scholarly journals GFR in Healthy Aging: an Individual Participant Data Meta-Analysis of Iohexol Clearance in European Population-Based Cohorts

2020 ◽  
Vol 31 (7) ◽  
pp. 1602-1615 ◽  
Author(s):  
Bjørn O. Eriksen ◽  
Runolfur Palsson ◽  
Natalie Ebert ◽  
Toralf Melsom ◽  
Markus van der Giet ◽  
...  
Keyword(s):  
Healthy Aging ◽  
Meta Analysis ◽  
Additive Model ◽  
Healthy Person ◽  
Population Based ◽  
European Population ◽  
Older Age ◽  
Cross Sectional ◽  
Individual Participant ◽  
The Mean

BackgroundPopulation mean GFR is lower in older age, but it is unknown whether healthy aging is associated with preserved rather than lower GFR in some individuals.MethodsWe investigated the cross-sectional association between measured GFR, age, and health in persons aged 50–97 years in the general population through a meta-analysis of iohexol clearance measurements in three large European population-based cohorts. We defined a healthy person as having no major chronic disease or risk factors for CKD and all others as unhealthy. We used a generalized additive model to study GFR distribution by age according to health status.ResultsThere were 935 (22%) GFR measurements in persons who were healthy and 3274 (78%) in persons who were unhealthy. The mean GFR was lower in older age by −0.72 ml/min per 1.73 m2 per year (95% confidence interval [95% CI], −0.96 to −0.48) for men who were healthy versus −1.03 ml/min per 1.73 m2 per year (95% CI, −1.25 to −0.80) for men who were unhealthy, and by −0.92 ml/min per 1.73 m2 per year (95% CI, −1.14 to −0.70) for women who were healthy versus −1.22 ml/min per 1.73 m2 per year (95% CI, −1.43 to −1.02) for women who were unhealthy. For healthy and unhealthy people of both sexes, both the 97.5th and 2.5th GFR percentiles exhibited a negative linear association with age.ConclusionsHealthy aging is associated with a higher mean GFR compared with unhealthy aging. However, both the mean and 97.5 percentiles of the GFR distribution are lower in older persons who are healthy than in middle-aged persons who are healthy. This suggests that healthy aging is not associated with preserved GFR in old age.

scholarly journals Smoking and nasopharyngeal cancer: individual data meta-analysis of six prospective studies on 334 935 men

2021 ◽  
Author(s):  
Jia Huang Lin ◽  
Chi Pang Wen ◽  
Chao Qiang Jiang ◽  
Jian-Min Yuan ◽  
Chien Jen Chen ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Nasopharyngeal Cancer ◽  
Population Based ◽  
Individual Participant Data ◽  
Tobacco Control Policies ◽  
Hazard Ratios ◽  
Smoking Exposure ◽  
Drinking Status ◽  
Individual Participant ◽  
Never Smokers

Abstract Background The role of smoking in nasopharyngeal carcinoma (NPC) remains uncertain, especially in endemic regions. We conducted an individual participant data (IPD) meta-analysis of prospective cohort studies to investigate the associations between smoking exposure and risk of NPC. Methods We obtained individual participant data of 334 935 male participants from six eligible population-based cohorts in NPC-endemic regions, including two each in Guangzhou and Taiwan, and one each in Hong Kong and Singapore. We used one- and two-stage approaches IPD meta-analysis and Cox proportional hazard models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of NPC for smoking exposure adjusting for age and drinking status. Results During 2 961 315 person-years of follow-up, 399 NPC evens were ascertained. Risks of NPC were higher in ever versus never smokers (HRone-stage = 1.32, 95% CI = 1.07-1.63, P = 0.0088; HRtwo-stage = 1.27, 1.01-1.60, 0.04). These positive associations appeared to be stronger in ever smokers who consumed 16+ cigarettes/day (HRone-stage = 1.67, 95% CI = 1.29-2.16, P = 0.0001), and in those who started smoking at age younger than 16 (2.16, 1.33-3.50, 0.0103), with dose-response relationships (P-values for trend = 0.0028 and 0.0103, respectively). Quitting (versus daily smoking) showed a small reduced risk (stopped for 5+ years: HRone-stage = 0.91, 95% CI = 0.60-1.39, P = 0.66; for former smokers: HRtwo-stage = 0.84, 0.61-1.14, 0.26). Conclusions This first IPD meta-analysis from six prospective cohorts in endemic regions has provided robust observational evidence that smoking increased NPC risk in men. NPC should be added to the 12–16 cancer sites known to be tobacco-related cancers. Strong tobacco control policies, preventing young individuals from smoking, would reduce NPC risk in endemic regions.

