Breastfeeding and Atopic Dermatitis Risk: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

Dermatology ◽  
2019 ◽  
Vol 236 (4) ◽  
pp. 345-360 ◽  
Author(s):  
Bingjiang Lin ◽  
Ru Dai ◽  
Lingyi Lu ◽  
Xin Fan ◽  
Yingzhe Yu

Objectives: The effect of breastfeeding on atopic dermatitis (AD) remains controversial. To determine the association ­between breastfeeding and AD, we conducted an updated meta-analysis of prospective cohort studies. Methods: A comprehensive search of PubMed, EMBASE, MEDLINE and Cochrane Library was conducted. Studies meeting the predetermined criteria were evaluated by 2 authors independently. The pooled relative risk (RR) adjusted for confounders with its 95% CI was calculated by a random-effects model. Heterogeneity was explored by subgroup analysis and meta-regression. Results: A total of 27 studies were included for meta-analysis. The pooled estimates for the effect of total and exclusive breastfeeding on AD were 1.01 (95% CI 0.93–1.10) and 0.99 (95% CI 0.88–1.11), respectively. Heterogeneity was substantial across studies (total: p < 0.01 or I2 = 65.2%; exclusive: p < 0.01 or I2 = 72.3%). There was a weak evidence for a protective effect of breastfeeding against AD in cohorts with atopic heredity (total: RR 0.85, 95% CI 0.74–0.98; exclusive: RR 0.83, 95% CI 0.70–0.97). In cohorts without atopic heredity, the effect shifted to the risk side when limited to exclusive breastfeeding (RR 1.19, 95% CI 1.02–1.40) while it dropped towards null when limited to total breastfeeding (RR 1.11, 95% CI 0.94–1.31). Conclusions: There is no association between AD and breastfeeding, regardless of total or exclusive breastfeeding patterns. There is some evidence for a protective function of exclusive and total breastfeeding in a cohort with atopic heredity. The effect shifts to the risk side in cohorts without atopic heredity. However, these findings should be interpreted with caution because heterogeneity is evident.

2019 ◽  
Vol 96 (1135) ◽  
pp. 267-276 ◽  
Author(s):  
Yuan-Zheng Ye ◽  
Ya-Fei Chang ◽  
Bao-Zhu Wang ◽  
Yi-Tong Ma ◽  
Xiang Ma

BackgroundIt is unknown whether an abnormal level of von Willebrand factor (vWF) is correlated with the prognosis of patients with atrial fibrillation (AF) and current findings are controversial. This meta-analysis aimed to evaluate the association between vWF levels and the clinical prognosis of patients with AF.MethodsWe searched prospective cohort studies on PubMed, Embase, Web of Science, Cochrane Library and WanFang databases for vWF and adverse events of AF from inception of the databases to July 2019. The risk ratios of all-cause death, cardiovascular death, major adverse cardiac events (MACE), stroke and bleeding prognosis in patients with AF were analysed using a fixed-effects model or random-effects model, and all included studies were evaluated with heterogeneity and publication bias analysis.ResultsTwelve studies which included 7449 patients with AF were used in the meta-analysis. The average age was 71.3 years and the average follow-up time was 3.38 years. The analysis found that high vWF levels were associated with increased risks of all-cause death (RR 1.56; 95% CI 1.16 to 2.11, p=0.00400), cardiovascular death (RR 1.91; 95% CI 1.20 to 3.03, p=0.00600), MACE (RR 1.83; 95% CI 1.28 to 2.62, p=0.00090), stroke (RR 1.69; 95% CI 1.08 to 2.64, p=0.02000) and bleeding (RR 2.01; 95% CI 1.65 to 2.45, p<0.00001) in patients with AF.ConclusionsvWF is a risk factor for poor prognosis of AF, and patients with higher vWF levels have a higher risk of all-cause death, cardiovascular death, MACE, stroke and bleeding.


BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e016404 ◽  
Author(s):  
Yao Chen ◽  
Beibei Zhu ◽  
Xiaoyan Wu ◽  
Si Li ◽  
Fangbiao Tao

ObjectiveTo determine whether maternal vitamin D deficiency during pregnancy is associated with small for gestational age (SGA).MethodsA comprehensive literature search of PubMed, the Cochrane Library, Embase, and the Elsevier ScienceDirect library was conducted to identify relevant articles reporting prospective cohort studies in English, with the last report included published in February 2017. Pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were used to evaluate the correlation in a random effects model.ResultsA total of 13 cohort studies were included in this meta-analysis with a sample of 28 285 individuals from seven countries. The pooled overall OR for babies born SGA was 1.588 (95%CI 1.138 to 2.216; p<0.01) for women with vitamin D deficiency. The prevalence of vitamin D deficiency during pregnancy varied from 13.2% to 77.3%. Subgroup analyses identified no significant differences in the association between vitamin D deficiency and SGA based on study quality, gestational week during which blood sampling was performed, cut-off vitamin D levels, sample size, adjustment for critical confounders and method for measuring vitamin D.ConclusionThis meta-analysis suggests that vitamin D deficiency is associated with an increased risk of SGA.


BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e024171 ◽  
Author(s):  
Sabrina Ayoub-Charette ◽  
Qi Liu ◽  
Tauseef A Khan ◽  
Fei Au-Yeung ◽  
Sonia Blanco Mejia ◽  
...  

ObjectiveSugar-sweetened beverages (SSBs) are associated with hyperuricaemia and gout. Whether other important food sources of fructose-containing sugars share this association is unclear.DesignTo assess the relation of important food sources of fructose-containing sugars with incident gout and hyperuricaemia, we conducted a systematic review and meta-analysis of prospective cohort studies.MethodsWe searched MEDLINE, Embase and the Cochrane Library (through 13 September 2017). We included prospective cohort studies that investigated the relationship between food sources of sugar and incident gout or hyperuricaemia. Two independent reviewers extracted relevant data and assessed the risk of bias. We pooled natural-log transformed risk ratios (RRs) using the generic inverse variance method with random effects model and expressed as RR with 95% confidence intervals (CIs). The overall certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation system.ResultsWe identified three studies (1 54 289 participants, 1761 cases of gout), comparing the highest with the lowest level of exposure for SSBs, fruit juices and fruits. No reports were found reporting incident hyperuricaemia. Fruit juice and SSB intake showed an adverse association (fruit juice: RR=1.77, 95% CI 1.20 to 2.61; SSB: RR=2.08, 95% CI 1.40 to 3.08), when comparing the highest to lowest intake of the most adjusted models. There was no significant association between fruit intake and gout (RR 0.85, 95% CI 0.63 to 1.14). The strongest evidence was for the adverse association with SSB intake (moderate certainty), and the weakest evidence was for the adverse association with fruit juice intake (very low certainty) and lack of association with fruit intake (very low certainty).ConclusionThere is an adverse association of SSB and fruit juice intake with incident gout, which does not appear to extend to fruit intake. Further research is needed to improve our estimates.Trial registration numberNCT02702375; Results.


2016 ◽  
Vol 2016 ◽  
pp. 1-8
Author(s):  
Zhihong Xiao ◽  
Dong Ren ◽  
Wei Feng ◽  
Yan Chen ◽  
Wusheng Kan ◽  
...  

The association between height and risk of hip fracture has been investigated in several studies, but the evidence is inconclusive. We therefore conducted this meta-analysis of prospective cohort studies to explore whether an association exists between height and risk of hip fracture. We searched PubMed and EMBASE, Web of Science, and the Cochrane Library for studies of height and risk of hip fracture up to February 16, 2016. The random-effects model was used to combine results from individual studies. Seven prospective cohort studies, with 7,478 incident hip fracture cases and 907,913 participants, were included for analysis. The pooled relative risk (RR) was 1.65 (95% confidence interval (CI): 1.26–2.16) comparing the highest with the lowest category of height. Result from dose-response analysis suggested a linear association between height and hip fracture risk (P-nonlinearity = 0.0378). The present evidence suggests that height is positively associated with increased risk of hip fracture. Further well-designed cohort studies are needed to confirm the present findings in other ethnicities.


2020 ◽  
pp. jech-2020-213842
Author(s):  
Yong-Jae Lee ◽  
Hong-Bae Kim

BackgroundSeveral observational studies have been conducted to investigate the link between anaemia and adult depression but have shown inconsistent results. This systematic review and meta-analysis was performed to investigate this association.MethodsA comprehensive search of four electronic databases (PubMed, EMBASE, PsycINFO and the Cochrane Library) was conducted to identify relevant papers published up to November 2019 for the systematic review and meta-analysis. The Newcastle-Ottawa Scale was used to assess the methodological quality of selected studies. A random-effects model was used to draw metaestimates of the relationship between anaemia and adult depression.ResultsA total of 9706 papers were retrieved, and 14 observational epidemiological studies (9 case–control studies and 5 prospective cohort studies) comprising 10 764 cases of depression were finally included in this meta-analysis. The mean age of the participants ranged from 38.4 to 75.0 years. A significant association was identified between low haemoglobin levels and adult depression (OR or relative risk 1.43; 95% CI 1.23 to 1.65). Subgroup analyses according to study design, mean age, diagnostic criteria of anaemia, geographical region, number of participants, methodological quality and adjustment for various confounding factors such as education, smoking, comorbid disorders, physical activity, alcohol intake and medication use showed similar results.ConclusionsThe current study showed that anaemia was related to an increased risk of adult depression. One of the important limitations of our study was a moderate degree of heterogeneity due to the variety of assessment tools used to identify depression and the existence of publication bias. Another limitation of this meta-analysis was the lack of prospective cohort studies.


Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3019
Author(s):  
Jing-Wun Lu ◽  
Luo-Hua Yu ◽  
Yu-Kang Tu ◽  
Hung-Yu Cheng ◽  
Li-Yu Chen ◽  
...  

