Dayi Hu

Diabetes mellitus and risk of prostate cancer: an updated meta-analysis based on 12 case–control and 25 cohort studies

The association between diabetes and risk of prostate cancer has been investigated widely. However, study results remain inconsistent and contradictory. Using a meta-analytic approach, the present study explore the relationship incorporating more recent studies and provide more powerful evidence without the limitations of any individual study. Relevant studies were identified by searching Pubmed and the Cochrane Central Register of Controlled Trials through May 18, 2012. The strength of the relationship between diabetes mellitus and risk of prostate cancer was assessed using relative risk (RR). Either a fixed effects or random effects model was used to calculate the pooled RRs. Stratification analyses and sensitivity analyses were conducted, and publication bias was assessed by Egger’s test and Begg’s test. Twelve case–control studies involving 9,767 cases and 19,790 controls, and 25 cohort studies involving 118,825 cases were included. The person-years of follow-up ranged from 29,963 to 6,264,890 among included cohort studies. Diabetes was not significantly associated with incidence of prostate cancer in our analysis of case–control studies only (RRxa0=xa00.846, 95xa0% CI [0.710, 1.009]) or that of cohort studies only (RRxa0=xa00.925, 95xa0% CI [0.811, 1.054]). However, through subgroup analyses, statistically significant associations between diabetes and prostate cancer were found when considering population-based studies only (RRxa0=xa00.719, 95xa0% CI [0.637, 0.812]), cohort studies conducted in the United States (RRxa0=xa00.789, 95xa0% CI [0.727, 0.857]), and studies with follow-up of more than 5xa0years. Compared to risk of prostate cancer among people without diabetes, diabetic patients using insulin treatment experienced reduced incidence of prostate cancer in both case–control and cohort studies. The results suggest that diabetes mellitus is associated with decreased incidence of prostate cancer, specifically in the population of the United States. In addition, the time since onset of diabetes was positively associated with decreasing incidence of prostate cancer. The present conclusions should be considered carefully, however, and confirmed with further studies.

Reliability and validity of a Chinese version of the HADS for screening depression and anxiety in psycho-cardiological outpatients

AIMnThe Hospital Anxiety and Depression Scale (HADS) has been used widely with cardiovascular patients. This study aims to examine the reliability and validity of a Chinese version of HADS among psycho-cardiological outpatients.nnnMETHODSnOne hundred psycho-cardiological outpatients were asked to complete the Chinese version of HADS and were then interviewed according to the Mini International Neuropsychiatric Interview, Version 5 (MINI).nnnRESULTSnAccording to the MINI, 38 outpatients were diagnosed with major depression and 15 outpatients were diagnosed with an anxiety disorder. Compared with the MINI diagnoses, the optimum cutoff value of the anxiety subscale (HADS-A) was six (6) with a sensitivity of 81.6%, specificity of 75.8%, positive predictive value (PPV) of 54.0% and negative predictive value (NPV) of 91.9%; at the optimum cutoff value of nine (9), the depression subscale (HADS-D) had a sensitivity of 80.0%, specificity of 92.9%, PPV of 52.2% and NPV of 96.1%. The Cronbachs alpha coefficients of the HADS-A and HADS-D subscales were 0.753 and 0.764, respectively. The areas under the ROC curves of the HADS-A and the HADS-D subscales, as compared to MINI diagnoses of anxiety and depression, were 0.81 (SE = 0.05, 95%CI: [0.73, 0.90]) and 0.86 (SE = 0.05, 95%CI: [0.77, 0.94]), respectively.nnnCONCLUSIONSnThe HADS was found to be a reliable measurement tool for excluding depression and anxiety in psycho-cardiological outpatients.

