scholarly journals Metabolic syndrome and risk of colorectal adenoma and colorectal cancer: a meta-analysis

Author(s):  
Salah Eddine El Herrag ◽  
Youssouf Traoré ◽  
Méghit Boumediène Khaled

Background: Growing evidence suggests that metabolic syndrome (MetS) could be linked with the incidence of colorectal adenoma and cancer (CRA and CRC). Aims: Conducting a meta-analysis to assess the association of MetS with both CRA and CRC. Methods and Material: Relevant studies were identified by systematically searching PubMed database for articles published in the last ten years. A random effect analysis model and Mantel-Haenszel statistical method were used to obtain pooled risk ratios (RRs) and their 95% confidence intervals (CIs) for dichotomous data. The analyses were assessed for heterogeneity and publication bias. Results: 35 studies were included in the meta-analysis involving approximately 1300000 participants. A significant high risk for CRA was observed among patients with MetS compared to those without (RR = 1.43; 95% CI = 1.31, 1.57). The pooled RRs of CRC were 1.46 (95% CI = 1.36, 1.56). The risk estimates varied according to the type of the study (cohorts and non-cohorts), gender (men and women), MetS definition (NCEP-ATPIII, IDF, harmonized and others), populations (Asia, Europe, and the USA), and cancer location (colon and rectum). Conclusions: MetS is associated with an increased risk of CRA and CRC. The risk was higher for advanced adenomas. Taking into consideration MetS patients in the secondary prevention programs and the management of this condition in the aim of the primary prevention is highly recommended. Keywords: Metabolic syndrome, colorectal cancer, colorectal adenoma, incidence, meta-analysis.

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yipei Yang ◽  
Ziyue Li ◽  
Haifeng Liang ◽  
Jing Tian

Abstract Objective Metabolic syndrome (MetS) has been associated with hypercoagulative status. However, previous studies evaluating the association between MetS and incidence of venous thromboembolism (VTE) after total joint arthroplasty (TJA) showed inconsistent results. We performed a meta-analysis to evaluate the influence of MetS on the risk of VTE following TJA. Methods Cohort studies were identified by the search of PubMed, Embase, and the Cochrane’s Library databases. A random-effect model was used if considerable heterogeneity was detected; otherwise, a fixed-effect model was used. Subgroup analyses according to the category of VTE, definition of MetS, category of procedure, and follow-up durations were performed. Results Seven cohort studies with 1,341,457 patients that underwent TJA were included, with 118,060 MetS patients (8.8%) at baseline. With a follow-up duration up to 3 months after surgery, 9788 patients had VTE. Pooled results with a random-effect model showed that MetS was not associated with increased overall VTE after TJA (adjusted risk ratio [RR] = 1.24, 95% confidence interval [CI] 0.89 ~ 1.72, p = 0.20; I2 = 69%). The results were not significantly affected by the diagnostic criteria of MetS, category of the procedure, and follow-up durations. Subgroup analyses showed that MetS was not associated with an increased the risk of pulmonary embolism ([PE], RR 1.06, 95% CI 0.37 ~ 3.02, p = 0.91), but an increased risk of deep vein thrombosis (DVT) after TJA (RR 3.38, 95% CI 1.83 ~ 6.24, p < 0.001). Conclusions Current evidence from observational studies suggests MetS might be associated with an increased risk of DVT but not PE after TJA.


Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1736
Author(s):  
Matteo Lazzeroni ◽  
Federica Bellerba ◽  
Mariarosaria Calvello ◽  
Finlay Macrae ◽  
Aung Ko Win ◽  
...  

There appears to be a sex-specific association between obesity and colorectal neoplasia in patients with Lynch Syndrome (LS). We meta-analyzed studies reporting on obesity and colorectal cancer (CRC) risk in LS patients to test whether obese subjects were at increased risk of cancer compared to those of normal weight. We explored also a possible sex-specific relationship between adiposity and CRC risk among patients with LS. The summary relative risk (SRR) and 95% confidence intervals (CI) were calculated through random effect models. We investigated the causes of between-study heterogeneity and assessed the presence of publication bias. We were able to retrieve suitable data from four independent studies. We found a twofold risk of CRC in obese men compared to nonobese men (SRR = 2.09; 95%CI: 1.23–3.55, I2 = 33%), and no indication of publication bias (p = 0.13). No significantly increased risk due to obesity was found for women. A 49% increased CRC risk for obesity was found for subjects with an MLH1 mutation (SRR = 1.49; 95%CI: 1.11–1.99, I2 = 0%). These results confirm the different effects of sex on obesity and CRC risk and also support the public measures to reduce overweight in people with LS, particularly for men.