scholarly journals Ultra-processed food consumption in Barbados: evidence from a nationally representative, cross-sectional study

2021 ◽  
Vol 10 ◽  
Author(s):  
Rachel M. Harris ◽  
Angela M. C. Rose ◽  
Suzanne Soares-Wynter ◽  
Nigel Unwin
Keyword(s):  
Communicable Disease ◽  
Population Based ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Targeted Interventions ◽  
Sweetened Beverages ◽  
Group 4 ◽  
The Mean ◽  
Nationally Representative

Abstract Our objective was to describe, for the first time in an English-speaking Caribbean country, the contribution of ultra-processed foods (UPFs) to nutrients linked to non-communicable disease. Using a cross-sectional study design, dietary data were collected from two non-consecutive 24-h dietary recalls. Recorded food items were then classified according to their degree of processing by the NOVA system. The present study took place in Barbados (2012–13). A representative population-based sample of 364 adult Barbadians (161 males and 203 females) aged 25–64 years participated in the study. UPFs represented 40⋅5 % (838 kcal/d; 95 % CI 791, 885) of mean energy intake. Sugar-sweetened beverages made the largest contribution to energy within the UPF category. Younger persons (25–44 years) consumed a significantly higher proportion of calories from UPF (NOVA group 4) compared with older persons (45–64 years). The mean energy shares of UPF ranged from 22⋅0 to 58⋅9 % for those in the lowest tertile to highest tertile. Within each tertile, the energy contribution was significantly higher in the younger age group (25–44 years) compared with the older (45–64 years). One-quarter of persons consume ≥50 % of their daily calories from UPF, this being significantly higher in younger persons. The ultra-processed diet fraction contained about six times the mean of free sugars and about 0⋅8 times the dietary fibre of the non-ultra-processed fraction (NOVA groups 1–3). Targeted interventions to decrease the consumption of UPF especially in younger persons is thus of high priority to improve the diet quality of Barbadians.

scholarly journals Prenatal and postnatal exposure to acetaminophen in relation to autism spectrum and attention-deficit and hyperactivity symptoms in childhood: Meta-analysis in six European population-based cohorts

2021 ◽  
Author(s):  
Silvia Alemany ◽  
Claudia Avella-García ◽  
Zeyan Liew ◽  
Raquel García-Esteban ◽  
Kosuke Inoue ◽  
...  
Keyword(s):  
Attention Deficit ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Collaborative Study ◽  
Population Based ◽  
Autism Spectrum ◽  
European Population ◽  
Autism Spectrum Conditions ◽  
Adhd Symptoms ◽  
Postnatal Exposure

AbstractThe potential etiological role of early acetaminophen exposure on Autism Spectrum Conditions (ASC) and Attention-Deficit/Hyperactivity Disorder (ADHD) is inconclusive. We aimed to study this association in a collaborative study of six European population-based birth/child cohorts. A total of 73,881 mother–child pairs were included in the study. Prenatal and postnatal (up to 18 months) acetaminophen exposure was assessed through maternal questionnaires or interviews. ASC and ADHD symptoms were assessed at 4–12 years of age using validated instruments. Children were classified as having borderline/clinical symptoms using recommended cutoffs for each instrument. Hospital diagnoses were also available in one cohort. Analyses were adjusted for child and maternal characteristics along with indications for acetaminophen use. Adjusted cohort-specific effect estimates were combined using random-effects meta-analysis. The proportion of children having borderline/clinical symptoms ranged between 0.9 and 12.9% for ASC and between 1.2 and 12.2% for ADHD. Results indicated that children prenatally exposed to acetaminophen were 19% and 21% more likely to subsequently have borderline or clinical ASC (OR = 1.19, 95% CI 1.07–1.33) and ADHD symptoms (OR = 1.21, 95% CI 1.07–1.36) compared to non-exposed children. Boys and girls showed higher odds for ASC and ADHD symptoms after prenatal exposure, though these associations were slightly stronger among boys. Postnatal exposure to acetaminophen was not associated with ASC or ADHD symptoms. These results replicate previous work and support providing clear information to pregnant women and their partners about potential long-term risks of acetaminophen use.

scholarly journals Longitudinal association between CRP levels and risk of psychosis: a meta-analysis of population-based cohort studies

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Emanuele F. Osimo ◽  
Luke Baxter ◽  
Jan Stochl ◽  
Benjamin I. Perry ◽  
Stephen A. Metcalf ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Meta Analysis ◽  
Random Effect ◽  
Population Based ◽  
Continuous Variable ◽  
Cross Sectional ◽  
Standard Deviation Increase ◽  
Suspected Infection ◽  
Longitudinal Association ◽  
Incident Cases

