The association between essential trace element mixture and cognitive function in Chinese community-dwelling older adults.

BACKGROUND: The evidence about the effect of essential trace element (ETE) mixture on cognitive function amongst older adults is limited. This study aims to evaluate the associations of single ETEs and ETE mixture with cognitive function using a representative sample of community-dwelling older adults in China. METHODS: A total of 3814 older adults were included in the study. Urinary concentrations of selenium (Se), vanadium (V), cobalt (Co), strontium (Sr), and molybdenum (Mo) were detected by inductively coupled plasma mass spectrometry. Cognitive function in older adults was assessed using the Chinese version of the Mini-Mental State Examination (MMSE). Linear regression and Bayesian kernel machine regression (BKMR) were performed to explore the associations of single ETEs and ETE mixture with cognitive function, respectively. RESULTS: Linear regression showed that urinary levels of Se and V were positively associated with MMSE scores in the adjusted single-element models. BKMR also showed marginally positive associations of Se and V with MMSE scores. Moreover, higher urinary levels of ETE mixture were significantly associated with increased MMSE scores in a dose-response pattern, and Se was the most important contributor within the mixture. Both Se and V demonstrated positive additive effects on the associations of other ETEs with MMSE scores, whereas Co had a negative additive effect. CONCLUSIONS: V and Se are positively associated with cognitive function, individually and as a mixture. ETE mixture exhibits a linear dose-response association with improved cognitive function, with Se being the most important component within the mixture. Mixture analyses rather than single ETE analyses may provide a real-world perspective on the relationship between ETE mixture and cognitive function. Further cohort studies are needed to clarify the association of multiple ETEs with cognitive function.

Meta-analysis of the mental health status of left-behind children in China.

The aims of this study were to systematically evaluate and comparatively analyse the mental health status of left-behind children (LBC) in China and to provide a scientific basis for mental intervention and healthy education for LBC. Six electronic databases were searched for studies (published from 1 January 2010 to 5 March 2018) of the mental health of LBC using the Mental Health Test scale. We only selected original articles that either reported the incidence of serious mental health status or the means and standard deviations of each factor score of the scale. The pooled rates and weighted mean difference were calculated. The results indicated that the incidence of serious mental health status of LBC is nearly 2.7 times higher than that of non-LBC. The scores for most of the factors analysed by the Mental Health Test of LBC were higher than those of non-LBC. In addition, the mental health status of left-behind girls is worse than that of left-behind boys. Except for impulsive tendency, there was no significant difference in the mental health status of LBC in primary and junior high schools. In terms of the different types of guardianship, the mental health status of LBC under a grandparent's guardianship and parental peer' guardianship is more serious than that of LBC under a single-parent guardianship. The mental health status of LBC is poor, particularly for left-behind girls. The primary mental problems faced by LBC are learning anxiety, social anxiety and physical symptoms. It is necessary to develop more targeted measures to prevent and manage LBC.

The resilience status of Chinese left-behind children in rural areas: a meta-analysis.

The resilience has become the main trend of the left-behind children's (LBC) mental health research. To evaluate the resilience status of Chinese LBC in rural areas, a meta-analysis was performed. Relevant studies were identified using electronic databases from 1990 to 2017. Pooled weighted mean difference (WMD) and 95% confidence interval (95% CI) were calculated with fixed and random effects models. A total of 14 cross-sectional studies with 9777 individuals were included in this meta-analysis. The results showed there was significant difference in the aspects of family support and RSCA (Resilience Scale for Chinese Adolescents) total score between LBC and non-left-behind children (NLBC). After stratification subgroup, significant difference in RSCA total score was also found in subgroup with sample size ≥700 and target population (LBC) between LBC and NLBC. In addition, there was no significant difference in resilience of male and female among LBC (P >0.05). We also found RSCA total score of LBC whose one parents migratingwere higher than both parents (P <0.05) and the time of parental migration (≤2 years) were higher than others (>2 years). In conclusion, more attention should be paid to the LBC, especially both parents migrating or parental migration (>2 years).

