Association between Smoking and Risk of Primary Biliary Cholangitis: A Systematic Review and Meta-Analysis

Background & Aims: Studies have suggested that smokers may have a higher risk of primary biliary cholangitis (PBC) although the results have been inconsistent. This systematic review and meta-analysis aim to better characterize the risk of PBC among smokers by identifying all relevant studies and summarizing their results together. Methods: A comprehensive literature review was conducted using Embase and Pubmed/MEDLINE databases from inception to September 2018 to identify all studies which compared the risk of PBC among current, ever and former smokers to non-smokers. Effect estimates from each study were extracted and combined together using the random-effect, generic inverse variance method of DerSimonian and Laird. Results: Nine case-control studies with 21,577 participants met the eligibility criteria and were included in the meta-analysis. The risk of PBC among ever smokers was significantly higher than non-smokers with the pooled odds ratio (OR) of 1.31 (95% CI, 1.03-1.67; I 2 89%). Subgroup analysis found that the risk was higher in both former smokers (pooled OR 1.36; 95% CI, 1.01-1.84; I 2 75%) and current smokers (pooled OR 1.18; 95% CI, 0.94-1.50; I 2 79%), although the latter did not reach statistical significance. Immunomodulatory and cytotoxic effect of cigarettes were the possible mechanisms behind this increased risk. Conclusions: A significantly increased risk of PBC among individuals who ever smoked was observed in this study, adding to the already long list of harmful health consequences of smoking.

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The Association Between Asthma and Risk of Myasthenia Gravis: A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-224462/v1 ◽

2021 ◽

Author(s):

Pitchaporn Yingchoncharoen ◽

Nipith Charoenngam ◽

Ben Ponvilawan ◽

Jerapas Thongpiya ◽

Thanat Chaikijurajai ◽

...

Keyword(s):

Systematic Review ◽

Myasthenia Gravis ◽

Meta Analysis ◽

Pooled Analysis ◽

Case Control ◽

Case Control Studies ◽

Eligibility Criteria ◽

Inverse Variance ◽

Increased Risk ◽

Independent Review

Abstract PurposeThis study aimed to investigate the association between asthma and risk of myasthenia gravis (MG) using the method of systematic review and meta-analysis.MethodsPotentially eligible studies were identified from Medline and EMBASE databases from inception to … using search strategy that comprised of terms for “Asthma” and “Myasthenia Gravis”. Eligible cohort study must consist of one cohort of individuals with asthma and another cohort of individuals without asthma. Then, the study must report relative risk (RR) with 95% confidence intervals (95% CIs) of incident MG between the groups. Eligible case-control studies must include cases with MG and controls without MG. Then, the study must explore their history of asthma. Odds ratio (OR) with 95% CIs of the association between asthma status and MG must be reported. Point estimates with standard errors were retrieved from each study and were combined together using the generic inverse variance method.ResultsA total of 6,835 articles were identified. After two rounds of independent review by five investigators, two cohort studies and three case-control studies met the eligibility criteria and were included into the meta-analysis. Pooled analysis showed that asthma was significantly associated with risk of MG with the pooled risk ratio of 1.38 (95%CI, 1.02 – 1.86). Funnel plot was symmetric.ConclusionThe current study found a significant association between asthma and increased risk of MG.

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Abstract 16310: Association Between the Use of Antithrombotics and Cardiac Implantable Electronic Device Infections: A Systematic Review and Meta-analysis

Circulation ◽

10.1161/circ.142.suppl_3.16310 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Chol Techorueangwiwat ◽

Chanavuth Kanitsoraphan ◽

Jakrin Kewcharoen

Keyword(s):

Systematic Review ◽

Effect Size ◽

Electronic Device ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Systemic Infection ◽

