Egger's Linear Regression Research Articles

Association between C-reactive protein and risk of schizophrenia: An updated meta-analysis.

C-reactive protein (CRP) has been indicated to be associated with the pathogenesis of schizophrenia (SZ) and other psychiatric disorders. The aim of this study is to investigate whether peripheral blood CRP levels are associated with the risk of SZ. We searched literature from databases of Pubmed, Embase and the Cochrane Library from inception to November 1, 2016 for studies that reported serum or plasma CRP levels in patients with SZ and non-SZ controls. At least two reviewers decided on eligibility and extracted data from included studies. Random effects meta-analyses were performed using standardized mean difference (SMD) as the effect estimate of the differences in CRP levels between subjects with SZ and healthy controls. We identified 18 studies representing 1963 patients with SZ and 3683 non-SZ controls. Compared with non-schizophrenics, blood CRP levels were moderately increased in people with SZ (SMD 0.53, 95% CI 0.30 to 0.76) irrespective of study region, sample size of included studies, patient mean age, age of SZ onset and patient body mass index. Publication bias was not detected through Egger's linear regression test (P = 0.292). We noticed that patients in Asia or Africa (n = 6, SMD 0.73, 95% CI 0.26 to 1.21) and whose age less than 30 years (n = 5, SMD 0.76, 95% CI 0.07 to 1.58) had substantially higher CRP levels. Our study provides evidence that higher CRP levels are associated with increased risk of SZ, especially for young adult patients less than 30 years. Further large-scale studies are strongly warranted to further confirm this association.

Genetic predisposition of IL-10 promoter polymorphisms with risk of multiple sclerosis: A meta-analysis

Interleukin-10 (IL-10) is a anti-inflammatory cytokine, which controls inflammation by inhibiting the synthesis of several cytokines produced by Th1 cells and macrophages. The association between Interleukin-10 promoter polymorphisms with the risk of multiple sclerosis (MS) remains inconclusive. In this study, a meta-analysis has been performed to assess the relationship between IL-10 gene polymorphisms rs1800896, rs1800871 and rs1800872 with the risk of MS. Nine case-control studies were selected involving 2755 participants. The association between the polymorphisms and MS was examined by the pooled odds ratios (ORs) with 95% confidence intervals (CIs) in allelic, homozygote, heterozygote, dominant and recessive genetic models. Of analyzed genetic models, the pooled ORs and CIs of each SNPs calculated based on random (I2>50) or fixed effects (I2<50) methods, which showed no significant association (p-value>0.05) of genetic predisposition with MS susceptibility across Asian and Caucasian populations. In addition, assessment based on funnel plot and Egger's linear regression test suggests no publication bias in all analyzed genetic models. Overall, our results demonstrated that rs1800896, rs1800871 and rs1800872 polymorphisms may not be the risk factor for the development of MS in both the populations.

PSAD Test in the Diagnosis of Prostate Cancer: a Meta-Analysis

The aim of this study is to evaluate the diagnostic value of prostate-specific antigen density (PSAD) test in detecting prostate cancer. We searched public databases including PubMed, Medline, Springer, Elsevier Science Direct, Cochrane Library, and Google scholar before June 2015. In this meta-analysis, specificity, positive LR, negative LR, and dOR of PSAD test in patients with prostate cancer were analyzed from published studies. We applied Meta-DiSc 1.4 and Stata 11.0 software to the meta-analysis. A total of 11 separate studies consisting of 1821 participants were considered in the meta-analysis. The results of this meta-analysis indicated that sensitivity, specificity, positive Likelihood Ratio (LR), negative LR, and Diagnostic Odds Ratio (dOR) of PSAD test for prostate cancer were 0.73 (95% CI = 0.69 to 0.78), 0.64 (95% CI = 0.61 to 0.66), 2.13 (95% CI = 1.64 to 2.76), 0.45 (95% CI = 0.35 to 0.57), and 5.87 (95% CI = 4.42 to 7.81), respectively. It also showed that the AUC and Q* index were 0.77 and 0.71, respectively. The results of the Egger's linear regression test showed that no publication bias existed (p > 0.05). In general, our results show that specificity, positive LR, negative LR, dOR, the area under the curve (AUC), and Q * index of PSAD test may be appropriate for detecting prostate cancer.

Dietary vitamin B2 intake and breast cancer risk: a systematic review and meta-analysis.