Systematic review and meta-analysis found higher levels of behavioural problems in male left-behind children aged 6-11 years.

AIM: Left-behind children (LBC) now account for more than 1 in 5 Chinese children, and they often suffer from behavioural problems when their parents leave their rural homes to seek work in urban areas. The primary aim of this meta-analysis was to compare the incidence rates and factor scores of behavioural problems in LBC, who now account for more than one-fifth of Chinese children, and non-LBC. METHODS: This systematic review and meta-analysis explored the children's characteristic behavioural problems using the Achenbach Child Behaviour Check List. A subgroup analysis was conducted to compare the different behavioural problems of LBC with different characteristics. The meta-analysis assessed 1405 papers and analysed 13 papers from 2007 to 2015, covering 10 264 LBC and 8909 non-LBC from 2 to 19 years of age. RESULTS: The incidence rates of behavioural problems were higher in LBC than non-LBC. The highest risks were noted in boys aged between 6 and 11 years of age, who were more likely to be withdrawn and be affected by somatic complaints, schizophreniform disorder, compulsive behaviour and depression. CONCLUSION: Interventions and policies are urgently needed to tackle behavioural issues among LBC, especially high-risk males aged 6-11 years.

Association between circulating leptin levels and multiple sclerosis: a systematic review and meta-analysis.

AIM: Leptin, synthesised by adipocytes, has been identified as a hormone that can influence inflammatory activity. Several studies have investigated leptin levels in patients with multiple sclerosis (MS), but the results are not consistent. This study aims to derive a more precise evaluation on the relationship between circulating leptin levels and MS. DESIGN: A comprehensive literature searched up to July 2017 was conducted to evaluate the association of circulating leptin levels and MS. The random-effect model was applied to calculate pooled standardised mean difference (SMD) and its 95% CI. MAIN OUTCOME MEASURES: Circulating leptin levels of patients with MS and healthy controls. RESULTS: Of 2155 studies identified, 33 met eligibility criteria and 9 studies with 645 patients with MS and 586 controls were finally included in the meta-analysis. Meta-analysis revealed that, compared with the healthy control group, the MS group had significantly higher plasma/serum leptin levels, with the SMD of 0.70% and 95% CI (0.24 to 1.15). Subgroup analyses suggested that the leptin levels of patients with MS were associated with region, age, study sample size, measurement type, gender and blood sample type. CONCLUSION: Overall, our study suggests that patients with MS have a significantly higher leptin level than in healthy controls. Further mechanism studies and longitudinal large cohort studies are still needed to further reveal the role of leptin in the pathogenesis of MS.

Effect of Cholesteryl Ester Transfer Protein Gene TaqIB Polymorphism on the Risk of Ischemic Stroke: A Meta-Analysis.

BACKGROUND: The association between cholesteryl ester transfer protein (CETP) TaqIB polymorphism and ischemic stroke (IS) risk has generated conflicting results. To investigate whether the TaqIB polymorphism of the CETP gene was associated with the risk of IS, a meta-analysis was performed. METHODS: Studies were retrieved by searching PubMed, Web of Science, the Chinese National Knowledge Infrastructure, the Chinese Wanfang Database, and the Chinese VIP Database before January 16, 2017. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were used to assess the association. Depending on the heterogeneity the fixed-effects model or the random-effects model was used. RESULTS: A total of 6 case-control studies were identified with 1494 cases and 1370 controls. Overall, an association of CETP TaqIB polymorphism with IS was found in the 4 genetic models (B2B2 versus B1B1: OR = .63, 95% CI = .51-.79, P < .001; B1B2 + B2B2 versus B1B1: OR = .75, 95% CI = .64-.87, P < .001; B2B2 versus B1B2 + B1B1: OR = .70, 95% CI = .57-.85, P < .001; B2 versus B1: OR = .78, 95% CI = .70-.87, P < .001). In the subgroup analysis by ethnicity, similar risks were also observed in Asian population. CONCLUSIONS: This meta-analysis indicates that CETP TaqIB polymorphism is associated with IS risk, and the B2 allele is a protective factor for IS.