Cardiac Implantable Electronic Device ◽

Inverse Variance ◽

Increased Risk

Introduction: Studies have shown that the use of antiplatelet and anticoagulant increases the risk of cardiac implantable electronic device (CIED) infection following the implantation. However, results were contradicting. In this study, we performed a systematic review and meta-analysis to explore the effect of antiplatelets and anticoagulants and the risk of CIED infection following the implantation. Methods: We searched the databases of MEDLINE and EMBASE from inception to March 2020. Included studies were published studies of patients undergoing CIED implantations which reported effect size of the use of either antiplatelet or anticoagulant, or both, on the risk of CIED infections. CIED infection was defined as either device-related local or systemic infection. Data from each study were combined using the random-effects, generic inverse variance method of Der Simonian and Laird to calculate effect size and 95% confidence intervals (CI). Results: Fifteen studies from 2008-2019 involving a total of 72,028 patients were included. In random-effect model, we found that the use of antiplatelet was not associated with an increased risk of CIED infections (risk ratio (RR) =1.13, 95% CI: 0.89-1.44, p=0.314, I 2 =51.3%), while the use of anticoagulant was associated with increased risk of CIED infections (RR =1.50, 95%CI: 1.02-2.21, p=0.038, I 2 =75%). There was no publication bias observed in the funnel plot as well as no small-study effect observed in Egger’s test. Conclusions: Our meta-analysis demonstrated that the use of anticoagulant significantly increases the risk of CIED infection following the implantation by up to 1.50-fold, however, this effect was not observed with antiplatelet use. Our study suggested that patients on anticoagulation considering CIED implantations should proceed with caution.

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The Relation between Caffeine Consumption and Endometriosis: An Updated Systematic Review and Meta-Analysis

Nutrients ◽

10.3390/nu13103457 ◽

2021 ◽

Vol 13 (10) ◽

pp. 3457

Author(s):

Konstantinos S. Kechagias ◽

Konstantinos Katsikas Triantafyllidis ◽

Margarita Kyriakidou ◽

Panagiotis Giannos ◽

Ilkka Kalliala ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Statistical Significance ◽

Caffeine Intake ◽

Contributing Factors ◽

Case Control Studies ◽

Caffeine Consumption ◽

Increased Risk ◽

Probable Role

While the contributing factors leading to endometriosis remain unclear, its clinical heterogeneity suggests a multifactorial causal background. Amongst others, caffeine has been studied extensively during the last decade as a putative contributing factor. In this systematic review and meta-analysis, we provide an overview/critical appraisal of studies that report on the association between caffeine consumption and the presence of endometriosis. In our search strategy, we screened PubMed and Scopus for human studies examining the above association. The main outcome was the relative risk of endometriosis in caffeine users versus women consuming little or no caffeine (<100 mg/day). Subgroup analyses were conducted for different levels of caffeine intake: high (>300 mg/day) or moderate (100–300 mg/day). Ten studies were included in the meta-analysis (five cohort and five case-control studies). No statistically significant association was observed between overall caffeine consumption and risk for endometriosis (RR 1.12, 95% confidence interval (CI) 0.97–1.28, I2 = 70%) when compared to little or no (<100 mg/day) caffeine intake. When stratified according to level of consumption, high intake was associated with increased risk of endometriosis (RR 1.30, 95%CI 1.04–1.63, I2 = 56%), whereas moderate intake did not reach nominal statistical significance (RR 1.18, 95%CI 0.99–1.40, I2 = 37%). In conclusion, caffeine consumption does not appear to be associated with increased risk for endometriosis. However, further research is needed to elucidate the potential dose-dependent link between caffeine and endometriosis or the probable role of caffeine intake as a measurement of other unidentified biases.

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Tobacco smoking and the risk of atrial fibrillation: A systematic review and meta-analysis of prospective studies

European Journal of Preventive Cardiology ◽

10.1177/2047487318780435 ◽

2018 ◽

Vol 25 (13) ◽

pp. 1437-1451 ◽

Cited By ~ 33

Author(s):

Dagfinn Aune ◽

Sabrina Schlesinger ◽

Teresa Norat ◽

Elio Riboli

Keyword(s):