AbstractMeta-analyses of cross-sectional studies suggest that patients with psychosis have higher circulating levels of C-reactive protein (CRP) compared with healthy controls; however, cause and effect is unclear. We examined the prospective association between CRP levels and subsequent risk of developing a psychotic disorder by conducting a systematic review and meta-analysis of population-based cohort studies. Databases were searched for prospective studies of CRP and psychosis. We obtained unpublished results, including adjustment for age, sex, body mass index, smoking, alcohol use, and socioeconomic status and suspected infection (CRP > 10 mg/L). Based on random effect meta-analysis of 89,792 participants (494 incident cases of psychosis at follow-up), the pooled odds ratio (OR) for psychosis for participants with high (>3 mg/L), as compared to low (≤3 mg/L) CRP levels at baseline was 1.50 (95% confidence interval [CI], 1.09–2.07). Evidence for this association remained after adjusting for potential confounders (adjusted OR [aOR] = 1.31; 95% CI, 1.03–1.66). After excluding participants with suspected infection, the OR for psychosis was 1.36 (95% CI, 1.06–1.74), but the association attenuated after controlling for confounders (aOR = 1.23; 95% CI, 0.95–1.60). Using CRP as a continuous variable, the pooled OR for psychosis per standard deviation increase in log(CRP) was 1.11 (95% CI, 0.93–1.34), and this association further attenuated after controlling for confounders (aOR = 1.07; 95% CI, 0.90–1.27) and excluding participants with suspected infection (aOR = 1.07; 95% CI, 0.92–1.24). There was no association using CRP as a categorical variable (low, medium or high). While we provide some evidence of a longitudinal association between high CRP (>3 mg/L) and psychosis, larger studies are required to enable definitive conclusions.

scholarly journals Arm Based on LEg blood pressures (ABLE-BP): can systolic leg blood pressure measurements predict systolic brachial blood pressure? Protocol for an individual participant data meta-analysis from the INTERPRESS-IPD Collaboration

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e040481
Author(s):  
Sinead T J McDonagh ◽  
James P Sheppard ◽  
Fiona C Warren ◽  
Kate Boddy ◽  
Leon Farmer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Public Involvement ◽  
Meta Analysis ◽  
Patient And Public Involvement ◽  
Prognostic Models ◽  
Individual Participant Data ◽  
Dissemination Strategy ◽  
Cross Sectional ◽  
Individual Participant ◽  
Meta Analyses

IntroductionBlood pressure (BP) is normally measured on the upper arm, and guidelines for the diagnosis and treatment of high BP are based on such measurements. Leg BP measurement can be an alternative when brachial BP measurement is impractical, due to injury or disability. Limited data exist to guide interpretation of leg BP values for hypertension management; study-level systematic review findings suggest that systolic BP (SBP) is 17 mm Hg higher in the leg than the arm. However, uncertainty remains about the applicability of this figure in clinical practice due to substantial heterogeneity.AimsTo examine the relationship between arm and leg SBP, develop and validate a multivariable model predicting arm SBP from leg SBP and investigate the prognostic association between leg SBP and cardiovascular disease and mortality.Methods and analysisIndividual participant data (IPD) meta-analyses using arm and leg SBP measurements for 33 710 individuals from 14 studies within the Inter-arm blood pressure difference IPD (INTERPRESS-IPD) Collaboration. We will explore cross-sectional relationships between arm and leg SBP using hierarchical linear regression with participants nested by study, in multivariable models. Prognostic models will be derived for all-cause and cardiovascular mortality and cardiovascular events.Ethics and disseminationData originate from studies with prior ethical approval and consent, and data sharing agreements are in place—no further approvals are required to undertake the secondary analyses proposed in this protocol. Findings will be published in peer-reviewed journal articles and presented at conferences. A comprehensive dissemination strategy is in place, integrated with patient and public involvement.PROSPERO registration numberCRD42015031227.