The effect of contraceptive methods on reproductive tract infections risk: a cross-sectional study having a sample of 52,481 women.

OBJECTIVE: The aim of this study was to investigate the association between specific contraceptives use and reproductive tract infections (RTIs). STUDY DESIGN: Participants consisted of 52,481 rural married women of reproductive age identified from a cross-sectional study in Anhui Province of China. The questionnaire, gynecological examination, and laboratory inspection were used to collect data. The subgroup analysis was performed to estimate the effect of the specific contraceptives on the specific RTIs. RESULTS: A total of 49,970 (95.2 %) women used contraceptive methods and 31,390 (59.8 %) women had at least one RTI. Overall, use of intrauterine device (IUD), condom, female sterilisation, rhythm method, and oral contraceptive (OC) were associated with RTIs. In the subgroup analysis, IUD use was a risk factor for endocervicitis, bacterial vaginosis (BV), and trichomoniasis; condom, rhythm method, and OC were associated with endocervicitis; female sterilisation was associated with endocervicitis and trichomoniasis. Moreover, male sterilisation was associated with endocervicitis; withdrawal was a protective factor for endocervicitis and a risk factor for trichomoniasis; subdermal implant was associated with candidiasis and pelvic inflammatory disease (PID). CONCLUSIONS: All the contraceptive methods may lead to the RTIs. A properly assessment for contraceptive methods use is needed for female reproductive health.

Prevalence of Internet addiction and its association with social support and other related factors among adolescents in China.

A cross-sectional study design was applied amongst a random sample (n = 10158) of Chinese adolescents. Self-completed questionnaires, including demographic characteristics, Internet use situation, Youth Internet Addiction Test, Youth Social Support Rating Scale and Zung Self-rating Depression Scale were utilized to examine the study objectives. Among the study population, the prevalence rate of Internet addiction was 10.4%, with 1038 (10.2%) moderately and 21 (0.2%) severely addicted to the Internet. Results from the multivariate logistic regression analyses suggested that a variety of related factors have significant effects on Internet addiction (parental control, per capita annual household income, academic performance, the access to Internet, online activities). The correlation coefficients showed that Internet addiction was negatively correlated with social support and positively associated with depression. Social support had a significant negative predictive effect on Internet addiction. The mediating effect of depression between social support and Internet addiction was remarkable.

Methylenetetrahydrofolate reductase (MTHFR) polymorphism susceptibility to schizophrenia and bipolar disorder: an updated meta-analysis.

Previous studies examining the possible role of the methylenetetrahydrofolate reductase (MTHFR) polymorphisms in the development of schizophrenia (SZ) and bipolar disorder (BPD) have provided inconclusive findings, this meta-analysis was therefore designed to get a more reliable assessment. A total of 38 articles were identified through a search of electronic databases, up to 27 February 2014. Odds ratios (ORs) with 95% confidence interval (CIs) were calculated using random effects models. Meta-analysis showed that MTHFR C677T was significantly associated with SZ, the highest OR was found for the recessive model (for TT vs. CT + CC: OR = 1.34, 95% CI: 1.18-1.53); a marginal association of MTHFR C677T with increased risk of BPD has also been found for the recessive model (OR = 1.26, 95% CI: 1.00-1.59). Subgroup analysis by ethnicity indicated that the significant association with SZ and BPD existed among Asian and African populations, but not for the white. MTHFR A1298C was significant associated with SZ, the highest OR for the dominant model (OR = 1.13, 95% CI: 1.03-1.24). Subgroup analysis indicated a significant association with SZ existed in Asian populations, not among the white populations and no significant association was detected between the MTHFR A1298C and BPD in all groups. We conclude that MTHFR polymorphism is associated with SZ and BPD among Asian, African populations, but not the white.