Association of ADIPOQ gene polymorphisms and coronary artery disease risk: A meta-analysis based on 12 465 subjects

INTRODUCTIONnCoronary artery disease (CAD) is one of the most common cardiovascular diseases and is a major cause of morbidity and mortality worldwide. Various researchers have investigated the role of ADIPOQ gene in the risk of CAD, yet their results have been inconsistent.nnnMETHODSnTo evaluate the association between ADIPOQ genetic polymorphisms and CAD risk, relevant studies published before October 2011 were identified by searching PubMed and EMBASE. Studies were selected using previously defined criteria. The strength of the relationship between the four single nucleotide polymorphisms (SNPs) of the ADIPOQ gene and CAD risk was assessed using odds ratios (ORs).nnnRESULTSnA total of 12 465 subjects from 17 case-control studies were identified in the present study. Based on the relevant studies, it was determined that the risk of CAD was not associated with rs2241766 in any genetic model. Increased risk of CAD was associated with rs266729 in allele contrast (1.11, [1.03, 1.20]) and dominant genetic model (1.15, 95%CI: [1.05, 1.27]); increased risk of CAD was also associated with rs822395 in additive (1.63, 95%CI: [1.19, 2.22]) and recessive genetic model (1.71, 95%CI: [1.27, 2.30]). It was further determined that the rs1501299 polymorphism reduced the risk of CAD in the additive (0.80, 95%CI: [0.67, 0.94]) and recessive genetic model (0.81, 95%CI: [0.68, 0.95]). In the stratified analysis, significant associations were found in Asian subjects for rs266729 and in Caucasian subjects for rs1501299.nnnCONCLUSIONnThere is an association between ADIPOQ gene polymorphisms and CAD risk. Different SNPs of the ADIPOQ gene have different associations with CAD risk, and appear to increase risk in individuals of Asian ethnicity while decrease the CAD risk in Caucasians. However, the overall strength of association was mild to moderate.

IL-6 gene polymorphisms and CAD risk: a meta-analysis.

The potential relationship between Interleukin-6 (IL-6) gene polymorphisms and coronary artery disease (CAD) has been widely investigated. However, study findings on the −174 G/C and −572 G/C variants remain inconsistent and somewhat controversial. The present meta-analysis was conducted in an attempt to provide a more robust synthesis conclusion. PubMed and Embase were used to search for all relevant studies published on or before May 22, 2012. A total of 19 studies were ultimately included in the analysis. Overall combined risk was calculated with fixed or random-effects models. Subgroup and sensitivity analyses were performed. Among the included studies, no statistically significant differences were found between controls and CAD cases for the G allele contrasts of the −174 G/C and −572 G/C polymorphisms. The co-dominant genetic model was evaluated for the −174 G/C polymorphism. A significant association was detected using GG versuss CC (ORxa0=xa00.801, 95xa0% CI: [0.652, 0.983], Pxa0=xa00.034). However, the association was not obviously in subgroup analysis by ethnicity. The recessive genetic model was evaluated for the −572 G/C polymorphism. The relationship between −572 G/C polymorphism and CAD risk was only found to be significant in Asian populations (random-effects: ORxa0=xa01.908, 95xa0% CI: [1.016, 3.581], Pxa0=xa00.044) using GG versus GC+CC. No obvious publication bias was found by Begg’s funnel plots and the Egger’s linear regression test (Pxa0=xa00.315 for −174 G/C polymorphism and Pxa0=xa00.118 for −572 G/C polymorphism). Our study indicated that the association between the IL-6 gene and CAD risk was mild and moderate for the −174 G/C and −572 G/C polymorphisms. However, this relationship requires additional investigation through well-designed studies with larger sample sizes.

Evaluation of EZSCAN as a screening tool for impaired glucose metabolism

AIMSnTo evaluate the performance of EZSCAN as a screening tool for impaired glucose metabolism (IGM), including impaired glucose tolerance, impaired fasting glucose and undiagnosed diabetes in a Chinese population.nnnMETHODSn876 subjects participated in the study. All subjects underwent tests of EZSCAN, glycated hemoglobin, fasting plasma glucose (FPG), and oral glucose tolerance test (OGTT). Correlation of electrical skin conductance (ESC) with glucose level was evaluated by Pearson correlation coefficient. EZSCAN performance was assessed by receiver operating characteristic curve.nnnRESULTSnAmong the 876 subjects, 53% had normal glucose tolerance (NGT), and 47% had IGM. The ESC for the hands and feet was 72 ± 10 μS and 75 ± 7 μS, respectively, in NGT group; and 64 ± 13 μS and 67 ± 11 μS, respectively, in IGM group. The ESC at hands and feet was significantly correlated with both 2h-OGTT and FPG (p<0.001). NGT group demonstrated a EZSCAN score of 33 ± 11%, which is significantly lower than that of IGM group (44 ± 12%, p<0.001). The cut-off point of EZSCAN for IGM detection was 40% with a sensitivity of 80% and a specificity of 72%.nnnCONCLUSIONSnEZSCAN is a useful screening tool for identifying subjects at increased risk for impaired glucose metabolism in prediabetes and diabetes. Diagnostic laboratory test should be performed in subjects with EZSCAN scores greater than 40%.

Percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in the treatment of diabetic patients with multi-vessel coronary disease: a meta-analysis.

Diabetes is prevalent in patients with coronary artery disease. In diabetic patients with multi-vessel coronary disease, percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are widely used for revascularization. We aimed to compare the effectiveness and safety of PCI and CABG in these patients. Nine randomized controlled trials were identified in which a total of 1047 diabetic patients were randomly assigned to PCI and 1054 to CABG. Results showed that five-year mortality was significantly higher in diabetic patients after PCI than after CABG (risk difference (RD) of 7%; P<0.001); repeated revascularization was more common after PCI than after CABG (one-year RD of 13%; P<0.001); major adverse cardiac and cerebrovascular events were also more frequent after PCI (one-year RD of 12%; P<0.001); however, the cerebrovascular accident rate was lower in the PCI group than the CABG group (one-year RD of -2%; P=0.004). Conclusively, in diabetic patients with multi-vessel coronary disease, CABG was not only more effective than PCI in reducing mortality but also led to fewer repeated revascularizations and fewer major adverse cardiac and cerebrovascular events. Despite these benefits, CABG did put diabetic patients at higher risk for cerebrovascular accident than PCI.

A meta-analysis about the association between −1082G/A and −819C/T polymorphisms of IL-10 gene and risk of type 2 diabetes

The present meta-analysis was conducted to investigate the association between the -1082G/A and -819C/T polymorphisms of the IL-10 gene and risk of type 2 diabetes mellitus (T2DM). Relevant articles were identified by searching PubMed, Embase, and Web of Science. Pooled odds ratios (ORs) were used to assess the strength of the association between target polymorphisms and the risk of T2DM. Significant associations between the -1082G/A polymorphism and T2DM were found for the allele contrast (OR=0.90, 95% CI: [0.83, 0.98], P=0.02), homozygote contrast (OR=0.82, 95% CI: [0.69, 0.97], P=0.02), and recessive genetic model (OR=0.85, 95% CI: [0.74, 0.96], P=0.01). However, no significant association was found for the dominant genetic model (OR=0.91, 95% CI: [0.80, 1.05], P=0.08). The association between -819C/T polymorphism and T2DM was significant for the allele contrast (OR=0.73, 95% CI: [0.64, 0.84], P<0.01); however, no significant associations were found for -819C/T in the homozygote contrast (OR=1.01, 95% CI: [0.38, 2.67], P=0.99), dominant genetic model (OR=0.94, 95% CI: [0.50, 1.77], P=0.86), and recessive genetic model (OR=0.92, 95% CI: [0.50, 1.68], P=0.78). No significant publication bias was detected. This meta-analysis suggests that allele A of -1082G/A and allele C of -819C/T in the IL-10 gene have potentially protective effects in terms of risk of T2DM.

ADIPOQ gene polymorphisms and cancer risk: a meta-analysis.

The results of studies investigating the association between ADIPOQ gene polymorphisms and risk of cancer have been inconsistent and often contradictory. The present meta-analysis was conducted in order to overcome the limitations of any individual study and to provide a more precise overall effect estimate. Relevant studies were identified by searching PubMed and Embase for articles published through May 2012. The strength of the relationship between the ADIPOQ gene and risk of cancer was assessed using odds ratios (ORs). Either a fixed-effects or a random-effects model was used to calculate the overall risk estimates. Fifteen studies were included and five SNPs were considered. A significant association was found between SNP rs2241766 and risk of cancer in the recessive genetic model (OR: 0.768, 95% CI: [0.626,0.942], P=0.011); a significant relationship was also found between SNP rs1501299 and risk of cancer in both an allele contrast (OR: 0.141, 95%CI: [0.113,0.176], P<0.001) and the dominant genetic model (OR: 0.904, 95%CI: [0.830,0.985], P=0.021); no association was found with the rs266729, rs822395, or rs822396 SNPs. Adjusted ORs were also considered, but no statistically significant association was found in homozygote contrasts for any of the five SNPs after adjustment. Our results suggest that two polymorphisms, SNP rs2241766 and SNP rs1501299, of the ADIPOQ gene may be associated with reduced risk of cancer. However, the overall strength of association is mild to moderate, and additional well-designed studies are needed to confirm the present conclusion.