Epidemiological studies assessing the relationship between dietary vitamin B2 and the risk of breast cancer have produced inconsistent results. Thus, we conducted this meta-analysis of epidemiologic studies to evaluate this association. We searched English-language MEDLINE publications and conducted a manual search to screen eligible articles. A random-effect model was used to pool study-specific risk estimates. Egger's linear regression test was also used to detect publication bias in meta-analysis. In our meta-analysis, ten studies comprising totally 12,268 breast cancer patients were available in the analyses. Pooled relative risk (RR) comparing the highest to the lowest vitamin B2 intake and breast cancer incidence was 0.85 [95% confidence interval (CI)=0.76-0.95]. No significant heterogeneity existed across the studies (P=0.086, I 2=40.7%). No publication bias was found. The results of dose-response analysis also showed that an increment of 1mg/day was inversely related to the risk of breast cancer (RR=0.94; 95% CI=0.90-0.99). Results from our meta-analysis indicated that dietary vitamin B2 intake is weakly related to the reduced risk of breast cancer. Additional research is also necessary to further explore this association.

Association of RAGE gene Gly82Ser polymorphism with coronary artery disease and ischemic stroke: A systematic review and meta-analysis.

Background:The receptor for advanced glycosylation end products (RAGE) has been widely linked to diabetic atherosclerosis, but its effects on coronary artery disease (CAD) and ischemic stroke (IS) remain controversial. The Gly82Ser polymorphism is located in the ligand-binding V domain of RAGE, suggesting a possible influence of this variant on RAGE function. The aim of the present study is to clarify the association between the RAGE Gly82Ser polymorphism and susceptibility to CAD and IS.Methods:Eligible studies were identified through a comprehensive literature search. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the association of Gly82Ser polymorphism with CAD and IS risk. Fixed- or random-effects model was used depending on the heterogeneity between studies. A funnel plot and Egger linear regression test were applied to assess publication bias. We also performed subgroup analyses to investigate potential sources of heterogeneity.Results:A total of 16 eligible articles containing 18 studies were analyzed. The pooled analysis indicated that the Gly82Ser polymorphism significantly increased CAD risk in recessive and homozygous genetic models (SS vs GS + GG: OR = 1.34, 95% CI = 1.09–1.64; SS vs GG: OR = 1.38, 95% CI = 1.12–1.71). A significant association between the Gly82Ser polymorphism and IS risk was observed in all tested models except the heterozygous genetic model (GS + SS vs GG: OR = 1.20, 95% CI = 1.04–1.38; SS vs GS + GG: OR = 2.20, 95% CI = 1.74–2.78; SS vs GG: OR = 2.23, 95% CI = 1.72–2.91; S vs G: OR = 1.32, 95% CI = 1.05–1.65). Subgroup analysis suggested an association between CAD and IS risk and the Gly82Ser polymorphism in the Chinese population, but not in the non-Chinese population.Conclusions:The current meta-analysis suggests that the RAGE Gly82Ser polymorphism is associated with an increased risk of CAD and IS, especially in the Chinese population. However, better-designed studies with larger sample sizes are needed to validate the results.

Efficacy and safety of prostate-targeted local therapy in patients with newly diagnosed oligometastatic prostate cancer: a systematic review and meta-analysis

BackgroundThe role of local therapy for the management of oligometastatic prostate cancer at diagnosis still remains poorly defined. We did a systematic review and meta-analysis evaluating local therapy of the primary tumour for patients with oligometastatic prostate cancer at diagnosis as well as the patients who can benefit the most. MethodsFor this systematic review, we searched PubMed, EMBASE, Medline, and the Cochrane Library for studies from database inception until March, 2016, for local therapy of the primary tumour in patients with oligometastatic prostate cancer. No language restrictions were applied. We estimated the risk of bias for the individual research studies using the Newcastle-Ottawa Scale (NOS). We assessed the publication bias using both the Egger's linear regression approach and funnel plots. The baseline characteristics on trial, patient, and treatment level were extracted. The primary outcomes were overall survival and disease-specific survival. All statistical analyses were performed using Stata v.12.0 software (StataCorp, College Station, TX, USA). FindingsSeven retrospective studies were selected for inclusion, including a total of 24 203 patients who were recruited from 1989 to 2010 form Sweden, USA, and Germany. For overall survival, the pooled hazard ratio (HR) in patients treated with local therapy compared with no local therapy was 0·53 (95% CI 0·40–0·71; p <0·01). Local therapy was also associated with a 49% improvement of disease-specific survival (HR 0·51, 95% CI 0·37–0·69, p<0·01). This significant increase in disease-specific survival was better pronounced in patients younger (HR 0·34, 0·23–0·52, p<0·01) than 65 years than in those 65 years or older (HR 0·44, 0·28–0·68, p <0·01). The tumour-specific factor was associated with the improved survival in patients with AJCC (American Joint Committee on Cancer) M1a stage (HR 0·29, 0·18–0·48, p<0·01) than in those with M1b (HR 0·40, 0·24–0·68, p<0·001) and M1c (HR 0·34; 0·24–0·50, p<0·01). InterpretationLocal therapy for a primary tumour conferred a significantly better outcome in fit patients with oligometastatic prostate cancer at diagnosis. The evidence also suggests that radical prostatectomy is a preferable local therapy procedure for patients aged 65 years or younger or for those who have an AJCC stage M1a tumour. We believe that important local therapy factors should be systematically assessed to develop a personalised approach to improve patient survival FundingThis study was supported by the Prostate Cancer Foundation Young Investigator Award 2013, the National Natural Science Foundation of China (81300627 and 81370855) and Programs from Science and Technology Department of Sichuan Province (2013SZ0006 and 2014JY0219).

