Efficacy of Antimicrobial-Impregnated Catheters for Prevention of Bloodstream Infections in Pediatric Patients: A Meta-Analysis

Background: Multiple Randomized controlled trials (RCTs) have evaluated the efficacy of antimicrobial-impregnated catheters to prevent catheter-related bloodstream infections (CRBSI). However, the RCTs showed contradictory results, the studies were limited in sample size and methodology quality. Thus, we conducted a meta-analysis to overcome these RCT limitations.Methods: We designed a meta-analysis of RCTs comparing antimicrobial-impregnated and conventional catheters for the prevention of CRBSI. We conducted a detailed search of various databases for RCTs published before November 2019. We calculated mean differences (MDs) and pooled odds ratios (ORs) with 95% confidence intervals (CIs) using a random-effects model.Results: We included five RCTs with a total of 2,294 patients. The incidence of CRBSI between the two groups was 0.50 (95% CI, 0.19–1.27), with evidence of heterogeneity (I2 = 55%). The difference was not statistically significant (p = 0.15). On subgroup analysis based on the age of the sample, there was no difference in the rate of CRBSI in the neonatal population [0.42 (95% CI, 0.08–2.27 I2 = 61% p = 0.31] as well as pediatric population [0.45 (95% CI, 0.12–1.67 I2 = 39% p = 0.23]. The summary OR on the incidence of catheter colonization between antimicrobial-impregnated and conventional catheters was 0.64 (95% CI, 0.17–2.35), with no evidence of heterogeneity (I2 = 0%) and a non-significant difference (p = 0.50).Conclusions: To conclude, analysis of a limited number of heterogeneous studies mostly with a small sample indicates that the CRBSI and catheter colonization rates are similar between conventional and antimicrobial-impregnated catheters in the pediatric and neonatal population. There is an urgent need for large-scale RCTs focusing on different antimicrobial-impregnated catheters in these patients to further enhance current evidence.

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Prevalence of Olfactory Dysfunction Among COVID-19 Patients with Self-Reported Smell Loss Versus Objective Olfactory Tests: A Systematic Review and Meta-Analysis

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v36i1.1649 ◽

2021 ◽

Vol 36 (1) ◽

pp. 6

Author(s):

Joyce Anne Regalado ◽

Mariel Mae Tayam ◽

Romiena Santos ◽

January Gelera

Keyword(s):

Meta Analysis ◽

Small Sample ◽

Olfactory Dysfunction ◽

Contact Tracing ◽

P Value ◽

Objective Testing ◽

Significant Difference ◽

Objective Tests ◽

The Difference ◽

Smell Loss

ABSTRACTBackground: Olfactory dysfunction (OD) in COVID-19 presents as a sudden onset smell loss commonly seen in mild symptomatic cases with or without rhinitis but can occur as an isolated symptom. The reported prevalence of OD among COVID-19 patients ranged from 5% to 98%. Although numerous studies have been conducted about their association, these were mainly based on self-reported cases and subjective questionnaires. Objective: This study investigates whether there is a significant difference in the prevalence of olfactory dysfunction between self-reported and objective testing using validated objective olfactory tests among RT-PCR confirmed COVID-19 patients. Methods: PubMed (MEDLINE), Cochrane, Web of Science, and Google Scholar were searched for studies investigating the prevalence of OD by using objective olfactory tests among patients who self-reported OD (November 1, 2019 to July 31, 2020). All studies were assessed for quality and bias using the Cochrane bias tool. Patient demographics, type of objective olfactory test, and results of self-reported OD and objective testing were reported. Results: Nine studies encompassing 673 patients met the inclusion criteria. Validated objective olfactory tests used in the included studies were CCCRC, SST and SIT. Overall prevalence of OD among patients who self-reported was higher after objective testing (71% versus 81%). This was also seen in when we performed subgroup analysis based on the objective tests that were used. However, meta-analysis using random effects model showed no significant difference in the overall prevalence of OD (p value=.479, 95% CI 56.6 to 84.0 versus 71.2 to 89.8) as well as in the subgroups. Conclusion: To the best of our knowledge, this is the first meta-analysis that statistically reviewed articles that evaluated the difference between self-reported and objective tests done on the same patients. Results showing that self-reporting OD approximates the results of the objective tests among COVID-19 positive patients may imply that self-reporting can be sufficient in contact tracing and triggering swabbing and self quarantine during the time of COVID-19 and objective tests can be used as an adjunct in the diagnosis particularly in research. However, this study was limited by small sample size and articles done in European countries hence, interpretation and application of the results of this study must be approached with care. Further studies documenting the difference between self-reporting and objective test in large scale setting involving different countries may be helpful in establishing a definitive consensus.