Vegetarian dietary patterns provide health benefits for cardiovascular health; however, the studies examining the association of vegetarian diets with stroke incidence showed inconsistent findings. We systematically evaluated the risk of incident stroke among vegetarians (diets excluding meat, poultry, fish, and seafood) compared among nonvegetarians. A systematic search of PubMed, EMBASE, Cochrane Library, and Web of Science was performed until 20 May 2021. Prospective cohort studies comparing the risk estimates for incident stroke between vegetarians and nonvegetarians were included. Of 398 articles identified in the database search, data from seven cohort studies (408 total stroke cases in 29,705 vegetarians and 13,026 total stroke cases in 627,728 nonvegetarians) were included. The meta-analysis revealed no significant association between adhering to the vegetarian dietary patterns and the risk of incident stroke (HR = 0.86; 95% CI = 0.67–1.11; I2 = 68%, n = 7). Subgroup analyses suggested that studies conducted in Asia and those with a mean baseline age of participants 50–65 years showed a lower risk of stroke in vegetarians. Moreover, no significant association between vegetarian diets and the risk of ischemic stroke (HR = 0.56; 95% CI = 0.22–1.42; I2 = 82%, n = 3) or hemorrhagic stroke (HR = 0.77; 95% CI = 0.19–3.09; I2 = 85%, n = 2) was found. To be conclusive, no strong relationship between vegetarian diets and the incidence of stroke was observed. Given the limited certainty of evidence from NutriGrade, future well-designed studies are warranted to provide solid evidence on this topic.


2021 ◽  
Vol 11 ◽  
Author(s):  
Yongfeng Lao ◽  
Xiaolong Li ◽  
Lijuan He ◽  
Xin Guan ◽  
Rongxin Li ◽  
...  

BackgroundControversial results of the association between alcohol consumption and risk of bladder cancer were reported by the previous meta-analyses.ObjectiveTo quantitatively investigate the association between alcohol consumption and risk of bladder cancer based on prospective cohort studies, and explore whether there is potential dose-response relation.MethodPubMed, EMBASE, the Cochrane Library databases, China Biology Medicine disc (CBM), and Chinese National Knowledge Infrastructure (CNKI) were searched for relevant studies. Categorical meta-analysis was performed for risk estimates of any alcohol consumers versus non-drinkers as well as different drinking degrees (light, moderate, and heavy) versus none. And two-stage generalized least-squares regression and restricted cubic spline, as well as fixed-effects dose-response models, were used for linear and nonlinear dose-response relation exploration.Results9 prospective cohort studies including 1,971,396 individuals were finally included. We did not observe a significant association between alcohol intake and the risk of bladder cancer in the entire population. Linear association was detected in those who consumed alcohol from liquor or spirits (P linear=0.02). One drink increment each day of alcohol could elevate the risk of bladder cancer by 9% (RR=1.09; 95%CI: 1.01-1.17). Alcohol was a risk factor of bladder cancer for male drinkers (RR=1.23; 95%CI: 1.13-1.35; I2=3.7%), while none linear or nonlinear relation was found.ConclusionNo significant association between alcohol consumption and bladder cancer risk was found in the entire population, but there was a linear dose-response relation in those who consume alcohol from liquor or spirits. Alcohol may elevate the risk of bladder cancer in males in a dose-independent way.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, PROSPERO (CRD42020216195).


Author(s):  
Wenjun Zhu ◽  
Xiaoxiao Ling ◽  
Jindong Ding Petersen ◽  
Jinyu Liu ◽  
Anqi Xiao ◽  
...  

AbstractNeurosurgical clipping and endovascular coiling are both standard therapies to prevent rebleeding after aneurysmal subarachnoid hemorrhage (aSAH). However, controversy still exists about which is the optimal treatment. This meta-analysis aims to assess the effectiveness and safety of two treatments with high-quality evidence. Web of Science, Cochrane Library, EMBASE, Pubmed, Sinomed, China National Knowledge Infrastructure, and Wanfang Data databases were systematically searched on August 5, 2021. Randomized controlled trials (RCTs) and prospective cohort studies that evaluated the effectiveness and safety of clipping versus coiling in aSAH patients at discharge or within 1-year follow-up period were eligible. No restriction was set on the publication date. Meta-analyses were conducted to calculate the pooled estimates and 95% confidence intervals (CI) of relative risk (RR). Eight RCTs and 20 prospective cohort studies were identified. Compared to coiling, clipping was associated with a lower rebleeding rate at discharge (RR: 0.52, 95% CI: 0.29––0.94) and a higher aneurysmal occlusion rate (RR: 1.33, 95% CI: 1.19–1.48) at 1-year follow-up. In contrast, coiling reduced the vasospasm rate at discharge (RR: 1.45, 95% CI: 1.23–1.71) and 1-year poor outcome rate (RR: 1.27, 95% CI: 1.16–1.39). Subgroup analyses presented that among patients with a poor neurological condition at admission, no statistically significant outcome difference existed between the two treatments. The overall prognosis was better among patients who received coiling, but this advantage was not significant among patients with a poor neurological condition at admission. Therefore, the selection of treatment modality for aSAH patients should be considered comprehensively.


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