Long-Term Cognitive Decline After Stroke: An Individual Participant Data Meta-Analysis

Stroke ◽  
2021 ◽  
Author(s):  
Jessica W. Lo ◽  
John D. Crawford ◽  
David W. Desmond ◽  
Hee-Joon Bae ◽  
Jae-Sung Lim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Recurrent Stroke ◽  
Meta Analysis ◽  
Older Age ◽  
Individual Participant Data ◽  
Individual Participant ◽  
Global Cognition

Background and Purpose: Poststroke cognitive impairment is common, but the trajectory and magnitude of cognitive decline after stroke is unclear. We examined the course and determinants of cognitive change after stroke using individual participant data from the Stroke and Cognition Consortium. Methods: Nine longitudinal hospital-based cohorts from 7 countries were included. Neuropsychological test scores and normative data were used to calculate standardized scores for global cognition and 5 cognitive domains. One-step individual participant data meta-analysis was used to examine the rate of change in cognitive function and risk factors for cognitive decline after stroke. Stroke-free controls were included to examine rate differences. Based on the literature and our own data that showed short-term improvement in cognitive function after stroke, key analyses were restricted to the period beginning 1-year poststroke to focus on its long-term effects. Results: A total of 1488 patients (mean age, 66.3 years; SD, 11.1; 98% ischemic stroke) were followed for a median of 2.68 years (25th–75th percentile: 1.21–4.14 years). After an initial period of improvement through up to 1-year poststroke, decline was seen in global cognition and all domains except executive function after adjusting for age, sex, education, vascular risk factors, and stroke characteristics (−0.053 SD/year [95% CI, −0.073 to −0.033]; P <0.001 for global cognition). Recurrent stroke and older age were associated with faster decline. Decline was significantly faster in patients with stroke compared with controls (difference=−0.078 SD/year [95% CI, −0.11 to −0.045]; P <0.001 for global cognition in a subgroup analysis). Conclusions: Patients with stroke experience cognitive decline that is faster than that of stroke-free controls from 1 to 3 years after onset. An increased rate of decline is associated with older age and recurrent stroke.

scholarly journals Soft drinks consumption, diet quality and BMI in a Mediterranean population

2010 ◽  
Vol 14 (5) ◽  
pp. 778-784 ◽  
Author(s):  
Eva Balcells ◽  
Mario Delgado-Noguera ◽  
Ricardo Pardo-Lozano ◽  
Taïs Roig-González ◽  
Anna Renom ◽  
...  
Keyword(s):  
Mediterranean Diet ◽  
Sedentary Lifestyle ◽  
Population Based ◽  
Soft Drinks ◽  
Mediterranean Population ◽  
Regression Analyses ◽  
Cross Sectional ◽  
Independent Population ◽  
The Mean ◽  
Diet Score

AbstractObjectivesEvidence of the effects of soft drinks consumption on BMI and lifestyle in adult populations is mixed and quite limited. The aim of the present study was to determine the association of soft drinks consumption with BMI and lifestyle in a representative Mediterranean population.DesignTwo independent, population-based, cross-sectional (2000 and 2005) studies. Dietary intake was assessed using a validated FFQ. Weight and height were measured.SettingGirona, Spain.SubjectsRandom sample of the 35- to 74-year-old population (3910 men and 4285 women).ResultsLess than half (41·7 %) of the population consumed soft drinks; the mean consumption was 36·2 ml/d. The prevalence of sedentary lifestyle increased with the frequency of soft drinks consumption (P = 0·025). Daily soft drinks consumption significantly increased the risk of low adherence to the Mediterranean diet (OR = 0·57, 95 % CI 0·44, 0·74 v. top tertile of Mediterranean diet score). Multiple linear regression analyses, controlled for potential confounders, revealed that an increment in soft drinks consumption of 100 ml was associated with a 0·21 kg/m2 increase in BMI (P = 0·001). Only implausibly low reports of energy consumption showed a null association between soft drinks consumption and BMI.ConclusionsSoft drinks consumption was not embedded in a healthy diet context and was positively associated with BMI and sedentary lifestyle in this Mediterranean population.

Prevalence of epilepsy in autism spectrum disorders: A systematic review and meta-analysis

Autism ◽  
2021 ◽  
pp. 136236132110450
Author(s):  
Xian Liu ◽  
Xin Sun ◽  
Caihong Sun ◽  
Mingyang Zou ◽  
Yiru Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intellectual Disability ◽  
Human Development ◽  
Human Development Index ◽  
Clinical Sample ◽  
Meta Analysis ◽  
Population Based ◽  
Cross Sectional ◽  
Development Index ◽  
Pooled Prevalence