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Acupotomy Therapy for Shoulder Adhesive Capsulitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/2010816 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 5

Author(s):

Jianyu You ◽

Fengyun Yang ◽

Naigang Liu ◽

Nana Tang ◽

Ting Fang ◽

...

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Large Scale ◽

Meta Analysis ◽

Adhesive Capsulitis ◽

Small Sample ◽

Control Group ◽

Controlled Trials ◽

Randomized Controlled ◽

Significant Difference

Objective. Acupotomy therapy is widely used for pain management. However, the efficacy of acupotomy on shoulder adhesive capsulitis (SAC) is still uncertain. The aim of this study was to determine the effectiveness and safety of acupotomy therapy for SAC. Methods. We searched seven electronic databases to collect randomized controlled trials (RCTs) of acupotomy for SAC published before April 2019. A meta-analysis was performed according to the Cochrane systematic review method by using RevMan 5.3 software. Results. A total of eight RCTs involving 501 patients were enrolled. Meta-analysis showed that acupotomy was significantly better than the control group in debasing the Visual Analogue Scale (VAS) score (MD = −0.97, 95% CI = [−1.49, −0.45], P=0.0003) and improving the Constant–Murley Score (CMS) (MD = 8.46, 95% CI = [1.04, 15.87], P=0.03), and there was no significant difference in adverse events (OR = 1.24, 95% CI = [0.34, 4.52], P=0.74) between the two groups. Conclusion. Acupotomy therapy is an effective and safe treatment for SAC, and this treatment can be recommended for the management of SAC. Due to the low quality and small sample size of the included studies, more rigorously designed RCTs with high quality and large-scale are recommended in future.

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Relationship between total plasma homocysteine and the risk of aneurysms – a meta-analysis

VASA ◽

10.1024/0301-1526/a000891 ◽

2020 ◽

pp. 1-6

Author(s):

Hanji Zhang ◽

Dexin Yin ◽

Yue Zhao ◽

Yezhou Li ◽

Dejiang Yao ◽

...

Keyword(s):

Large Scale ◽

Meta Analysis ◽

Single Species ◽

Total Plasma ◽

Control Groups ◽

Randomized Controlled ◽

Randomized Controlled Studies ◽

The Difference ◽

The Relationship ◽

Healthy Participants

Summary: Our meta-analysis focused on the relationship between homocysteine (Hcy) level and the incidence of aneurysms and looked at the relationship between smoking, hypertension and aneurysms. A systematic literature search of Pubmed, Web of Science, and Embase databases (up to March 31, 2020) resulted in the identification of 19 studies, including 2,629 aneurysm patients and 6,497 healthy participants. Combined analysis of the included studies showed that number of smoking, hypertension and hyperhomocysteinemia (HHcy) in aneurysm patients was higher than that in the control groups, and the total plasma Hcy level in aneurysm patients was also higher. These findings suggest that smoking, hypertension and HHcy may be risk factors for the development and progression of aneurysms. Although the heterogeneity of meta-analysis was significant, it was found that the heterogeneity might come from the difference between race and disease species through subgroup analysis. Large-scale randomized controlled studies of single species and single disease species are needed in the future to supplement the accuracy of the results.

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Endoscopic versus Surgical Intervention for Painful Obstructive Chronic Pancreatitis: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10122636 ◽

2021 ◽

Vol 10 (12) ◽

pp. 2636

Author(s):

Ka Wing Ma ◽

Hoonsub So ◽

Euisoo Shin ◽

Janice Hoi Man Mok ◽

Kim Ho Kam Yuen ◽

...