Association between apolipoprotein B EcoRI polymorphisms and coronary heart disease

The study was carried out to examine the association between apolipoproteinB (ApoB) EcoRI polymorphism (E- vs. E+) (rs1042031) and coronary heart disease (CHD) risk by systematically analyzing multiple independent studies. The Hardy-Weinberg equilibrium (HWE) test was applied to assess genotype frequency distribution in healthy controls. The quality of the studies was assessed using the Newcastle-Ottawa scale (NOS). Power analysis was performed with Power and Precision V4 software. Afixed effect model was used because no deviation from homogeneity was found. Publication bias was quantified and examined with Begg's funnel plot test and Egger's linear regression method. The meta-analysis was performed by Stata12.0 software. Atotal of 21 eligible association studies were merged in this meta-analysis and the pooled sample consisted of 2994 CHD patients and 3258 healthy controls. No significant publication bias and heterogeneity were observed in these studies. The pooled odds ratio (OR) and 95% confidence interval (CI) of E- vs. E+ were 1.18 (1.06-1.32). The pooled OR (95% CI) of E+ E- + E- E- vs. E+ E+ was 1.18 (1.04-1.34). This meta-analysis indicated that ApoB EcoRI confers amoderate risk for CHD and the E- allele at this locus might be asusceptibility allele for the development of CHD.

Matrix Metalloproteinase-1 Expression in Women With and Without Pelvic Organ Prolapse: A Systematic Review and Meta-analysis.

This meta‐analysis was conducted to estimate the association between matrix metalloproteinase‐1 (MMP‐1) expression and pelvic organ prolapse (POP) in women. Relevant studies published before 6 December 2015 were identified by searching PubMed, Ovid, EBSCO, and EMBASE. A total number of five case–control studies, including 182 POP cases and 192 controls, were identified. The results indicated that women without POP had a lower MMP‐1 level of expression compared with women with POP (odds ratio = 0.54, 95% confidence interval: 0.43–0.67, P = 0.000). After stratification by biopsy site, ethnicity, or menopausal status, this finding was also confirmed in the subgroup analysis with no significant changes. Egger's linear regression test revealed a potential publication bias (P = 0.028). The findings of our study indicate that women who suffer from POP have a higher expression level of MMP‐1 than women without POP.

Association between SLCO1B1 -521T>C and -388A>G polymorphisms and risk of statin-induced adverse drug reactions: A meta-analysis.

An increasing number of studies have investigated the association between SLCO1B1 −521T>C and −388A>G polymorphisms and the risk of statin-induced adverse drug reactions (ADRs), but the results have been inconsistent. This meta-analysis was performed to gain more insight into the relationship. PubMed, Embase, Cochrane Library and Web of Science were searched for relevant articles published before March 5th, 2015. The quality of included studies was evaluated by the Newcastle-Ottawa Quality scale. Pooled effect estimates (odds ratios [ORs] or hazard ratios [HRs) and corresponding 95 % confidence intervals (CIs) were calculated to assess the association in overall and subgroup analyses for various genetic models. Begg’s rank correlation test and Egger’s linear regression test were used to examine the publication bias. A total of nine cohort and four case–control studies involving 11, 246 statin users, of whom 2, 355 developing ADRs were included in the analysis. Combined analysis revealed a significant association between the SLCO1B1−521T>C polymorphism and increased risk for ADRs caused by various statins, but the synthesis heterogeneity was generally large (dominant model: pooled effect estimate = 1.85, 95 % CI 1.20–2.85, P = 0.005; I2 = 80.70 %, Pheterogeneity < 0.001). Subgroup analysis by statin type showed that the ADRs risk was significantly elevated among simvastatin users (dominant model: pooled effect estimate = 3.43, 95 % CI 1.80–6.52, P = 0.001; I2 = 59.60 %, Pheterogeneity = 0.060), but not among atorvastatin users. No significant relationship was found between the −388A>G polymorphism and ADRs caused by various statins (dominant model: pooled effect estimate = 0.94, 95 % CI 0.79–1.13, P = 0.526; I2 = 40.10 %, Pheterogeneity = 0.196). The meta-analysis suggests that SLCO1B1 −521T>C polymorphism may be a risk factor for statin-induced ADRs, especially in simvastatin therapy. Conversely, there may be no significant association for −388A>G polymorphism.

