scholarly journals Sex-Specific Exposure–Effect Relationship Between Physical Activity and Incident Atrial Fibrillation in the General Population: A Dose–Response Meta-Analysis of 16 Prospective Studies

2021 ◽  
Vol 8 ◽  
Author(s):  
Qin Wan ◽  
Yue Zhou ◽  
Wengen Zhu ◽  
Xiao Liu
Keyword(s):  
Physical Activity ◽  
Atrial Fibrillation ◽  
General Population ◽  
Linear Relationship ◽  
Linear Model ◽  
Dose Response ◽  
Prospective Studies ◽  
Meta Analysis ◽  
Exposure Effect ◽  
Non Linear

Background: Since evidence regarding the relationship between physical activity (PA) and atrial fibrillation (AF) incidence is inconsistent among studies, we performed a dose–response meta-analysis to comprehensively evaluate the exposure–effect association between PA and incident AF and the potential sex difference in the general population.Methods: The PubMed and Embase databases were searched for eligible studies published up to July 2020 (PROSPERO: CRD42018091692). The non-linear or linear exposure–effect relationship between PA and AF was examined using the robust error meta-regression method.Results: A total of 16 prospective studies involving 1,449,017 individuals and 39,884 AF cases were included. We observed an inverse non-linear association between PA level and incident AF (I2 = 0%, pnon−linearity < 0.001). In the linear model, a 5 metabolic equivalent of task (MET)-h/week increase in PA was associated with a decreased risk of AF [risk ratio (RR) = 0.992, 95% confidence interval (CI): 0.988–0.996, I2 = 0%]. In the sex-stratified analysis, we observed an inverse non-linear relationship between PA level and AF risk in females (I2 = 90%, pnon−linearity < 0.0001) but not in males (I2 = 0%, pnon−linearity = 0.40). In the linear model, a 5 MET-h/week increase in PA was associated with a reduced risk of AF in females (RR = 0.982, 95% CI: 0.975–0.989, I2 = 71%) but not in males (RR = 0.998, 95% CI: 0.994–1.002, I2 = 0%), with a significant interaction observed between the two groups (pinteraction < 0.0001).Conclusion: There was an inverse non-linear relationship between PA level and incident AF in the general population. The beneficial effect of PA in reducing AF risk might be predominantly observed in females.

scholarly journals 100% Fruit juice intake and cardiovascular risk: a systematic review and meta-analysis of prospective and randomised controlled studies

2020 ◽  
Author(s):  
Lanfranco D’Elia ◽  
◽  
Monica Dinu ◽  
Francesco Sofi ◽  
Massimo Volpe ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Dose Response ◽  
Prospective Studies ◽  
Fruit Juice ◽  
Meta Analysis ◽  
Inverse Association ◽  
Non Linear ◽  
Randomised Controlled ◽  
The Relationship

Abstract Purpose The relationship between 100% fruit juice (100%FJ) consumption and cardiovascular risk is object of debate: indeed, recently published investigations provided new but discrepant evidence on this important question and International dietary guidelines are not in agreement on recommendations about fruit juice consumption. Therefore, we performed a meta-analysis of the prospective studies and the randomised controlled trials (RCTs) that explored the relationship between 100%FJ intake, cardiovascular risk profile and risk of cardiovascular events. Methods We performed a systematic search of publications up to August 2019. Summary relative risks and exploration of linearity of the association were estimated for prospective studies and summary mean differences (MDs) calculated for RCTs. Results A total of 21 prospective studies and 35 RCTs met the inclusion criteria. Dose–response analysis detected a significant inverse association between low-moderate 100%FJ consumption and risk of stroke (up to 200 ml/day) or total CV events (up to 170 ml/day) compared with no consumption, with a non-linear relationship (p for non-linearity < 0.05). No significant association was found for coronary heart disease and diabetes risk. In RCTs, a favorable and significant effect of 100%FJ intake was detected on blood pressure (systolic, MD: − 3.14 mmHg; diastolic, MD: − 1.68 mmHg), arterial compliance (carotid-femoral pulse wave velocity, − 0.38 m/s) and endothelial function (flow-mediated dilation, 2.10%). Neutral effects were found on body weight, blood lipids and glucose metabolism. Conclusions The results of these analyses indicate that 100%FJ consumption is not associated with higher CV risk. A non-linear inverse dose–response relationship occurs between 100%FJ consumption and CV disease, in particular for risk of stroke, probably mediated by the decrease in blood pressure. Trial registration PROSPERO registration number (CRD42019135577).