Keyword(s):

Chronic Pancreatitis ◽

Pain Relief ◽

Meta Analysis ◽

Small Sample ◽

Cochrane Library ◽

Endoscopic Drainage ◽

Complication Rates ◽

Surgical Drainage ◽

Endocrine Insufficiency ◽

Significant Difference

There is limited evidence on the standard care for painful obstructive chronic pancreatitis (CP), while comparisons of endoscopic and surgical modes for pain relief have yielded conflicting results from small sample sizes. We aimed to obtain a clear picture of the matter by a meta-analysis of these results. We searched the Pubmed, Embase, and Cochrane Library databases to identify studies comparing endoscopic and surgical treatments for painful obstructive CP. Pooled effects were calculated by the random effect model. Primary outcomes were overall pain relief (complete and partial), and secondary outcomes were complete and partial pain relief, complication rate, hospitalization duration, and endocrine insufficiency. Seven studies with 570 patients were included in the final analysis. Surgical drainage was associated with superior overall pain relief [OR 0.33, 95% CI 0.23–0.47, p < 0.001, I2 = 4%] and lesser incidence of endocrine insufficiency [OR 2.10, 95% CI 1.20–3.67, p = 0.01, I2 = 0%], but no significant difference in the subgroup of complete [OR 0.57, 95% CI 0.32–1.01, p = 0.054, I2 = 0%] or partial [OR 0.67, 95% CI 0.37–1.22, p = 0.19, I2 = 0%] pain relief, complication rates [OR 1.00, 95% CI 0.41–2.46, p = 0.99, I2 = 49%], and hospital stay [OR −0.54, 95% CI −1.23–0.15, p = 0.13, I2 = 87%] was found. Surgery is associated with significantly better overall pain relief and lesser endocrine insufficiency in patients with painful obstructive CP. However, considering the invasiveness of surgery, no significant differences in complete or partial pain relief, and heterogeneity of a few parameters between two groups, endoscopic drainage may be firstly performed and surgical drainage may be considered when endoscopic drainage fails.

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Kinesio Taping for Balance Function after Stroke: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/8470235 ◽

2019 ◽

Vol 2019 ◽

pp. 1-15 ◽

Cited By ~ 4

Author(s):

Yijuan Hu ◽

Dongling Zhong ◽

Qiwei Xiao ◽

Qiang Chen ◽

Juan Li ◽

...

Keyword(s):

Systematic Review ◽

Treatment Duration ◽

Meta Analysis ◽

Current Evidence ◽

Cochrane Library ◽

Clinical Effects ◽

Balance Function ◽

Balance Impairment ◽

Kinesio Taping ◽

Significant Difference

Objective. With the increasing social and economic burdens of balance impairment after stroke, the treatment for balance impairment after stroke becomes a major public health problem worldwide. Kinesio taping (KT) as a part of clinical practice has been used widely in the treatment of balance impairment after stroke. However, the clinical effects of KT for balance function have not been confirmed. The objective of this study is to investigate the effects and safety of KT for balance impairment after stroke. Methods. We conducted a systematic review (SR) and meta-analysis of randomized controlled trials (RCTs) on the effects of KT for balance impairment after stroke. We searched the following databases: (1) English databases: EMBASE (via Ovid), MEDLINE (via Ovid), the Cochrane library, PubMed, and PEDro; (2) Chinese databases: China Biology Medicine (CBM), Wan Fang database, China National Knowledge Infrastructure (CNKI), and VIP. Besides, hand searches of relevant references were also conducted. We systematically searched from the inception to December 2018, using the keywords (Kinesio, Kinesio Tape, tape, or Orthotic Tape) and (stroke, hemiplegia, or hemiplegic paralysis) and (balance or stability). The search strategies were adjusted for each database. The reference lists of included articles were reviewed for relevant trials. For missing data, we contacted the authors to get additional information. Results. 22 RCTs involved 1331 patients, among which 667 patients in the experimental group and 664 patients in the control group were included. Results of meta-analysis showed that, compared with conventional rehabilitation (CR), there was significant difference in Berg Balance Scale (BBS) (MD=4.46, 95%CI 1.72 to 7.19, P=0.001), Time Up and Go Test (TUGT) (MD=-4.62, 95%CI -5.48 to -3.79, P < 0.00001), functional ambulation category scale (FAC) (MD=0.53, 95%CI 0.38 to 0.68, P < 0.00001), Fugl-Meyer assessment (FMA-L) (MD=4.20, 95%CI 3.17 to 5.24, P < 0.00001), and Modified Ashworth Scale (MAS) (MD=-0.38, 95%CI -0.49 to -0.27, P < 0.00001). The results of subgroup analysis showed that there was no significant difference between KT and CR with ≤4 weeks treatment duration (< 4 weeks: MD=5.03, 95%CI -1.80 to 11.85, P=0.15; =4 weeks: MD=4.33, 95%CI -1.50 to 10.15, P=0.15), while there was significant difference with more than 4-week treatment duration (MD=4.77, 95%CI 2.58 to 6.97, P < 0.0001). Conclusions. Based on current evidence, KT was more effective than CR for balance function, lower limb function, and walking function in poststroke patients. Longer treatment duration may be associated with better effects. However, more well-conducted RCTs are required in the future.

