with random effects models. Results. Fourteen observational cohort studies (13 publications) were located via literature search. The heterogeneity of the included data was high (I-squared = 72.9%). Pooling all the cohorts yielded a meta-SMR of 1.45 (95% CI: 1.22–1.72, p<0.0001) for lung cancer among the study subjects exposed to talc. Subgroup analysis for asbestos contamination showed no significant difference in lung cancer death between subjects exposed to talc with and without asbestos (p=0.8680), indicating that this confounding factor may have no significance. Conclusions. This study provides evidence that nonasbestiform talc might still increase the risk of lung cancer. Further epidemiological studies are required to evaluate the safety of workers with occupational talc exposure.

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AWARENESS ABOUT INDOOR AIR POLLUTION IN GENERAL POPULATION OF RAWALPINDI AND ISLAMABAD

Pakistan Journal of Public Health ◽

10.32413/pjph.v8i2.118 ◽

2018 ◽

Vol 8 (2) ◽

pp. 80-83

Author(s):

Nadia Tariq ◽

Tamkeen Jaffry ◽

Rahma Fiaz ◽

Abdul Majid Rajput ◽

Sadaf Khalid

Keyword(s):

Air Pollution ◽

General Population ◽

Indoor Air ◽

Indoor Air Pollution ◽

Economic Status ◽

Educational Status ◽

Epidemiological Studies ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Significant Difference

Background: Indoor air pollutants are increasingly being associated with respiratory illnesses leading to high degree of morbidity and mortality. There are not sufficient epidemiological studies from Pakistan which assess level of awareness of indoor air pollution resulting in respiratory diseases in population. Methods: This cross sectional survey was carried out on general population of Rawalpindi/Islamabad. Sample size was 223 study subjects selected by non-probability convenient sampling. Knowledge of the study subjects was determined with regard to indoor air pollution, its effects on health and different sources of indoor air pollution with the help of a questionnaire. The influence of age, gender, educational status and socio economic status on the level of awareness was also analyzed. Results: Out of total 223 participants, 115 were males and108 females. Participants aware of indoor air pollution were 91.5% and adequate awareness about its sources was 80.7%. Those who knew indoor air pollution is detrimental to health were 95.1%. Awareness about building construction dust as source of indoor air pollution was maximum (84.8%). There was significant difference in awareness among participants with different monthly incomes and educational status and also between males and females. Conclusion: This study concludes that general population of Rawalpindi/Islamabad has fairly good awareness about sources of indoor air pollution. Use of harmful material causing indoor air pollution should be limited or substituted with better ones where possible.

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Health Consequences of an Elite Sporting Career: Long-Term Detriment or Long-Term Gain? A Meta-Analysis of 165,000 Former Athletes

Sports Medicine ◽

10.1007/s40279-020-01379-5 ◽

2020 ◽

Author(s):

Adam Runacres ◽

Kelly A. Mackintosh ◽

Melitta A. McNarry

Keyword(s):

General Population ◽

Cancer Mortality ◽

English Language ◽

Meta Analysis ◽

Premature Mortality ◽

Epidemiological Studies ◽

Registration Number ◽

Mortality Ratio ◽

Former Elite Athletes

Abstract Introduction Exercise is widely accepted to improve health, reducing the risk of premature mortality, cardiovascular disease (CVD) and cancer. However, several epidemiological studies suggest that the exercise-longevity relationship may be ‘J’ shaped; with elite athlete’s likely training above these intensity and volume thresholds. Therefore, the aim of this meta-analysis was to examine this relationship in former elite athletes. Methods 38,047 English language articles were retrieved from Web of Science, PubMed and SportDiscus databases published after 1970, of which 44 and 24 were included in the systematic review and meta-analysis, respectively. Athletes were split into three groups depending on primary sport: Endurance (END), Mixed/Team, or power (POW). Standard mortality ratio’s (SMR) and standard proportionate mortality ratio (SPMR) were obtained, or calculated, and combined for the meta-analysis. Results Athletes lived significantly longer than the general population (male SMR 0.69 [95% CI 0.61–0.78]; female SMR 0.51 [95% CI 0.40–0.65]; both p < 0.01). There was no survival benefit for male POW athletes compared to the general population (SMR 1.04 [95% CI 0.91–1.12]). Although male athlete’s CVD (SMR 0.73 [95% CI 0.62–0.85]) and cancer mortality (SMR 0.75 [95% CI 0.63–0.89]), were significantly reduced compared to the general population, there was no risk-reduction for POW athletes CVD mortality (SMR 1.10 [0.86–1.40]) or END athletes cancer mortality (SMR 0.73 [0.50–1.07]). There was insufficient data to calculate female sport-specific SMR’s. Discussion Overall, athletes live longer and have a reduced incidence of both CVD and cancer mortality compared to the general population, refuting the ‘J’ shape hypothesis. However, different health risks may be apparent according to sports classification, and between sexes, warranting further investigation. Trial registration PROSPERO (registration number: CRD42019130688).

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