Association Between Tissue Inhibitor of Metalloproteinase-3 Gene Methylation and Gastric Cancer Risk: A Meta-Analysis.

The tumor suppressor gene tissue inhibitor of metalloproteinase-3 (TIMP-3) has been reported to be frequently and significantly downregulated in gastric cancer, and its downregulation is correlated with hypermethylation in its promoter region. However, the association between TIMP-3 methylation and gastric cancer risk remains unclear. In this study, we assessed the relationship between TIMP-3 promoter methylation and gastric cancer risk by performance of a meta-analysis. Relevant studies were identified in a comprehensive literature search using PubMed, Embase, and Web of Science databases. The strength of the association between TIMP-3 methylation and the risk of gastric cancer was assessed by odds ratio (OR) with the corresponding 95% confidence interval (CI). The heterogeneity among studies was tested using the Q-statistics and I(2) metric. The publication bias was examined by Begg's funnel plots and Egger's linear regression test. A total of 1096 subjects from eight studies were included in the present meta-analysis. Overall, a significant association between TIMP-3 methylation and gastric cancer risk was observed (OR = 8.65; 95% CI 4.31-17.37; p < 0.001). Stratified analyses by ethnicity, sample materials, and detection methods also revealed increased gastric cancer risk in individuals harboring methylated TIMP-3. Moreover, no publication bias was detected in the present meta-analysis. Our results show a positive correlation between TIMP-3 promoter methylation and gastric cancer risk and indicated that TIMP-3 promoter methylation may be used as a molecular marker for gastric cancer.

The effect of Astragalus as an adjuvant treatment in type 2 diabetes mellitus: A (preliminary) meta-analysis

Ethnopharmacological relevanceAstragalus is a traditional Chinese medicine that is widely used for tonifying Qi (Qi mainly means life energy) to treat diabetes mellitus and its complications. Aim of the studyWe performed a meta-analysis to evaluate the effect of Astragalus in adjuvant treatment of type 2 diabetes mellitus (T2DM), and to provide novel information to improve clinical decision-making. Materials and methodsWe conducted an exhaustive database search (PubMed, EMbase, Cochrane Library, China Knowledge Resource Integrated Database (CNKI), Wanfang data and SinoMed) of studies associated with “Astragalus” and “type 2 diabetes mellitus” until December 2015. Following quality assessment of study eligibility, the extracted data were statistically analyzed using STATA, ver. 12.0 (Stata Corp.). ResultsA total of 13 studies with 1054 participants were included in this meta-analysis. Two subgroups were identified, based on Astragalus dosing regimens: control group vs. Astragalus injection (AI); control group vs. Astragalus aqueous decoction (AAD). The pooled results showed that, in comparison with control group, Astragalus administration significantly reduced fasting plasma glucose (FPG) in both the AI group (WMD=−0.28, 95% CI=−0.46 to −0.10, P=0.002, I2=18.5%) and the AAD group (WMD=−0.83, 95% CI=−1.07 to −0.58, P=0.000, I2=0.0%); postprandial plasma glucose (PPG) was also significantly reduced in the AI group (WMD=−0.47, 95% CI=−0.77 to −0.17, P=0.002, I2=46.8%) and the AAD group (WMD=−1.19, 95% CI=−1.63 to −0.75, P=0.000, I2=49.3%). Fasting insulin (Fins) was significantly reduced only in the AAD treatment group (SMD=−0.33, 95% CI=−0.55 to −0.10, P=0.005, I2=1.0%) as was the homeostasis model assessment insulin resistance index (HOMA-IRI) levels (SMD=−1.66, 95% CI=−3.24 to −0.09, P=0.038, I2=94.0%). Although AAD treatment significantly reduced levels of glycated hemoglobin A1c (HbA1c) (WMD=−1.77, 95% CI=−3.06 to −0.47, P=0.007, I2=90.8%), AI treatment failed to show significant efficacy (WMD=−0.28, 95% CI=−0.63 to 0.06, P=0.102, I2=83.8%). Sensitivity analysis failed to detect outliers in all studies while Egger's linear regression test revealed a lack of publication bias in this meta-analysis (P=0.771, 95%CI =−3.51 to 4.56). ConclusionsAstragalus may be beneficial as an adjuvant therapy in the treatment of type 2 diabetes. However, due to the limited quality of existing studies, further high-quality studies are warranted before definitive conclusions may be reached.