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Study on the Distribution Characteristics and Influencing Factors of Homocysteine in the Physical Examination Population

10.21203/rs.3.rs-520296/v1 ◽

2021 ◽

Author(s):

Fang Bao ◽

Ming Cui ◽

Xiuying Shi ◽

Shaoqing Ju ◽

Hui Cong

Keyword(s):

Blood Pressure ◽

Physical Examination ◽

Large Scale ◽

Kidney Injury ◽

Scientific Basis ◽

Cerebrovascular Diseases ◽

Health Examination ◽

Significant Difference ◽

The Difference

Abstract Background: Homocysteine (Hcy) is considered to be an independent risk factor for cardiovascular and cerebrovascular diseases. No study has evaluated the distribution of Hcy on a large-scale health examination. Accordingly, this study aimed to investigate the level and distribution of Hcy in the healthy physical examination population and the correlation with other biomarkers, and analyzed for cardiovascular and other diseases. The prevention provides an important scientific basis.Methods: From February 2017 to April 2020, 8063 medical examination populations were selected for analysis. Determination of serum Hcy, TC, TG, LDL-c, HDL-c, ALT, ALP, γ-GT, TBIL, GLU, urea, Cr, UA and related metabolic risk factors. According to the multivariate regression model of age, gender, smoking, drinking, body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP), the relationship between Hcy and other biochemical indicators was evaluated. Results: Among 8063 cases, the age, BMI, SBP and DBP of the high-Hcy group were higher than those of the low-Hcy group, the difference was statistically significant (P<0.05), and the proportion of males, smoking and drinking were higher than the low In the Hcy group, the difference was statistically significant (P<0.05); the ALT, ALP, γ-GT, TBIL, Urea, Cr, UA, and TG in the high Hcy group were higher than those in the low Hcy group, and the difference was statistically significant (P<0.05 ); HDL-c in the high-Hcy group was lower than that in the low-Hcy group, and the difference was statistically significant (P<0.05). There was no statistically significant difference in TC, LDL-c, and GLU between the high- and low-Hcy groups (P>0.05). In multivariate analysis, lnHDL-C was negatively correlated with lnHcy (β=-0.038, SE=0.016, P<0.05), lnCr was positively correlated with lnHcy (β=0.055, SE=0.016, P<0.05), lnUA and lnHcy were positive correlation (β=0.043, SE=0.019, P<0.05). Conclusion: Hcy is closely related to HDL-c, Cr and UA, which indicates that Hcy may affect the metabolism of HDL-c and UA, and can also be used as an auxiliary diagnostic index for kidney injury.

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Comparison between Ologen implant and Mitomycin C in trabeculectomy: A Systematic Review and Meta-Analysis

10.21203/rs.2.10619/v1 ◽

2019 ◽

Author(s):

Xiaoyan Liu ◽

Yali Du ◽

Min Lei ◽

Leyi Zhuang ◽

Peng Lv

Keyword(s):