Atrial Fibrillation ◽

Systematic Review ◽

Relative Risk ◽

Prospective Studies ◽

Meta Analysis ◽

Adjusted Relative Risk ◽

Case Control Studies ◽

Increased Risk ◽

Former Smokers ◽

Summary Relative Risk

Background Epidemiological studies on smoking and atrial fibrillation have been inconsistent, with some studies showing a positive association while others have found no association. It is also unclear whether there is a dose–response relationship between the number of cigarettes smoked or pack-years and the risk of atrial fibrillation. We conducted a systematic review and meta-analysis to clarify the association. Design Systematic review and meta-analysis. Methods We searched the PubMed and Embase databases for studies of smoking and atrial fibrillation up to 20 July 2017. Prospective studies and nested case–control studies within cohort studies reporting adjusted relative risk estimates and 95% confidence intervals (CIs) of atrial fibrillation associated with smoking were included. Summary relative risks (95% CIs) were estimated using a random effects model. Results Twenty nine prospective studies (22 publications) were included. The summary relative risk was 1.32 (95% CI 1.12–1.56, I2 = 84%, n = 11 studies) for current smokers, 1.09 (95% CI 1.00–1.18, I2 = 33%, n = 9) for former smokers and 1.21 (95% CI 1.12–1.31, I2 = 80%, n = 14) for ever smokers compared to never smokers. Comparing current versus non-current smokers the summary relative risk was 1.33 (95% CI 1.14–1.56, I2 = 78%, n = 10). The summary relative risk was 1.14 (95% CI 1.10–1.20, I2 = 0%, n = 3) per 10 cigarettes per day and 1.16 (95% CI 1.09–1.25, I2 = 49%, n = 2) per 10 pack-years and there was no evidence of a non-linear association for cigarettes per day, Pnon-linearity = 0.17. Conclusions The current meta-analysis suggests that smoking is associated with an increased risk of atrial fibrillation in a dose-dependent matter, but the association is weaker among former smokers compared to current smokers.

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Proton pump inhibitors and histamine-2 receptor antagonists on the risk of pancreatic cancer: a systematic review and meta-analysis

QJM ◽

10.1093/qjmed/hcz234 ◽

2019 ◽

Cited By ~ 3

Author(s):

P Laoveeravat ◽

S Thavaraputta ◽

W Vutthikraivit ◽

S Suchartlikitwong ◽

T Mingbunjerdsuk ◽

...

Keyword(s):

Systematic Review ◽

Pancreatic Cancer ◽

Sensitivity Analysis ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Meta Analysis ◽

Random Effect ◽

Case Control Studies ◽

Receptor Antagonists ◽

Inverse Variance

Abstract Background Proton pump inhibitors (PPI) and histamine-2 receptor antagonists (H2RA) have been widely used for multiple purposes. Recent studies have suggested an association between these medications and the risk of pancreatic cancer. However, the results have been inconclusive. Aim We, therefore, conducted a study to assess the risk of developing pancreatic cancer in patients who used PPI and H2RA. Design A systematic review and meta-analysis. Methods A literature search was performed using MEDLINE and EMBASE databases from inception through February 2019. Studies that reported risk ratio comparing the risk of pancreatic cancer in patients who received PPI or H2RA versus those who did not receive treatments were included. Pooled risk ratios (RR) and 95% confidence intervals (CI) were calculated using a random-effect generic inverse variance method. Sensitivity analysis, excluding one study at a time, was performed. Results After screening abstracts from the searching methods, seven studies (six case–control studies and one cohort study) were included in the analysis with total 546 199 participants. Compared to patients who did not take medications, the pooled RR of developing pancreatic cancer in patients receiving PPI and H2RA were 1.73 (95% CI: 1.16–2.57) and 1.26 (95% CI: 1.02–1.57), respectively. However, the sensitivity analysis of PPI changed the pooled RR to 1.87 (95% CI: 1.00–3.51) after a study was dropped out. Likewise, H2RA sensitivity analysis also resulted in non-significant pooled RR. Conclusions This meta-analysis did not find the strong evidence for the associations between the use of PPI and H2RA and pancreatic cancer.

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High parity is associated with increased risk of cervical cancer: Systematic review and meta-analysis of case-control studies

10.21203/rs.3.rs-397999/v1 ◽

2021 ◽

Author(s):

Yohannes Tekalegn ◽

Biniyam Sahiledengle ◽

Demelash Woldeyohannes ◽

Daniel Atlaw ◽

Fikreab Desta ◽

...

Keyword(s):