Children in rural China enjoyed a significant increase in quality of life from 2009 to 2011.

AIM: Little is known about the long-term change in quality of life (QoL) among children in rural China. This study longitudinally examined changes and predictors of QoL among children in one rural county between 2009 and 2011. METHODS: We interviewed 816 children from seven to 16 years of age in 2009 and 2011 using a range of QoL tools. Multivariate forward stepwise linear regression analysis was used to examine the relationships between follow-up QoL and socio-demographic, family environment and psychosocial factors. RESULTS: Overall QoL scores improved significantly from 71.1 ± 14.6 to 72.8 ± 16.3 (p = 0.005). QoL was positively related to annual family income (ß = 0.14, p < 0.001) and baseline QoL (ß = 0.21, p < 0.001) and negatively related to older age (ß = -0.19, p < 0.001), being female (ß = -0.08, p = 0.011), being left in the care of family members by working parents (ß = -0.09, p = 0.004), negative coping styles (ß = -0.10, p = 0.005) and depression (ß = -0.11, p = 0.006). CONCLUSION: Quality of life significantly improved among children in rural China over a two-year period from 2009 to 2011. It was positively related to annual family income and baseline QoL and negatively related to older age, being female, being left in the care of family members by working parents, negative coping styles and depression.

Prevalence and associated factors of induced abortion among rural married women: a cross-sectional survey in Anhui, China.

AIM: This study aims to assess the prevalence of and factors associated with induced abortion among married women in rural areas of Anhui Province, China. MATERIAL AND METHODS: A multistage probability sampling method was used to identify a representative sample of 53,652 married women aged 18-49 years in rural areas of Anhui Province, China. All women were interviewed in the form of a standardized questionnaire. RESULTS: We found that 32.0% (16,800) of these women had had at least one induced abortion: 21.1% (11,090) of women had had one; 7.6% (3976) of women had had two; and 4.1% (1734) of women had had at least three. The number of induced abortions per 100 pregnancies was found to be 22.0. Multivariate analysis showed that education, the age of a woman at her first marriage, number of total births, number of total pregnancies, and contraceptive methods were significant predictors for induced abortion after controlling for women's current age, employment and family yearly income. CONCLUSION: The study shows that the prevalence of induced abortion is still very high among married women in rural China, and highly effective methods of contraception (sterilization, intrauterine device) decrease women's recourse to induced abortion.

Incidence and risk factors of bacterial vaginosis among pregnant women: a prospective study in Maanshan city, Anhui Province, China.

AIM: The aim of this study was to identify the incidence and risk factors of bacterial vaginosis among pregnant women. MATERIAL AND METHODS: Prospective data from a cohort of 668 pregnant women were used to identify potential risk factors for bacterial vaginosis during pregnancy by Cox proportional hazards regression. RESULTS: A total of 204 incident cases of bacterial vaginosis were diagnosed in 274.8 woman-years of follow-up. The bacterial vaginosis incidence rate was 0.74 per 1 woman-year and median prevalence during follow-up was 15.6%. In the adjusted model, changing underwear nearly everyday, miscarriage history, urinary tract infection during follow-up, husbands' education level, and concurrent trichomoniasis and candidiasis remained significantly associated with bacterial vaginosis (adjusted hazard ratio and 95% confidence interval were 1.87 [1.26-2.77]; 2.96 [1.96-4.47]; 2.41 [1.05-5.49]; 0.50 [0.32-0.77]; 1.82 [1.02-3.25]; 1.88 [1.30-2.70], respectively). CONCLUSION: Bacterial vaginosis during pregnancy can be affected by many factors, and some are indirectly acting factors. Further prospective studies that include a larger sample size and more information on the development of bacterial vaginosis are needed.

Change and associated factors of self-esteem among children in rural China: A two-year longitudinal study.