Reporting quality and effect size comparison in randomized controlled trials of bo's abdominal acupuncture using CONSORT statement and STRICTA

ObjectiveTo evaluate the reporting quality of randomized controlled trials (RCT) that compared Bo's abdominal acupuncture with conventional body acupuncture, and compare the efficacy and safety between them by performing a Meta-analysis. MethodsAll RCTs comparing Bo's abdominal acupuncture with conventional body acupuncture were included. English and Chinese databases were searched from their respective inceptions to March 2014. The reporting quality was assessed according to the “Consolidated Standards of Reporting Trials” (CONSORT) checklist for parallel RCTs and the revised “Standards for Reporting Interventions in Clinical Trials of Acupuncture” (STRICTA). A Meta-analysis was conducted to synthesize the effect sizes, and publication bias was evaluated by the Egger linear regression test using Stata. ResultsNinety-seven studies were included, of which most lacked adequate reporting information, and 80.4% showed that the efficacy of abdominal acupuncture is superior to conventional body acupuncture, especially for the following diseases: lumbar disc herniation, cervical spondylosis, omarthritis and cervical vertigo, except simple obesity. Effect-sizes were controversial when evaluating different outcomes. ConclusionThe international standard CONSORT statement and STRICTA guidelines should be strictly applied when reporting acupuncture RCTs in the future. Abdominal acupuncture appears to be more effective compared with conventional body acupuncture for some diseases. However, further high quality blind RCTs using validated outcome indexes and standard reporting are warranted.

Association Between Apolipoprotein B XbaI Polymorphism and Coronary Heart Disease in Han Chinese Population: A Meta-Analysis.

To examine the association between apolipoprotein B (ApoB) XbaI polymorphisms (rs693) and coronary heart disease (CHD) risk among the Han Chinese population by systematically analyzing multiple independent studies. The Hardy-Weinberg equilibrium test was applied to check genetic equilibrium among genotypes for the selected literatures. The quality of the studies was assessed by using the NewcastleOttawa Scale. Power analysis was performed with Power and Precision V4 software. A fixed or random effect model was used on the basis of heterogeneity. Publication bias was quantified and examined with Begg's funnel plot test and Egger's linear regression test. The meta-analysis was performed by Stata 12.0 software. A total of 10 eligible association studies were included in this meta-analysis, and the pooled sample consisted of 1195 CHD patients and 1178 health controls. No consistent inference regarding publication bias for the included studies was obtained by using the two above-mentioned methods. The pooled odds ratios (95% confidence intervals [CIs]) for X(-) versus X(+) allele and X(+)X(+) + X(+)X(-) versus X(-)X(-) genotype were 2.25 (1.40-3.62) and 2.21 (1.39-3.50), respectively. This meta-analysis indicated that ApoB XbaI allele confers a significant risk towards the development of CHD among the Han Chinese population.

Circulating adiponectin levels in various malignancies: an updated meta-analysis of 107 studies.

Early detection of cancers is challenging for lack of specific biomarkers. Adiponectin is an adipokine predominantly derived from adipocytes and hypoadiponectinemia has been reported to associate with risk of many types of cancers. However, available evidence is controversial. Some studies show that increased adiponectin levels correlate with cancer risk. Therefore, we performed a meta-analysis of the association between circulating adiponectin levels and cancer development. A systematic search of PubMed, EMBASE, Wiley Online Library and Cochrane Library was conducted for eligible studies involving circulating adiponectin and malignancies from inception to August 8, 2015. Standard mean differences (SMDs) with 95% confidence intervals (95% CIs) were calculated by use of a random-effect model. Funnel plot and Egger's linear regression test were conducted to examine the risk of publication bias. 107 studies were included with 19,319 cases and 25,675 controls. The pooled analysis indicated that circulating adiponectin levels were lower in patients with various cancers than in controls, with a pooled SMD of −0.334 μg/ml (95% CI, −0.465 to −0.203, P = 0.000). No evidence of publication bias was observed. Circulating high molecular weight adiponectin levels were also lower in cancer patients than in controls, with a pooled SMD of −0.502 μg/ml (95% CI, −0.957 to −0.047, P = 0.000). This meta-analysis provides further evidence that decreased adiponectin levels is associated with risk of various cancers. Hypoadiponectinemia may represent a useful biomarker for early detection of cancers.

