Sleep duration mediates the association between heavy metals and the prevalence of depression: an integrated approach from the NHANES (2005-2020).

Purpose: This study investigates the association between heavy metal exposure and the prevalence of depression, with the mediating role of sleep duration. Method: Our study investigated the association between heavy metal concentration and depression risk in the NHANES from 2005 to 2020. We used logistic regression analysis, WQS regression model and BKMR model to assess the association. Mediation analysis was performed to explore the role of sleep duration in heavy metal exposure-induced depression. Result: Of the 10,825 individuals included in this study, 705 (6.85%) were diagnosed with depression. We found a positive association between the cadmium (Cd), cobalt (Co), lead (Pb), antimony (Sb), wolfram (W) concentration and the prevalence of depression. Moreover, heavy metals mixtures were positively correlated with the prevalence of depression, with Cd identified as the main contributor in the WQS regression model (0.4654). Furthermore, sleep duration mediated the association between Cd, molybdenum (Mo), Pb, Sb, W exposure and prevalence of depression, explaining 3.12%, 15.84%, 18.24%, 9.56%, 3.68% of the effect. Conclusion: The findings affirm that heavy metal exposure is linked to higher depression incidence and that this relationship is partly mediated by sleep duration alterations. The study underscores the importance of environmental health monitoring and interventions aimed at reducing heavy metal exposure to mitigate its psychological impacts.

The Impact of Bariatric Surgery on Pancreatic Cancer Risk: a Systematic Review and Meta-Analysis.

A growing body of evidence suggests that bariatric surgery is associated with a reduced risk of some cancers. This meta-analysis aims to determine whether bariatric surgery affects pancreatic cancer risk. We conducted a comprehensive literature search of PubMed, Embase, and Web of Science databases. Fixed-effect models were used to estimate pooled data and presented as odds ratio (OR) and 95% confidence interval (CI). Heterogeneity was assessed using the Cochran Q test and I2 test. A total of 9 cohort studies involving 1,147,473 patients were included in the analysis. The pooled OR was 0.76 (95% CI = 0.64-0.90). The Cochran Q test and I2 test indicated only mild heterogeneity (P = 0.12, I2 = 38%). In the subgroup analyses, the pooled OR was 0.67 (95% CI = 0.54-0.82) for North America. In the subgroup analyses by mean follow-up time, the pooled OR was 0.46 (95% CI = 0.28-0.74) for less than 5 years. In conclusion, bariatric surgery has a positive effect on pancreatic cancer reduction, especially in North America. This effect may diminish or disappear with time.

The relationship between the use of metformin and the risk of pancreatic cancer in patients with diabetes: a systematic review and meta-analysis.

OBJECTIVE: We aim to evaluate the relationship between the use of metformin and the risk of pancreatic cancer in type 2 diabetes patients. METHOD: We systematically searched the observational studies on PubMed, Embase, Web of Science, Cochrane Library, clinicalrials.gov, and CNKI databases, extracted relevant data, combined the OR value and 95% CI using the random effect model, and conducted a sensitivity analysis, subgroup analysis, and meta-regression to evaluate the size and stability of this relationship. RESULT: Twenty-nine studies from twenty-four articles met our inclusion criteria, including more than 2 million subjects. Overall analysis showed that compared with no use of metformin, the use of metformin could reduce the risk of pancreatic cancer in patients with type 2 diabetes (OR = 0.82, 95% CI (0.69, 0.98)). Subgroup analysis showed that compared with the use of hypoglycemic drugs, the use of metformin could reduce the risk of pancreatic cancer in patients with type 2 diabetes (OR = 0.79, 95% CI (0.66, 0.94)). However, compared with no drugs or only diet therapy, metformin users might increase the risk of pancreatic cancer (OR = 2.19, 95% CI (1.08, 4.44)). Sensitivity analysis confirmed the stability of the study, and there was no significant publication bias. CONCLUSION: Compared with the no-use of metformin, metformin users with diabetes can reduce the risk of pancreatic cancer. More research is needed to prove it works.