scholarly journals Dose–response association of dietary sodium intake with all-cause and cardiovascular mortality: a systematic review and meta-analysis of prospective studies

2018 ◽  
Vol 22 (2) ◽  
pp. 295-306 ◽  
Author(s):  
Alireza Milajerdi ◽  
Kurosh Djafarian ◽  
Sakineh Shab-Bidar
Keyword(s):  
Systematic Review ◽  
Dose Response ◽  
Prospective Studies ◽  
Sodium Intake ◽  
Meta Analysis ◽  
Dietary Sodium ◽  
Linear Association ◽  
All Cause Mortality ◽  
Non Linear ◽  
Cvd Mortality

AbstractObjectiveHigh Na intake has been associated with different health problems. However, serious controversies exist over studies investigating associations of Na intake with mortality from all-causes and CVD. The present systematic review and meta-analysis was done to investigate, for the first time, the dose–response association of dietary Na intake with all-cause and CVD mortality among prospective studies.DesignRelevant papers published up to August 2017 were searched in MEDLINE, EMBASE and Google Scholar databases. Prospective cohort studies on the association of dietary Na intake with all-cause or/and CVD mortality were included. Linear and non-linear dose–response associations between Na intake and CVD and all-cause mortality were examined.ResultsOverall, twenty publications met inclusion criteria. A significant non-linear association (P<0·001) was found between Na intake and CVD mortality risk among studies assessing urinary Na excretion, with a relatively steep slope at Na intakes above 2400mg/d. However, the association was not significant in studies using dietary Na intake (P=0·61). Additionally, the non-linear association of Na intake with all-cause mortality was also non-significant. No linear association (effect size; 95 % CI; I2) was seen between 100mg/d increment in Na intake and CVD mortality (1·01; 0·97, 1·05; 98·4 %) or all-cause mortality (1·01; 1·00, 1·02; 89·2 %). Following subgroup analyses, the association between Na intake and CVD mortality was observed only among studies conducted in the USA (0·99; 0·99, 1·00; 20·0 %).ConclusionsThe study showed a direct association between urinary Na excretion and CVD mortality which was more considerable at intakes above 2400mg/d. In contrast, no significant association was found between Na intake and all-cause mortality. Further long-term prospective studies on different populations are required to confirm these findings.

Non-linear Relationship between Tacrolimus Blood Concentration and Acute Rejection After Kidney Transplantation: A Systematic Review and Dose-Response Meta-Analysis of Cohort Studies

2019 ◽  
Vol 25 (21) ◽  
pp. 2394-2403
Author(s):  
Saifu Yin ◽  
Turun Song ◽  
Xingxing Li ◽  
Hanyue Xu ◽  
Xueling Zhang ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Acute Rejection ◽  
Linear Relationship ◽  
Dose Response ◽  
Blood Concentration ◽  
Meta Analysis ◽  
West China Hospital ◽  
West China ◽  
One Stage ◽  
Non Linear

Background: Maintaining the exposure of tacrolimus (Tac) after kidney transplantation (KT) must be necessary to prevent acute rejection (AR) and improve graft survival，but there is still no clear consensus on the optimal Tac target blood concentration and concentration-effect relationship is poorly defined. Methods: We conducted a dose-response meta-analysis to quantitatively assess the association between Tac blood concentration and (AR) or adverse effects after KT. A comprehensive search of PubMed, Embase and Cochrane library databases was conducted to find eligible studies up to 10th September 2018. Unpublished data from patients receiving KT in West China Hospital (Sichuan University, China) were also collected. Both twostage dose-response and one-stage dose-response meta-analysis models were used to improve the statistical power. Results: A total of 4967 individuals from 10 original studies and 1453 individuals from West China Hospital were eligible for the ultimate analysis. In the two-stage dose-response meta-analysis model, we observed a significant non-linear relationship between Tac blood concentration and AR (P < 0.001) with moderate heterogeneity (I2 = 46.0%, P = 0.08). Tac blood concentration at 8ng/ml was associated with the lowest risk of AR (RR: 0.26, 95%CI: 0.13 - 0.54) by reference to 2ng/ml. Tac concentration at 7.0 - 11.0 ng/ml reduced the risk of AR by at least 70%, 5-14 ng/ml by at least 60%, and 4.5 – 14 ng/ml at least 50%. In the one-stage dose-response model, we also found a strong non-linear relationship between Tac and AR (P < 0.001) with moderate heterogeneity (I2 = 41.2%, P = 0.10). Tac concentration of 7.5 ng/ml was associated with the lowest risk of AR (RR: 0.35, 95%CI: 0.16 - 0.77). The blood concentration at 5.5 - 9.5 ng/ml was associated with the reduced AR by at least 60% and 4.5 - 10.5 ng/ml by at least 50% by reference to 2 ng/ml. Conclusion: Maintaining Tac blood concentration at 5 - 9.5 ng/ml within the first year may prevent AR most effectively.