Transcription Factor 7-Like 2 (TCF7L2) rs7903146 Polymorphism as a Risk Factor for Gestational Diabetes Mellitus: A Meta-Analysis.

BackgroundThere are racial and ethnic differences in the prevalence of gestational diabetes mellitus (GDM). Prior meta-analyses included small samples and very limited non-Caucasian populations. Studies to determine the relationship between transcription factor 7 like-2 (TCF7L2) rs7903146 polymorphism and risk of GDM in Hispanics/Latinos are recently available. The present meta-analysis was to estimate the impact of allele variants of TCF7L2 rs7903146 polymorphism on GDM susceptibility in overall population and racial/ethnic subgroups.MethodsLiterature was searched in multiple databases including PubMed, Web of Science, EMBASE (Ovid SP), Airiti Library, Medline Complete, and ProQuest up to July 2015. Allelic frequency for TCF7L2 rs7903146 polymorphism in GDM and control subjects was extracted and statistical analysis was performed using Comprehensive Meta-Analysis (CMA) 2.0 statistical software. The association between TCF7L2 rs7903146 polymorphism and GDM risk was assessed by pooled odd ratios (ORs) using five gene models (dominant, recessive, homozygote, heterozygote, and allele). Stratified analysis based on race/ethnicity was also conducted. The between-study heterogeneity and contribution of each single study to the final result was tested by Cochran Q test and sensitivity analyses, respectively. Publication bias was evaluated using Egger’s linear regression test.ResultsA total of 16 studies involving 4,853 cases and 10,631 controls were included in this meta-analysis. Significant association between the T-allele of rs7903146 and GDM risk was observed under all genetic models, dominant model (OR = 1.44, 95% CI = 1.19–1.74), recessive model (OR = 1.35, 95% CI = 1.08–1.70), heterozygous model (OR = 1.31, 95% CI = 1.12–1.53), homozygous model (OR = 1.67, 95% CI = 1.31–2.12), and allele model (OR = 1.31, 95% CI = 1.12–1.53). Stratified analysis by race/ethnicity showed a statistically significant association between rs7903146 polymorphism and susceptibility to GDM under homozygous genetic model (TT versus CC) among whites, Hispanics/Latinos and Asians. Sensitivity analysis showed that the overall findings were robust to potentially influential decisions of the 16 studies included. No significant evidence for publication bias was observed in this meta-analysis for overall studies and subgroup studies.ConclusionsThis meta-analysis showed that the T allele of TCF7L2 rs7903146 polymorphism was associated with susceptibility of GDM in overall population in white, Hispanic/Latino and Asian sub-groups. Asians with homozygous TT allele of rs7903146 polymorphism have highest risk of GDM (OR = 2.08) followed by Hispanics/Latinos (OR = 1.80) and whites (OR = 1.51). The highest and lowest frequency of T allele of rs7903146 was found in Malaysia and South Korea, respectively. Future studies are needed to profile genetic risk for GDM among high risk Asian and Pacific Islander subgroups.

Effect of Body Mass Index on Overall Survival of Pancreatic Cancer: A Meta-Analysis.