Childhood has been targeted as an especially important period for self-esteem formation. The aim of this study is to examine the change and associated factors of self-esteem among children in rural China. A two-year longitudinal study was conducted with a general elementary and secondary school population in Anhui Province, China including 816 children aged between 7 and 16 years. Generalized estimating equation (GEE) was used to examine relationships between low self-esteem and socio-demographic, family environment, and psychosocial factors. On average, self-esteem level among children was increased across three assessments. Multivariable analysis (GEE) showed that low self-esteem in children was clearly associated with male gender (OR = 1.45, 95%CI = 1.12-1.89), moderate and severe family dysfunction (OR = 1.88, 95%CI = 1.40-2.51; OR = 1.88, 95%CI = 1.25-2.83, respectively), quality of life (OR = .97, 95%CI = .96-.98), depression (OR = 1.89, 95%CI = 1.32-2.70), anxiety (OR = 2.05, 95%CI = 1.51-2.77), positive coping styles (OR = .91, 95%CI = .89-.94), and negative coping styles (OR = 1.05, 95%CI = 1.03-1.07). Self-esteem is a dynamic rather than a static construct during childhood. Low self-esteem among children was associated with a number of socio-demographic, family environment, and psychosocial factors. Further studies exploring the pathways and mechanisms by which the effect of these factors impact on self-esteem among children are warranted.

Association of microtubule associated protein tau/Saitohin (MAPT/STH) MAPT_238bp/STH Q7R polymorphisms and Parkinson's disease: A meta-analysis.

BACKGROUND: The association between the extended tau haplotype (H1) and susceptibility to Parkinson's disease (PD) was controversial in previous studies. Therefore, we performed this meta-analysis to determine whether the additional polymorphisms in MAPT_238bp and STH Q7R which both included in H1 are associated with PD. METHODS: 19 studies were identified by a search of PubMed, PDGENE, Elsevier, Springer Link, CBM (Chinese Biomedical Database), CNKI (Chinese National Knowledge Infrastructure), VIP (Chinese), and Wanfang (Chinese) databases, up to May 2014. Additionally, manual retrieval of the references of identified articles was performed. Odds ratios (ORs) with 95% confidence interval (CI) were calculated using random effects model or fixed effects model based on the between-study heterogeneity. The subgroup analyses were performed by the ethnicity. All the statistical tests were conducted using Stata 9.0. RESULTS: Both of MAPT_238bp/STH Q7R polymorphisms had a significant association with PD risk in all genetic models. Subgroup analyses by ethnicity showed that the association between MAPT_238bp polymorphism and PD existed in Caucasian populations. CONCLUSIONS: The results of this meta-analysis suggested that MAPT_238bp/STH Q7R polymorphisms might modulate the risk of PD susceptibility. Certainly, additional well-designed studies are required to confirm these findings.

Cytochrome P450 1A1 (CYP1A1) polymorphism and susceptibility to esophageal cancer: an updated meta-analysis of 27 studies.

Cytochrome P450 1A1 (CYP1A1) polymorphisms are known to play a crucial role in the development and metastasis of malignant diseases including esophageal cancer. However, the results of previous studies investigating the association between CYP1A1 polymorphisms and esophageal cancer risk have been inconsistent. This meta-analysis of 27 eligible studies, encompassing 4,215 esophageal cancer cases and 6,339 control subjects, pooled the odds ratios (ORs) with corresponding 95 % confidence intervals (95 % CI) to assess this association. The effects of ethnicity (Caucasian and Asian) and histopathology type (esophageal squamous cell carcinoma and esophageal adenocarcinoma) were considered in subgroup analyses. A significant association was observed between the CYP1A1 Ile/Val gene polymorphism and esophageal cancer in all of the genetic models (Ile/Val vs. Ile/Ile, OR = 1.41, 95 % CI = 1.25-1.58; Val/Val vs. Ile/Ile, OR = 1.94, 95 % CI = 1.34-2.82; Ile/Val + Val/Val vs. Ile/Ile, OR = 1.49, 95 % CI = 1.33-1.66). The subgroup analysis based on ethnicity showed that the association between the CYP1A1 Ile/Val polymorphism and esophageal cancer existed in Asian and Caucasian populations. However, no association was observed between the CYP1A1 MspI polymorphism and esophageal cancer in either subgroup or in the overall population. These results suggested that the CYP1A1 Ile/Val polymorphism was associated with an increased risk of esophageal cancer, whereas the CYP1A1 MspI polymorphism may not have increased susceptibility to esophageal cancer. Further studies are required to confirm these findings.