Systematic Review ◽

Cervical Cancer ◽

Odds Ratio ◽

Meta Analysis ◽

Random Effect ◽

Epidemiological Studies ◽

Analysis Model ◽

Case Control Studies ◽

High Parity ◽

Increased Risk

Abstract Background: Cervical cancer is the fourth most common cancer among women. High parity has long been suspected with an increased risk of cervical cancer. Evidence from the existing epidemiological studies regarding the association between parity and cervical cancer is variable and inconsistent. Therefore, the objective of this systematic review and meta-analysis was to synthesize the best available evidence on the epidemiological association between parity and cervical cancer. Methods: MEDLINE/PubMed, HINARI, Google scholar, Science direct, and Cochrane Libraries were systematically searched. Cochrane Q statistics and I2 tests were performed to assess heterogeneity among included studies. Begg's test and egger's regression analysis were performed to assess publication bias. A random-effect meta-analysis model was used to compute pooled odds ratio of the association between parity and cervical cancer. Results: A total of 6975 participants (1998 patients; 4977 controls) were incorporated in the 13 articles included in the final meta-analysis. The meta-analysis revealed that women with parity greater than or equal to three had 2.4 times higher odds of developing cervical cancer compared to women with parity less than three [pooled odds ratio (POR) = 2.4, 95% CI: 1.9-3.2]. Conclusion: High parity is associated with an increased risk of cervical cancer. Strong epidemiological studies are recommended to further explore the mechanisms and role of parity in the causation of cervical cancer.

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Psoriatic Arthritis and Risk of Vertebral Fracture: A Systematic Review and Meta-analysis

Current Rheumatology Reviews ◽

10.2174/1573397117666210908094349 ◽

2021 ◽

Vol 17 ◽

Author(s):

Nipith Charoenngam ◽

Ben Ponvilawan ◽

Jerapas Thongpiya ◽

Pitchaporn Yingchoncharoen ◽

Patompong Ungprasert

Keyword(s):

Systematic Review ◽

Psoriatic Arthritis ◽

Vertebral Fracture ◽

Cohort Studies ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Eligibility Criteria ◽

Inverse Variance ◽

Independent Review

Objective: This study was conducted in order to determine the association between psoriatic arthritis and risk of vertebral fracture by pooling the evidence from previous studies. Methods: Potentially eligible studies were identified from MEDLINE and EMBASE database from inception to March 2020 using search strategy that comprised of terms for “Psoriatic Arthritis” and “Vertebral Fracture”. Studies were eligible for the meta-analysis if they were cohort studies that included psoriatic arthritis and individuals without psoriasis and followed them for incident vertebral fracture. Studies were also required to report standardized incidence ration, hazard risk ratio or relative risk with related 95% confidence intervals (CI) comparing the incidence of vertebral fracture between the two cohorts. The retrieved point estimates with standard errors from each study were pooled into the final result by the random-effect model, generic inverse variance method. Results: A total of 26,090 articles were identified. After two rounds of independent review by three investigators, we included five cohort studies that met the eligibility criteria in the meta-analysis. PsA is significantly associated with VF the pooled odds ratio of 2.09 (95% CI, 1.11 – 3.96; I2 70%). The funnel plot was fairly asymmetric, thus, the publication bias in favor of studies may present. Conclusions: This systematic review and meta-analysis indicates that psoriatic arthritis patients have a significantly elevated risk of developing vertebral fracture.

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Statins and Risk of Cholangiocarcinoma: A Systematic Review and Meta-analysis

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-2990 ◽

2020 ◽

Vol 29 (4) ◽

pp. 629-635

Author(s):

Karn Wijarnpreecha ◽

Elizabeth S Aby ◽

Hassan Ghoz ◽

Wisit Cheungpasitporn ◽

Frank J Lukens ◽

...

Keyword(s):

Systematic Review ◽

Literature Review ◽

Odds Ratio ◽

Meta Analysis ◽

Random Effect ◽

Pooled Analysis ◽

Eligibility Criteria ◽

Comprehensive Literature Review ◽

Current Systematic Review ◽

Inverse Variance

Background and Aims: The use of statins has been shown to be associated with a decreased risk of cholangiocarcinoma (CCA) in many studies although the results have been inconsistent. We conducted this systematic review and meta-analysis to further investigate this possible association by identifying all relevant studies and combining their results together. Methods: A comprehensive literature review was conducted utilizing the MEDLINE and EMBASE databases through March 2020 to identify all studies that compared the risk of CCA among individuals who use statins with individuals who do not use statins. Effect estimates from each study were extracted and combined using the random-effect, generic inverse variance method of DerSimonian and Laird. Results: A total of seven studies with 6,251,187 participants fulfilled the eligibility criteria and were included in this meta-analysis. The pooled analysis found a significantly decreased risk of CCA among individuals who use statins compared with individuals who do not use statins with the pooled odds ratio of 0.68 (95% CI: 0.52-0.89; I 2 96%). Conclusions: The current systematic review and meta-analysis found a significant association between the use of statins and a decreased risk of CCA.