Although obesity has been identified as a risk factor for pancreatic cancer, the important question of whether obesity influences the prognosis of pancreatic cancer has not been explicated thoroughly. We therefore performed a meta-analysis to investigate the association between body mass index (BMI) and survival outcomes of patients with pancreatic cancer.Studies that described the relationship between BMI and overall survival (OS) of pancreatic cancer were searched in PubMed, Embase, Ovid, and Cochrane Library Databases from the earliest available date to May 12, 2015. Hazard ratios (HRs) for OS in each BMI category from individual studies were extracted and pooled by a random-effect model. Dose–response meta-analysis was also performed to estimate summary HR and 95% confidence interval (CI) for every 5-unit increment. Publication bias was evaluated by Begg funnel plot and Egger linear regression test.Ten relevant studies involving 6801 patients were finally included in the meta-analysis. Results showed that obesity in adulthood significantly shortened OS of pancreatic cancer patients (HR: 1.29, 95% CI: 1.17–1.41), whereas obesity at diagnosis was not associated with any increased risk of death (HR: 1.10, 95% CI: 0.78–1.42). For every 5-kg/m2 increment in adult BMI, the summary HR was 1.11 (95% CI: 1.05–1.18) for death risk of pancreatic cancer. However, no dose–response relationship was found in the BMI at diagnosis. Egger regression test and Begg funnel plot both revealed no obvious risk of publication bias.In conclusion, increased adult BMI is associated with increased risk of death for pancreatic cancer patients, which suggested that obesity in adulthood may be an important prognostic factor that indicates an abbreviated survival from pancreatic cancer. More studies are needed to validate this finding, and the mechanism behind the observation should be evaluated in further studies.

Sufentanil and Bupivacaine Combination versus Bupivacaine Alone for Spinal Anesthesia during Cesarean Delivery: A Meta-Analysis of Randomized Trials.

ObjectiveThe addition of lipophilic opioids to local anesthetics for spinal anesthesia has become a widely used strategy for cesarean anesthesia. A meta-analysis to quantify the benefits and risks of combining sufentanil with bupivacaine for patients undergoing cesarean delivery was conducted.MethodsA comprehensive literature search without language or date limitation was performed to identify clinical trials that compared the addition of sufentanil to bupivacaine with bupivacaine alone for spinal anesthesia in healthy parturients choosing cesarean delivery. The Q and I2 tests were used to assess heterogeneity of the data. Data from each trial were combined using relative ratios (RRs) for dichotomous data or weighted mean differences (WMDs) for continuous data and corresponding 95% confidence intervals (95% CIs) for each trial. Sensitivity analysis was conducted by removing one study a time to assess the quality and consistency of the results. Begg’s funnel plots and Egger’s linear regression test were used to detect any publication bias.ResultsThis study included 9 trials containing 578 patients in the final meta-analysis. Sufentanil addition provided a better analgesia quality with less breakthrough pain during surgery than bupivacaine alone (RR = 0.10, 95% CI 0.06 to 0.18, P < 0.001). Sensory block onset time was shorter and first analgesic request time was longer in sufentanil added group compared with the bupivacaine-alone group (WMD = −1.0 min, 95% CI −1.5 to −0.58, P < 0.001 and WMD = 133 min, 95% CI 75 to 213, P < 192, respectively). There was no significant difference in the risk of hypotension and vomiting between these two groups. But pruritus was more frequentely reported in the group with sufentanil added (RR = 7.63, 95% CI 3.85 to 15.12, P < 0.001).ConclusionBupivacaine and sufentanil combination is superior to that of bupivacaine alone for spinal anesthesia for cesarean delivery in analgesia quality. Women receiving the combined two drugs had less breakthrough pain, shorter sensory block onset time, and longer first analgesic request time. However, the addition of sufentanil to bupivacaine increased the incidence of pruritus.

The Effect of ShenQi FuZheng Injection in Combination with Chemotherapy versus Chemotherapy Alone on the Improvement of Efficacy and Immune Function in Patients with Advanced Non-Small Cell Lung Cancer: A Meta-Analysis.

ObjectiveTo evaluate the effect of ShenQi FuZheng Injection (SFI) on cellular immunity and clinical efficacy in patients with advanced non small cell lung cancer(NSCLC) when combined with chemotherapy.MethodsElectronic databases including EMBASE, PUBMED, the conference proceedings of the American Society of Clinical Oncology (ASCO), Cochrane, Chinese National Knowledge Infrastructure (CNKI), and Chinese Biological Medical disc(CBM) were searched, until July, 2015. The randomized controlled clinical studies reporting results of efficacy and immune function were collected according to the inclusion criteria. Cochrane handbook 5.1.0 was applied to assess the quality of included trials and Revman 5 software was used for data analysis.ResultsFifteen studies including 1006 cases of advanced NSCLC were included based on the inclusion criteria. The results of meta-analysis showed that there were significant differences in percentages of CD3+ cells (SMD = 13.48; 95%CI: 8.11–18.85; p<0.01), CD4+ cells (SMD = 10.78; 95%CI, 6.38–15.18; p<0.01), NK [WMD = 8.59, 95% CI(3.97, 13.21), p = 0.003], and ratio of CD4+/ CD8+ (SMD = 0.32; 95%: 0.28–0.36; p<0.01) between SFI combination group and control group, whereas the difference was not significant in CD8+ (SMD = -1.44; 95%CI, -4.53–1.65; p = 0.36). Funnel plot, Begg's rank correlation test and Egger's linear regression analysis indicated that there was significant publication bias across studies.ConclusionSFI is effective to improve the efficacy of chemotherpay and function of cellular immunity in NSCLC patients, however, high quality RCTs are needed to further confirm the findings.