The literature from inception to 2020 on the prevalence of epilepsy in autistic individuals was systematically reviewed and further explored by subgroup analyses and meta-regression models. This systematic review is registered with PROSPERO (CRD42020179725). A total of 66 studies from 53 articles were included. The updated pooled prevalence of epilepsy in autistic individuals was 10% (95% CI: 6–14). The respective prevalence estimate of epilepsy was 19% (95% CI: 6–35) in the clinical sample-based cross-sectional study, 7% (95% CI: 3–11) in the cohort study, and 9% (95% CI: 5–15) in the population-based cross-sectional study. The pooled prevalence of epilepsy was 7% (95% CI: 4–11) in autistic children and 19% (95% CI: 14–24) in autistic adults. Compared to the school-aged group, the adolescence group (OR: 1.15, 95% CI: 1.06–1.25) and the pre-school group (OR: 1.06, 95% CI: 0.94–1.19) were positively associated with the prevalence of epilepsy. The moderators of age, human development index of the country, gender, and intellectual function accounted for most of the heterogeneity. The prevalence estimates were associated with age, female gender, intellectual disability rate, and the human development index of countries. About 1/10 autistic individuals co-occurred with epilepsy, which was common in the clinical setting, adolescents, adults, females, or patients with intellectual disability, and less common in the country with high human development index. Lay abstract Autistic individuals experience higher co-occurring medical conditions than the general population, and yet the estimates of autistic individuals with epilepsy are not updated. Co-occurrence of epilepsy in autistic individuals often aggravated cognitive impairment and increased the risk of poor long-term prognosis. Thus, an updated systematic review and meta-analysis was conducted to study the relevant articles published from inception to 2020, evaluate the prevalence of epilepsy in autistic individuals, and further explore the putative factors influencing the prevalence. A total of 66 studies from 53 articles were included in this study. The results showed that epilepsy is more common in autistic individuals than in the general population. The prevalence of epilepsy in autistic individuals in the clinical sample-based studies was higher than that in the population-based based cross-sectional or cohort studies. The prevalence of epilepsy in autistic adults was higher than that in autistic children. A significantly increased prevalence of epilepsy was detected in the autistic adolescent group (11–17 years old), and a higher trend of prevalence of epilepsy was observed in the autistic pre-school group (⩽ 6 -years-old) than that of the autistic school-aged group (7–10 years-old). The prevalence of epilepsy increased with age, female rate, and low intellectual function rate of autistic individuals. However, the human development index of countries was negatively associated with the pooled prevalence, which could be attributed to the different levels of awareness, diagnostic technologies, and autism-service support worldwide. About 1/10 autistic individuals also had epilepsy, which was common in the clinical setting, adolescents, adults, females, or patients with intellectual disability and less common in the country with high human development index. Thus, these findings provided critical and innovative views on the prevalence of epilepsy in autistic individuals and contributed to the targeted clinical management and preventive measures.

scholarly journals Prevalence and Predictors of Self-Medication Practices in India: A Systematic Literature Review and Meta-Analysis

2020 ◽  
Vol 15 (2) ◽  
pp. 90-101
Author(s):  
Muhammed Rashid ◽  
Manik Chhabra ◽  
Ananth Kashyap ◽  
Krishna Undela ◽  
Sai K. Gudi
Keyword(s):  
Associated Factors ◽  
Meta Analysis ◽  
Lower Class ◽  
Health Conditions ◽  
Cochrane Library ◽  
Self Medication ◽  
Cross Sectional ◽  
Scientific Databases ◽  
Minor Ailments ◽  
The Mean

Background: Self-Medication (SM) is a practice of using medications to treat selfdiagnosed symptoms without a legitimate prescription by a health care professional. Alongside posing a burden on a patient, SM practices are associated with certain unfavourable health conditions such as drug-resistance, adverse effects, drug-interactions, including death. Objective: To systematically review and quantify the prevalence of SM practices and its associated factors in India. Methodology: A comprehensive systematic search was performed using scientific databases such as PubMed and Cochrane library for the peer-reviewed research articles that were conducted in India without any language and date restrictions. Studies which were cross-sectional by design and assessing the prevalence and predictors of SM practices in India were considered for the review, and all the relevant articles were screened for their eligibility. Results: Of 248 articles, a total of 17 articles comprising of 10,248 participants were included in the meta-analysis. Overall, the mean prevalence of SM practices in India was observed to be 53.57%. Familiarity with the medication appears to be a major reason to practice SM (PR: 30.45; 95% Confidence Interval [CI]: 17.08-43.82; 6 studies), and the practice was noticed more among individuals from a middle-lower class family with a prevalence rate of 26.31 (95%CI: 2.02-50.60; P<0.0001). Minor ailments were the primary reason for practicing SM (PR: 42.46; 95%CI: 21.87- 63.06), among which headache was the most commonly reported (PR: 41.53; 95%CI: 18.05-65.02). Conclusion: Self-medication practices are quite frequent in India. While NSAIDs and anti-allergens are the most frequently utilized self-medicated drugs used for headache and cold and cough.

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