2021 ◽  
Author(s):  
Yohannes Tekalegn ◽  
Biniyam Sahiledengle ◽  
Demelash Woldeyohannes ◽  
Daniel Atlaw ◽  
Fikreab Desta ◽  
...  

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.


2021 ◽  
Vol 8 ◽  
Author(s):  
Xiao Li ◽  
Yajing Zhai ◽  
Jiaguo Zhao ◽  
Hairong He ◽  
Yuanjie Li ◽  
...  

Background: Patients with metabolic syndrome (MetS) have a higher risk of developing cardiovascular diseases (CVD). However, controversy exists about the impact of MetS on the prognosis of patients with CVD.Methods: Pubmed, Cochrane library, and EMBASE databases were searched. Cohort Studies and randomized controlled trials post hoc analyses that evaluated the impact of MetS on prognosis in patients (≥18 years) with CVD were included. Relative risk (RR), hazard rate (HR) and 95% confidence intervals (CIs) were calculated for each individual study by random-effect model. Subgroup analysis and meta-regression analysis was performed to explore the heterogeneity.Results: 55 studies with 16,2450 patients were included. Compared to patients without MetS, the MetS was associated with higher all-cause death [RR, 1.220, 95% CI (1.103 to 1.349), P, 0.000], CV death [RR, 1.360, 95% CI (1.152 to 1.606), P, 0.000], Myocardial Infarction [RR, 1.460, 95% CI (1.242 to 1.716), P, 0.000], stroke [RR, 1.435, 95% CI (1.131 to 1.820), P, 0.000]. Lower high-density lipoproteins (40/50) significantly increased the risk of all-cause death and CV death. Elevated fasting plasma glucose (FPG) (&gt;100 mg/dl) was associated with an increased risk of all-cause death, while a higher body mass index (BMI&gt;25 kg/m2) was related to a reduced risk of all-cause death.Conclusions: MetS increased the risk of cardiovascular-related adverse events among patients with CVD. For MetS components, there was an increased risk in people with low HDL-C and FPG&gt;100 mg/dl. Positive measures should be implemented timely for patients with CVD after the diagnosis of MetS, strengthen the prevention and treatment of hyperglycemia and hyperlipidemia.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21692-e21692
Author(s):  
Rohit Kumar ◽  
Naina Singh ◽  
Romy Jose Thekkekara ◽  
Sunny R K Singh ◽  
Sarah Elizabeth Harrington ◽  
...  

e21692 Background: Olanzapine is an atypical antipsychotic medication which has shown efficacy in prevention of chemotherapy-induced nausea and vomiting (CINV) in multiple trials. This study aims to investigate the efficacy of Olanzapine to prevent CINV with an up-to-date systematic review and meta-analysis. Methods: A literature search of Ovid MEDLINE, Embase and Cochrane library was performed to identify randomized controlled trials of olanzapine compared to other antiemetic therapy (5HT3 and/or NK1 antagonist with or without steroids) for prevention of CINV in patients age >=18 years up until December 2016. The primary endpoint was no emesis or nausea episodes in acute (0-24hrs), delayed (24-120hrs) and overall (0-120hrs) period in patients receiving highly or moderately emetogenic chemotherapy (HEC or MEC). Statistical analysis was performed using Review Manager (RevMan 5.3). The Mantel–Haenszel method was applied and random effect analysis model was used to calculate risk ratios. Results: From the literature, 12 RCTs met the inclusion criteria. The age range of patients was 18-89 years. Seven trials included only patients who received HEC while 5 trials included patients receiving either HEC or MEC in various proportions. Olanzapine was statistically superior for 5 primary endpoints except for no nausea in acute period (Table 1). In the non-steroids cohort, olanzapine was superior for no emesis in all 3 periods but statistically significant only for delayed period. Conclusions: Olanzapine is superior to other antiemetic therapy for prevention of CINV. It is less expensive and can improve patient’s quality of life and chemotherapy adherence. [Table: see text]


Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3284
Author(s):  
Alessandro Ottaiano ◽  
Mariachiara Santorsola ◽  
Paola Del Prete ◽  
Francesco Perri ◽  
Stefania Scala ◽  
...  