Lack of an association between angiotensin receptor blocker based therapy and increased risk of cancer: evidence from large observational studies.

Background A previous meta-analysis of randomized controlled studies that were not designed to investigate cancer as a primary outcome suggested that ARB-based therapy is associated with increased risk of cancer; however, results of recent observational studies considering the association have been contradictory. This study sought to evaluate the association between angiotensin receptor blocker (ARB)-based therapy and risk of cancer by conducting a meta-analysis of observational studies. Methods Relevant articles published before February 2014 were identified by searching PubMed and the Cochrane Library. Pooled relative risks (RRs) were determined using a random effects model and were used to assess the strength of association between use of ARB-based therapy and risk of cancer. Results Six retrospective cohort studies involving a total of 3,827,109 participants and four case-control studies involving a total of 193,029 cases were included. The present study found that ARB-based therapy was not significantly associated with an increased risk of cancer (RR = 0.87, 95%CI: [0.75, 1.01]). However, an analysis including only cohort studies suggested a significantly decreased risk of cancer among individuals with any history of ARB use as compared to those with no history of ARB use (RR = 0.80, 95%CI: [0.55, 0.95]); no significant association was found between ARB use and risk of cancer when the case-control studies were separately considered (RR = 1.03, 95%CI: [0.93, 1.13]). Subgroup analyses showed that use of ARB-based therapy was associated with decreased risk of lung cancer (RR = 0.81, 95%CI: [0.69, 0.94]); however, no significant associations were found with the other cancer sites investigated. Furthermore, no association was observed upon adjustment by type of ARB drug. No publication bias was detected. Conclusion Overall, ARB-based therapy was not associated with increased risk of cancer. However, its use may be related to decreased incidence of lung cancer; this finding should be considered carefully and confirmed with further studies.

Association between prevalence of hypertension and components of metabolic syndrome: the data from Kailuan community

Abstract This study aimed to investigate the potential association between prevalence of hypertension and components of metabolic syndrome (MetS) in general population of North China. A cross-section survey was conducted from September to December 2013 in Kailuan community of a Northern China city, Tangshan. Anthropometric measurements, blood tests and questionnaire surveys were administered to a total of 4675 subjects enrolled in this study. In this study, hypertension was defined as blood pressure>140/90u2009mmHg or medication for previously diagnosed hypertension. The definition of MetS adapted the IDF/AHA/NHLBI criteria. The prevalence of hypertension among population with or without individual or clustered components of MetS was compared and the respective contribution of every component of MetS to prevalence of hypertension was analyzed using multivariate logistic analysis. The overall prevalence of hypertension was 31.6% in enrolled subjects. People with components of MetS such as central obesity, elevated TG, high blood pressure, and abnormal glucose metabolism had a higher prevalence of hypertension compared with those without. The prevalence of hypertension in people with 0, 1, 2, 3, 4, and 5 components of MetS was 18.4%, 27.8%, 32.6%, 35.6%, 43.9%, and 54.7% (pu2009<u20090.05), respectively. After adjusting for age, gender, BMI, smoking and alcohol drinking, the prevalence of hypertension was significantly correlated with the following component of MetS including central obesity (OR 1.23 (1.04–1.46), pu2009<u20090.05), elevated TG (OR 1.21 (1.03–1.43), pu2009<u20090.05), high blood pressure (OR 3.34 (2.86–3.90), pu2009<u20090.05), and abnormal glucose metabolism (OR 1.23 (1.04–1.45), pu2009<u20090.05). Components of MetS could significantly contribute to the development of hypertension. Overall lifestyle improvement and control of metabolic associated risk factors should be the cornerstone of hypertension control in China.