Association of HTR2A T102C and A-1438G polymorphisms with susceptibility to major depressive disorder: a meta-analysis.

Serotonin 2A receptor (HTR2A) gene was implicated to be associated with major depressive disorder (MDD) susceptibility due to its role of key neurotransmitter in many physiologic processes. A great number of related studies reported in different populations have emerged. The results of these studies, however, have been inconsistent and thereby definite conclusions are difficult to establish. With the cumulative data in recent years, it was necessary to carry out a comprehensive analysis of previous findings. Electronic databases were systematically searched for studies published before May 2013. Pooled odds ratios (OR) and 95 % confidence interval (CI) were estimated under three different genetic models. Subgroup and sensitivity analyses were also performed. A total of 21 studies, 3,299 patients and 4,092 controls, met the selection criteria. 15 studies included HTR2A T102C polymorphism (with a total of 2,409 patients and 3,130 controls), and 9 studies included HTR2A A-1438G polymorphism (with a total of 1,510 patients and 2,281 controls). Our results showed that no significant association of MDD susceptibility with T102C polymorphism was found in allelic analysis and genotypic analysis (For T vs. C: OR = 1.06, 95 % CI = 0.95-1.18, P = 0.307; For TT + TC vs. CC: OR = 1.07, 95 % CI = 0.90-1.28, P = 0.451; For TT vs. TC + CC: OR = 1.08, 95 % CI = 0.95-1.22, P = 0.235). With respect to A-1438G polymorphism, however, carriers with A allele tend to suffer from MDD (AA + AG vs. GG: OR = 1.20, 95 % CI = 1.02-1.43, P = 0.030). When stratified by race for T102C polymorphism and A-1438G polymorphism of the HTR2A, we found no significant association. In conclusions, our study suggests that the A allele of A-1438G polymorphism might play a role in susceptibility to MDD. On the contrary, T102C polymorphism does not seem to be capable of modifying MDD risk.

Left-behind children in rural China experience higher levels of anxiety and poorer living conditions.

AIM: The number of rural Chinese parents who leave their children with family members to work in the cities has increased dramatically over the last decade. This study compared the social anxiety of left-behind children (LBC) and children not left behind (non-LBC). METHODS: We investigated 1694 LBC and 1223 non-LBC, aged seven to 17 years, in a Chinese province using a structured questionnaire that included questions about socio-demographic characteristics, social anxiety, family function, quality of life, neglect and physical abuse. RESULTS: LBC displayed higher social anxiety scores, more neglect, lower parental educational level, lower quality of life, lower family function and lower prevalence of physical abuse than non-LBC. Multiple linear regression models showed that higher Social Anxiety Scales for Children (SASC) scores in LBC were clearly associated with lower quality of life, poorer family function, physical abuse, being female, having more siblings and minorities. In non-LBC, they were associated with lower quality of life, poorer family function, neglect, being female and physical abuse. CONCLUSION: LBC have a relatively higher level of social anxiety and poorer living conditions than non-LBC, and there are differences in social anxiety, and its relevant factors, between the two groups.

Dietary pattern and risk of hyperuricemia: an updated systematic review and meta-analysis of observational studies.