scholarly journals Dose–response relationship between physical activity and mortality in adults with noncommunicable diseases: A systematic review and meta-analysis of cohort studies

2019 ◽  
Author(s):  
Wolfgang Geidl ◽  
Sabrina Schlesinger ◽  
Eriselda Mino ◽  
Lorena Miranda ◽  
Klaus Pfeifer
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Dose Response ◽  
Meta Analysis ◽  
Noncommunicable Diseases ◽  
List Type ◽  
Copd Patients ◽  
All Cause Mortality ◽  
Non Linear ◽  
The Relationship

ABSTRACTObjectiveTo investigate the relationship between post-diagnosis physical activity and mortality in patients with selected noncommunicable diseases, including breast cancer, lung cancer, type 2 diabetes (T2D), ischemic heart disease (IHD), chronic obstructive pulmonary disease (COPD), stroke, osteoarthritis, low back pain and major depressive disorders.DesignSystematic review and dose–response meta-analysis.Data sourcesPubMed, Scopus and the Web of Science were searched systematically for English publications from the inception of the platforms until August 2018. Additionally, the search was updated in August 2019.Eligibility criteriaProspective observational studies examining the relationship between at least three physical activity categories and all-cause mortality or disease-specific mortality as the primary outcome.ResultsIn total, 28 studies were included: 12 for breast cancer, 6 for T2D, 8 for IHD and 2 for COPD. The linear meta-analysis revealed that each 10 metabolic equivalent tasks (MET) h increase of physical activity per week was associated with a 22% lower mortality rate in breast cancer patients (Hazard Ratio [HR], 0.78; 95% CI: 0.71, 0.86), 12% in IHD patients (HR, 0.88; 95% CI: 0.83, 0.93), 30% in COPD patients (HR, 0.70; 95% CI: 0.45, 1.09) and 4% in T2D patients (HR, 0.96; 95% CI: 0.93, 0.99). The non-linear meta-analysis showed a regressive association with no threshold for the beneficial effect of physical activity on mortality.ConclusionHigher levels of post-diagnosis physical activity are associated with lower mortality rates in breast cancer, T2D, IHD and COPD patients, with evidence of a no-threshold and non-linear dose–response pattern.SUMMARY BOXExisting findings- Higher levels of physical activity are associated with a clear reduction in all-cause mortality in the general population.- In the general population, the shape of the dose–response curve between levels of physical activity and reduced mortality rates is characterized by a regressive, non-linear effect.New findings- Higher levels of post-diagnosis physical activity are associated with a clear reduction in all-cause mortality in adults with breast cancer, T2D, IHD and COPD.- The shape of the indication-specific dose–response curves between post-diagnosis physical activity and mortality are characterized by a regressive, non-linear association with (1) no threshold for the beneficial effect, (2) pronounced reductions of mortality for lower levels of physical activity compared to those who are physically inactive and (3) no harmful effects at higher levels of physical activity.

scholarly journals Dose-Response Relationship Among Body Mass Index, Abdominal Adiposity and Atrial Fibrillation in Patients Undergoing Cardiac Surgery: A Meta-Analysis of 30 Prospective Studies

2020 ◽  
Author(s):  
Menglu Liu ◽  
Kaibo Mei ◽  
Lixia Xie ◽  
Jianyong Ma ◽  
Peng Yu ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Body Mass ◽  
Prospective Studies ◽  
Meta Analysis ◽  
Valve Surgery ◽  
Current Evidence ◽  
Cochrane Library ◽  
Exposure Effect ◽  
Increased Risk