Background: This study was conducted to provide an updated estimate of the prognostic power of C-X-C chemokine receptor type 4 (CXCR4) in colorectal cancer (CRC), and analyze modalities of evaluating and reporting its expression. Methods: A systematic review with meta-analysis was performed and described according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Studies were identified through PubMed and Google Scholar. The pooled hazard ratios (HRs) for overall survival (OS) or progression-free survival (PFS) with 95% confidence interval (CI) were estimated with the random-effect model. Results: Sixteen studies were selected covering a period from 2005 to 2020. An immunohistochemical evaluation of CXCR4 was performed in all studies. Only in three studies assessment of mRNA through RT–PCR was correlated with prognosis; in the remaining studies, the authors identified prognostic categories based on immunohistochemical expression. In pooled analyses, significant associations were found between positive or high or strong expression of CXCR4 and T stage ≥3 (P = 0.0001), and positive or high or strong expression of CXCR4 and left side primary tumor localization (P = 0.0186). The pooled HR for OS was 2.09 (95% CI: 1.30–2.88) in favor of high CXCR4 expression; for PFS, it was 1.42 (95% CI: 1.13–1.71) in favor of high CXCR4 expression. Conclusion: High CXCR4 expression is clearly associated with increased risk of death and progression in CRC. However, strong methodologic heterogeneity in CXCR4 assessment hinders direct translation into clinical practice; thus, a consensus to streamline detection and scoring of CXCR4 expression in CRC is indicated.


2021 ◽  
Vol 10 (4) ◽  
pp. 710
Author(s):  
Abel Botelho Quaresma ◽  
Fernanda da Silva Barbosa Baraúna ◽  
Fábio Vieira Teixeira ◽  
Rogério Saad-Hossne ◽  
Paulo Gustavo Kotze

Background: With the paradigm shift related to the overspread use of biological agents in the treatment of inflammatory bowel diseases (IBD), several questions emerged from the surgical perspective. Whether the use of biologicals would be associated with higher rates of postoperative complications in ulcerative colitis (UC) patients still remains controversial. Aims: We aimed to analyze the literature, searching for studies that correlated postoperative complications and preoperative exposure to biologics in UC patients, and synthesize these data qualitatively in order to check the possible impact of biologics on postoperative surgical morbidity in this population. Methods: Included studies were identified by electronic search in the PUBMED database according to the PRISMA (Preferred Items of Reports for Systematic Reviews and Meta-Analysis) guidelines. The quality and bias assessments were performed by MINORS (methodological index for non-randomized studies) criteria for non-randomized studies. Results: 608 studies were initially identified, 22 of which were selected for qualitative evaluation. From those, 19 studies (17 retrospective and two prospective) included preoperative anti-TNF. Seven described an increased risk of postoperative complications, and 12 showed no significant increase postoperative morbidity. Only three studies included surgical UC patients with previous use of vedolizumab, two retrospective and one prospective, all with no significant correlation between the drug and an increase in postoperative complication rates. Conclusions: Despite conflicting results, most studies have not shown increased complication rates after abdominal surgical procedures in patients with UC with preoperative exposure to biologics. Further prospective studies are needed to better establish the impact of preoperative biologics and surgical complications in UC.


Author(s):  
Peter Cox ◽  
Sonal Gupta ◽  
Sizheng Steven Zhao ◽  
David M. Hughes