Adverse Events ◽

Success Rate ◽

Data Extraction ◽

Meta Analysis ◽

Collagen Matrix ◽

Current Evidence ◽

Cochrane Library ◽

Significant Difference ◽

Mean Differences ◽

Alternative Choice

Abstract Objective To evaluate the effectiveness and safety of the biodegradable collagen matrix (Ologen) implant in trabeculectomy. Research design and methods We searched Pubmed, Cochrane library, Embase and Web of Science databases to find studies that met our pre-stated inclusion criteria. Reference lists of retrieved articles were also reviewed. The search was finished by February 2019. Study selection, data extraction, quality assessment, and data analyses were performed according to the Cochrane standards. Either a fixed or a random-effects model was used to calculate the overall combined risk estimates. The efficacy measures were the weighted mean differences (WMDs) for the intraocular pressure reduction (IOPR) and the glaucoma medications reduction, the odds ratio (OR) for the success rate and adverse events. Results Fifteen randomized controlled trials involved 682 eyes were included in the meta-analysis. There were no statistically differences between two groups in the IOPR at any time postoperatively. The MD of the IOPR was [MD= -0.45,95% Confidence Interval (CI), (-2.36,1.46), P=0.65] at one day, [MD= -0.82,95% CI, (-1.97, 0.33), P=0.16] at one week, [MD= -1.33, 95% CI,(-3.12, 0.47), P=0.15] at one month, [MD= 0.11,95% CI, (-1.87, 2.08), P=0.92] at three months, [MD= -0.60,95% CI, (-2.27, 1.06), P=0.48] at six months, [MD= -0.33,95% CI, (-1.99, 1.32), P=0.69] at one year, [MD= -0.13,95% CI, (-1.90, 1.65), P=0.89] at two years, [MD= 2.54,95% CI, (-2.83, 7.90), P=0.35] at three years, [MD= 3.04,95% CI, (-3.95, 10.03), P=0.39] at five years. There was no statistically significant difference between the Ologen groups and MMC groups concerned the complete success rate [OR=1.19, 95%CI, (0.83, 1.71), P=0.35]. With regard to the adverse events, no obvirously significance was observed. Seven studies reported the change of antiglaucoma medications. We found that the change of antiglaucoma medications is higher in MMC groups than that in Ologen groups [MD=-0.18, 95%CI, (-0.33, -0.03), P=0.02]. There is no significant difference in complications between the two groups. Conclusions From the current evidence, Ologen may be an alternative choice for trabeculectomy when considering the efficacy and safety. However, MMC might be the preferred choice concerned cost-effectiveness.

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Efficacy of heavy eccentric calf training for treating mid-portion Achilles tendinopathy: a systematic review and meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2018-099934 ◽

2019 ◽

Vol 53 (17) ◽

pp. 1070-1077 ◽

Cited By ~ 15

Author(s):

Myles Calder Murphy ◽

Mervyn J Travers ◽

Paola Chivers ◽

James Robert Debenham ◽

Sean Iain Docking ◽

...

Keyword(s):

Systematic Review ◽

Natural History ◽

Small Sample Size ◽

Meta Analysis ◽

Achilles Tendinopathy ◽

Small Sample ◽

Current Evidence ◽

Eligibility Criteria ◽

Exercise Interventions ◽

And Function

ObjectiveTo assess the effectiveness of heavy eccentric calf training (HECT) in comparison with natural history, traditional physiotherapy, sham interventions or other exercise interventions for improvements in pain and function in mid-portion Achilles tendinopathy.DesignA systematic review and meta-analysis were conducted as per the PRISMA guidelines.Data sourcesPUBMED, CINAHL (Ovid) and CINAHL (EBSCO) were searched from inception until 24 September 2018.Eligibility criteriaRandomised controlled trials comparing HECT to natural history, sham exercise, traditional physiotherapy and other exercise interventions were included. Primary outcome assessing pain and function was the Victorian Institute of Sports Assessment-Achilles.ResultsSeven studies met the inclusion criteria. This review suggests HECT may be superior to both natural history, mean difference (MD) (95% CI) of 20.6 (11.7 to 29.5, one study) and traditional physiotherapy, MD (95% CI) of 17.70 (3.75 to 31.66, two studies). Following removal of one study, at high risk of bias, due to pre-planned sensitivity analysis, this review suggests HECT may be inferior to other exercise interventions, MD (95% CI) of −5.65 (-10.51 to −0.79, three studies). However, this difference is unlikely to be clinically significant.ConclusionCurrent evidence suggests that HECT may be superior to natural history and traditional physiotherapy while HECT may be inferior to other exercise interventions. However, due to methodological limitations, small sample size and a lack of data we are unable to be confident in the results of the estimate of the effect, as the true effect is likely to be substantially different.Systematic review registryPROSPERO registration number: CRD4201804493Protocol referenceThis protocol has been published open access: Murphy M, Travers MJ, Gibson, W. Is heavy eccentric calf training superior to natural history, sham rehabilitation, traditional physiotherapy and other exercise interventions for pain and function in mid-portion Achilles tendinopathy? Systematic Reviews 2018; 7: 58