Abstract Background: Whether being overweight increases the risk of postoperative atrial fibrillation (POAF) is unclear, and whether adiposity independently contributes to POAF has not been comprehensively studied. Thus, we conducted a meta-analysis to clarify the strength and shape of the exposure-effect relationship between adiposity and POAF.Methods: The PubMed, Cochrane Library, and EMBASE databases were searched for prospective studies (RCTs, cohort studies, and nest-case control studies) reporting data regarding the relationship between adiposity and the risk of POAF.Results: Thirty publications involving 139,302 patients were included. Analysis of categorical variables showed that obesity (RR: 1.39, P<0.001), but not being underweight (RR: 1.44, P=0.13) or being overweight (RR: 1.03, P=0.48), was associated with an increased risk of POAF. In the exposure-effect analysis, the summary RR for a 5-unit increment in body mass index (BMI) was 1.09 (P<0.001) for the risk of POAF. There was a significant linear relationship between BMI and POAF (Pnonlinearity=0.91); the curve was flat and began to rise steeply at a BMI of approximately 30. Notably, BMI levels below 30 (overweight) were not associated with a higher risk of POAF. In the subgroup analysis of surgery types, the pooled RR values for a BMI increase of 5 for coronary artery bypass graft and valve surgery were 1.21 (P<0.01) and 1.34 (P=0.25), respectively, suggesting that a potential difference in the association exists by surgery type. Additionally, waist obesity was associated with the risk of POAF (RR: 1.55, P<0.001).Conclusion: Based on the current evidence, our findings show that adiposity was independently associated with an increased risk of POAF, while being underweight or overweight might not significantly increase the POAF risk. The magnitude of the effect of obesity on AF in patients undergoing valve surgery might be small, and this finding needs to be further confirmed.

scholarly journals Dose-response relationship among body mass index, abdominal adiposity and atrial fibrillation in patients undergoing cardiac surgery: a meta-analysis of 30 prospective studies

2020 ◽  
Author(s):  
Menglu Liu ◽  
Kaibo Mei ◽  
Jianyong Ma ◽  
Peng Yu ◽  
Lixia Xie ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Body Mass ◽  
Prospective Studies ◽  
Meta Analysis ◽  
Valve Surgery ◽  
Current Evidence ◽  
Cochrane Library ◽  
Exposure Effect ◽  
Increased Risk

AbstractBackgroundWhether being overweight increases the risk of postoperative atrial fibrillation (POAF) is unclear, and whether adiposity independently contributes to POAF has not been comprehensively studied. Thus, we conducted a meta-analysis to clarify the strength and shape of the exposure-effect relationship between adiposity and POAF.MethodsThe PubMed, Cochrane Library, and EMBASE databases were searched for prospective studies (RCTs, cohort studies, and nest-case control studies) reporting data regarding the relationship between adiposity and the risk of POAF.ResultsThirty publications involving 139,302 patients were included. Analysis of categorical variables showed that obesity (RR: 1.39, P<0.001), but not being underweight (RR: 1.44, P=0.13) or being overweight (RR: 1.03, P=0.48), was associated with an increased risk of POAF. In the exposure-effect analysis, the summary RR for a 5-unit increment in body mass index (BMI) was 1.09 (P<0.001) for the risk of POAF. There was a significant linear relationship between BMI and POAF (Pnonlinearity=0.91); the curve was flat and began to rise steeply at a BMI of approximately 30. Notably, BMI levels below 30 (overweight) were not associated with a higher risk of POAF. In the subgroup analysis of surgery types, the pooled RR values for a BMI increase of 5 for coronary artery bypass graft and valve surgery were 1.21 (P<0.01) and 1.34 (P=0.25), respectively, suggesting that a potential difference in the association exists by surgery type. Additionally, waist obesity was associated with the risk of POAF (RR: 1.55, P<0.001).ConclusionBased on the current evidence, our findings show that adiposity was independently associated with an increased risk of POAF, while being underweight or overweight might not significantly increase the POAF risk. The magnitude of the effect of obesity on AF in patients undergoing valve surgery might be small, and this finding needs to be further confirmed.

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