Association between GNB3 c.825C > T polymorphism and the risk of overweight and obesity: A meta-analysis

BackgroundThe association between G protein β-polypeptide 3 gene (GNB3) c.825C>T polymorphism (rs5443) and the risk of overweight/obesity has been investigated in many published studies, but the results were conflicting and inconclusive. A meta-analysis was performed to make a more accurate assessment of the relationship. MethodsThe PubMed, ProQuest Health & Medical Complete, Web of Science, Chinese Biomedical Medical databases (CBM), Chinese National Knowledge Infrastructure (CNKI), and Wan Fang databases were searched to identify eligible literatures. Pooled odds ratios (ORs) with the corresponding 95% confidence intervals (CIs) were used to assess the strength of association between GNB3 c.825C>T polymorphism and overweight/obesity. ResultsEleven articles including 15 case–control studies with a total of 10,396 subjects (3171 cases of overweight/obesity and 7225 controls) were enrolled in the meta-analysis. The GNB3 c.825C>T was significantly associated with overweight/obesity under a recessive model (OR=1.22, 95% CI: 1.04–1.44, P=0.015). Moreover, the GNB3 825T allele was obviously associated with overweight alone in all inheritable models (P<0.05) except in a recessive model (P=0.084). In the stratification analysis by potential confounding variables, a significant association was observed between GNB3 c.825C>T polymorphism and overweight/obesity risk in males under an allelic model (P=0.008), a homozygous model (P=0.014), a recessive model (P=0.005), and a dominant model (P=0.049). And the results also showed that GNB3 c.825C>T polymorphism was significantly associated with overweight/obesity in subgroups of mean age less than 30years, consistent with HWE, and high-quality studies (P=0.027, P=0.043, P=0.040, respectively) under a recessive model, but not in other subgroups. Meta-regression also revealed that P value of HWE, publication year, and the quality scores of studies were the sources of heterogeneity in a recessive model and an allelic model. “Leave one out” sensitivity analyses indicated that the association was more significant after excluding some studies. The funnel plot and Egger's linear regression test and Begg's test revealed no apparent publication bias. ConclusionThis meta-analysis suggests that the presence of TT homozygote might be one of the genetic factors susceptible to overweight/obesity and that males or aged under 30years increase the genetic susceptibility.

Association of cytokine gene polymorphisms (IL‑6, IL‑12B, IL‑18) with Behcet's disease : A meta-analysis.

This study aims to investigate the association of cytokine gene polymorphisms with the risk of Behcet's disease (BD) via comprehensive meta-analysis. The Embase and PubMed databases covering the period from the earliest possible year to May2015 were searched. A total of 13eligible articles including 2,065BD patients and 1,559controls were recruited. Odds ratios (ORs) and 95 % confidence intervals (CIs) were used to assess the strength of the associations. Potential publication bias was evaluated using Egger's linear regression test. Meta-analysis indicated associations between IL‑6 rs1800795, IL‑12B rs3212227, and IL‑18 rs1946518 in all study subjects: IL‑18 rs1946518 in the dominant model (IL‑18 rs1946518: OR= 0.48, 95 % CI:0.34-0.70, P = 0.000) and the homozygote model (IL‑18 rs1946518: OR= 0.40, 95 % CI:0.25-0.65, P = 0.000); and IL‑6 rs1800795 and IL‑12B rs3212227 in the dominant model (IL‑6 rs1800795: OR= 0.53, 95 % CI:0.39-0.72, P = 0.000; IL‑12B rs3212227: OR= 1.26, 95 % CI:1.06-1.48, P = 0.007; IL‑18 rs1946518: OR= 0.46, 95 % CI:0.33-0.65, P = 0.000). No significant evidence for associations of IL‑18 rs187238 polymorphisms with BD susceptibility was detected. In summary, this meta-analysis finds that IL‑6 rs1800795 and IL‑18 rs1946518 polymorphisms decrease the risk of BD. However, IL‑12B rs3212227 increases BD susceptibility. Further large-scale investigation of this association is necessary.