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Large Scale Star Formation: Density Waves, Superassociations and Propagation

Symposium - International Astronomical Union ◽

10.1017/s0074180900096261 ◽

1987 ◽

Vol 115 ◽

pp. 457-481 ◽

Cited By ~ 3

Author(s):

Bruce G. Elmegreen

Keyword(s):

Star Formation ◽

Large Scale ◽

Density Waves ◽

Spiral Arms ◽

Gravitational Instabilities ◽

Significant Difference ◽

Star Formation In Galaxies ◽

The Difference ◽

The Waves

The hypothesis that density waves trigger star formation is critically examined. Much of the former evidence in favor of the hypothesis is shown to be inconsistent with modern observations. A comparison between galaxies with and without density waves reveals no significant difference in their star formation rates. A new role for density waves in the context of star formation might be based on four principles: 1. density waves are intrinsically strong, 2. the gas is compressed more than the stars in the wave, 3. star formation follows the gas, with no preferential trigger related to the wave itself, and 4. regions of star formation are larger in the spiral arms than they are between the arms. This new role for density waves is primarily one of organization: the waves place most of the gas in the arms, so most of the star formation is in the arms too. The waves also promote the coagulation of small clouds into large cloud complexes, or superclouds, by what appears to be a combination of collisional agglomeration and large-scale gravitational instabilities. Special regions where density waves do trigger a true excess of star formation are discussed, and possible reasons for the difference between these triggering waves and the more common, organizing, waves are mentioned. Other aspects of large-scale star formation, such as the occurrence of kiloparsec-size regions of activity and kiloparsec-range propagation, are illustrated with numerous examples. The importance of these largest scales to the overall mechanism of star formation in galaxies is emphasized.

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Waist height ratio predicts chronic kidney disease: a systematic review and meta-analysis, 1998–2019

Archives of Public Health ◽

10.1186/s13690-019-0379-4 ◽

2019 ◽

Vol 77 (1) ◽

Cited By ~ 1

Author(s):

Ling Liu ◽

Yanqiu Wang ◽

Wanjun Zhang ◽

Weiwei Chang ◽

Yuelong Jin ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Statistical Difference ◽

Meta Analysis ◽

Area Under The Curve ◽

Cochrane Library ◽

Height Ratio ◽

Physical Measurements ◽

Significant Difference ◽

The Difference

Abstract Background The incidence of chronic kidney disease (CKD) increases each year, and obesity is an important risk factor for CKD. The main anthropometric indicators currently reflecting obesity are body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR), but the rationality and merits of various indicators vary. This article aims to find whether the WHtR is a more suitable physical measurement that can predict CKD. Methods Pubmed, embase, the cochrane library, and web of science were systematically searched for articles published between 1998 and 2019 screening CKD through physical indicators. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data, and evaluated the quality of the methodology included in the study. Meta-analysis used the Stata 12.0 software. Results Nine studies were included, with a total of 202,283 subjects. Meta-analysis showed that according to the analysis of different genders in 6 studies, regardless of sex, WHtR was the area with the largest area under the curve (AUC). Except WHtR and visceral fat index (VFI) in women which showed no statistical difference, WHtR and other indicators were statistically different. In three studies without gender-based stratification, the area under the curve AUC for WHtR remained the largest, but only the difference between WHtR and BMI was statistically significant. When the Chinese population was considered as a subgroup, the area under the curve AUC for WHtR was the largest. Except for WHtR and VFI which showed no statistical difference in women, there was a statistically significant difference between WHtR and other indicators in men and women. Conclusion WHtR could be better prediction for CKD relative to other physical measurements. It also requires higher-quality prospective studies to verify the clinical application of WHtR.

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