AbstractThe aims of this systematic review and meta-analysis were to describe prevalence of cardiovascular disease in gout, compare these results with non-gout controls and consider whether there were differences according to geography. PubMed, Scopus and Web of Science were systematically searched for studies reporting prevalence of any cardiovascular disease in a gout population. Studies with non-representative sampling, where a cohort had been used in another study, small sample size (< 100) and where gout could not be distinguished from other rheumatic conditions were excluded, as were reviews, editorials and comments. Where possible meta-analysis was performed using random-effect models. Twenty-six studies comprising 949,773 gout patients were included in the review. Pooled prevalence estimates were calculated for five cardiovascular diseases: myocardial infarction (2.8%; 95% confidence interval (CI)s 1.6, 5.0), heart failure (8.7%; 95% CI 2.9, 23.8), venous thromboembolism (2.1%; 95% CI 1.2, 3.4), cerebrovascular accident (4.3%; 95% CI 1.8, 9.7) and hypertension (63.9%; 95% CI 24.5, 90.6). Sixteen studies reported comparisons with non-gout controls, illustrating an increased risk in the gout group across all cardiovascular diseases. There were no identifiable reliable patterns when analysing the results by country. Cardiovascular diseases are more prevalent in patients with gout and should prompt vigilance from clinicians to the need to assess and stratify cardiovascular risk. Future research is needed to investigate the link between gout, hyperuricaemia and increased cardiovascular risk and also to establish a more thorough picture of prevalence for less common cardiovascular diseases.


Author(s):  
Felix M. Onyije ◽  
Bayan Hosseini ◽  
Kayo Togawa ◽  
Joachim Schüz ◽  
Ann Olsson

Petroleum extraction and refining are major sources of various occupational exposures and of air pollution and may therefore contribute to the global cancer burden. This systematic review and meta-analysis is aimed at evaluating the cancer risk in petroleum-exposed workers and in residents living near petroleum facilities. Relevant studies were identified and retrieved through PubMed and Web of Science databases. Summary effect size (ES) and 95% confidence intervals (CI) were analysed using random effect models, and heterogeneity across studies was assessed (I2). Overall, petroleum industry work was associated with an increased risk of mesothelioma (ES = 2.09, CI: 1.58–2.76), skin melanoma (ES = 1.34, CI: 1.06–1.70 multiple myeloma (ES =1.81, CI: 1.28–2.55), and cancers of the prostate (ES = 1.13, Cl: 1.05–1.22) and urinary bladder (ES = 1.25, CI: 1.09–1.43) and a decreased risk of cancers of the esophagus, stomach, colon, rectum, and pancreas. Offshore petroleum work was associated with an increased risk of lung cancer (ES = 1.20; 95% CI: 1.03–1.39) and leukemia (ES = 1.47; 95% CI: 1.12–1.92) in stratified analysis. Residential proximity to petroleum facilities was associated with childhood leukemia (ES = 1.90, CI: 1.34–2.70). Very few studies examined specific exposures among petroleum industry workers or residents living in oil producing communities. The present review warrants further studies on specific exposure levels and pathways among petroleum-exposed workers and residents living near petroleum facilities.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Giacchetta ◽  
M Chiavarini ◽  
G Naldini ◽  
R Fabiani

Abstract Background The probability of developing invasive cutaneous malignant melanoma (CMM) is higher in women than in men up until the age of 49. Several studies investigated the association between hormonal factors and CMM. The aim of this systematic review and meta-analysis is to summarize the evidence on the association between Oral Contraceptives (OC) and the risk of CMM. Methods This review and meta-analysis follow the PRISMA guidelines. A systematic literature search was conducted on Medline and Web of Science until December 2019. Studies were eligible if reported a risk estimate for the association between OC and CMM. Heterogeneity testing was performed using Cochran's Q and I2 statistics. Publication bias was assessed by Egger's test and Begg's test. Meta-analysis was performed using random effect model. Results The results of the pooled analysis of all 32 studies showed no significant association between OC and the risk of CMM (OR 1.02; 95% CI 0.94-1.11; I2=39.32%, p = 0.013). The stratified analyses by study design found no significant association between OC and the risk of CMM neither in the 18 case-control studies (OR 1.02; 95% CI 0.87-1.21; I2=56.91%, p = 0.002) nor in the 14 cohort studies (OR 1.04; 95% CI 0.98-1.11; I2=0.00%, p = 0.557). No significant publication bias could be detected by Egger's test or Begg's test. Conclusions This meta-analysis of available literature suggests no significant association between OC and the risk of developing CMM. Further investigations are needed to evaluate the possible relationship of OC use and other hormonal factors potentially contributing to the increased risk of CMM in women during their reproductive years. Key messages Oral contraceptives (OC) do not significantly contribute to the risk of Cutaneous Malignant Melanoma (CMM). Further studies are needed to investigate the potential role of other hormonal factors in the increased probability of developing CMM in women during their reproductive years.


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