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Patients with psoriasis have a higher risk of dementia: A systematic review and meta-analysis

Indian Journal of Dermatology Venereology and Leprology ◽

10.25259/ijdvl_732_19 ◽

2021 ◽

Vol 0 ◽

pp. 1-8

Author(s):

Nipith Charoenngam ◽

Thanitsara Rittiphairoj ◽

Ben Ponvilawan ◽

Patompong Ungprasert

Keyword(s):

Systematic Review ◽

Cohort Studies ◽

Risk Ratio ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Epidemiological Studies ◽

Eligibility Criteria ◽

Inverse Variance ◽

Statistical Heterogeneity

Background: Patients with psoriasis may have a higher risk of dementia because of the higher inflammatory burden, although results from previous epidemiological studies have been inconsistent. Aims: To determine the association between psoriasis and risk of dementia by pooling the evidence from previous studies. Methods: Potentially eligible studies were identified from Medline and EMBASE databases from inception to July 2019 using a search that comprised terms for “psoriasis” and “dementia.” Studies were eligible for the meta-analysis if they were cohort studies that included psoriatic patients and individuals without psoriasis and followed them for incident dementia. Studies were also required to report standardized incidence ratio, hazard risk ratio or relative risk with related 95% confidence intervals (CI) comparing the incidence of dementia between the two cohorts. The retrieved point estimates with standard errors from each study were pooled into the final result by the random-effect model, generic inverse variance method. Results: A total of 8,861 articles were identified. After two rounds of independent review by three investigators, we included six cohort studies that met the eligibility criteria in the meta-analysis. The risk of dementia was significantly higher among psoriatic patients than in those without psoriasis with a pooled risk ratio of 1.16 (95% CI, 1.04–1.30; I2 95%). A funnel plot was relatively symmetric and was not suggestive of the presence of publication bias. Limitations: Limited accuracy of diagnosis of psoriasis and dementia as four included studies were coding-based studies, and high statistical heterogeneity among studies. Conclusion: This systematic review and meta-analysis indicates that psoriatic patients have a significantly elevated risk of developing dementia.

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Psoriasis and Risk of Uveitis: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2020/9308341 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Chayada Chaiyabutr ◽

Patompong Ungprasert ◽

Narumol Silpa-archa ◽

Chanisada Wongpraparut ◽

Leena Chularojanamontri

Keyword(s):

Systematic Review ◽

Psoriatic Arthritis ◽

Risk Ratio ◽

Meta Analysis ◽

Random Effect ◽

Study Groups ◽

Seronegative Spondyloarthropathy ◽

Analysis Technique ◽

Inverse Variance ◽

Increased Risk

Background. Uveitis is a known ophthalmologic manifestation of seronegative spondyloarthropathy, including psoriatic arthritis. However, the data is less clear among patients with psoriasis due to the limited number of published studies. Aims. To investigate whether the risk of incident and prevalent uveitis is elevated among patients with psoriasis using systematic review and meta-analysis technique. Methods. The MEDLINE and EMBASE databases were searched from their inception to May 2019. Eligible studies must have included a psoriasis group and a nonpsoriasis group. Eligible studies must also have investigated for prevalent or incident uveitis, and the magnitude of difference between the study groups must have been reported. Pooled risk ratio and 95% confidence interval (CI) were calculated using random-effect generic inverse variance methods. Results. Of 7,107 potentially eligible articles from the EMBASE and MEDLINE databases, 7 studies were included in the meta-analysis. Two of those studies compared the incidence, and 5 studies compared the prevalence of uveitis between the psoriasis and nonpsoriasis groups. For incident uveitis, a total of 5,865,801 patients (222,083 with psoriasis and 5,643,718 without psoriasis) were analyzed. For prevalent uveitis, a total of 1,343,436 patients (37,891 with psoriasis and 1,305,545 without psoriasis) were studied. The risk of incident uveitis was significantly higher among patients with psoriasis with a pooled risk ratio of 1.23 (95% CI: 1.05-1.45, I2=55%). The risk of prevalent uveitis was also significantly higher among patients with psoriasis with a pooled risk ratio of 1.97 (95% CI: 1.68-2.31, I2=0%). Conclusions. The results of this study revealed significantly increased risk of both prevalent and incident uveitis among patients with psoriasis.

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