Objectives: The associations of posteriori dietary patterns with the risk of hyperuricemia (HUA) are contradictory. Several fair-quality observational studies with inconsistent results have been published following a prior review. Herein, we carried out an updated systematic review and meta-analysis to quantitatively analyze the aforementioned relationships. Methods: Our analysis protocol has been registered with PROSPEPO (Number: CRD42022376745). English publications were searched in Embase, PubMed, and Web of Science from inception to January 1, 2024. Summary odds ratio (OR) and 95% confidence intervals (CIs) were calculated by a random-effects model. We also conducted subgroup, sensitivity, and meta-regression analyses and publication bias assessments. Results: Thirteen studies with a total of 163,192 participants were included in the current meta-analysis. Our finding revealed that the plant-based pattern was linked with a 17% decreased risk of HUA (OR = 0.83, 95%CI = 0.72-0.94, I2 = 72.9%, n = 10). There was no evidence of publication bias in the present analysis. The results of subgroup analyses were generally consistent with the main findings. In meta-regression analyses, no evidence of heterogeneity was detected in the subgroups. Furthermore, our analyses indicated that the animal-based food pattern (OR = 1.36, 95%CI = 1.25-1.47, I2 = 26.7%, n = 11) and sweet food pattern (OR = 1.24, 95%CI = 1.06-1.46, I2 = 0, n = 2) was related to an increased risk of HUA. Conclusion: The plant-based pattern is inversely correlated with HUA risk, whereas animal-based food patterns and sweet food patterns are positively correlated with HUA risk.

The role of preexisting diabetes mellitus on incidence and mortality of endometrial cancer: a meta-analysis of prospective cohort studies.

OBJECTIVE: The results of cohort studies are controversial regarding the association between preexisting diabetes mellitus (DM) and the risk of endometrial cancer (EC) incidence and mortality. The aim of this meta-analysis was to assess whether an association exists between them in prospective studies. METHODS: The PubMed and EMBASE database were searched for prospective cohort studies of preexisting DM on EC occurrence, mortality outcomes, updated up to June 2012. Data were independently extracted by 2 investigators using a standardized protocol. Summary relative risks (SRRs) with 95% confidence intervals (CIs) were estimated by the use of fixed-effect or random-effect models. Between-study heterogeneity was investigated using χ(2)-based Cochran Q statistic test and I statistics. RESULTS: A total of 21 cohort studies (20 articles) involving 12,195 incident cases and 575 deaths caused by EC were included in the analysis. Among these, 15 studies reported the risk of EC incidence, and 6 studies reported risk of EC mortality. The meta-analysis showed that DM was associated with an increased incidence of EC (SRR, 1.81; 95% CI, 1.38-2.37; test for heterogeneity: Q = 280.96, P < 0.001, I(2) = 95.4%), compared with individuals without diabetes or the general population. Subgroup analyses were conducted by geographical region, study design, year of publication, diabetes ascertainment, type of DM, and adjustments for some variables, and the positive association between DM and risk of EC was consistently observed in each subgroup. Sensitivity analyses also showed that no single study significantly influenced the pooled relative risk. No significant publication bias (P = 0.173) was found. Diabetes mellitus was not positively associated with EC mortality (SRR, 1.23; 95% CI, 0.80-1.90; test for heterogeneity: Q = 11.95, P = 0.035, I(2) = 58.2%). CONCLUSIONS: This meta-analysis of cohort studies suggests that there is a significant association between DM and increased risk of EC incidence but no increased risk of EC mortality.

PADI4 polymorphisms and susceptibility to rheumatoid arthritis: a meta-analysis.

The objective of the study was to investigate the association between peptidylarginine deiminase 4 (PADI4) polymorphism and susceptibility to rheumatoid arthritis (RA). An electronic searching strategy was employed to collect relevant studies on the association between PADI4 polymorphism and susceptibility to RA. The odds ratio (OR) with the 95 % confidence interval (95 % CI) was used to evaluate the RA risk presented by PADI4 polymorphism. Fixed or random effects models were selected based on heterogeneity. Publication bias was assessed using funnel plots, Begg's test, and Egger's test. A total of 27 studies from 21 articles were included. Six gene loci (padi4_94, 104, 92, 90, 89, and 100) were chosen for the meta-analysis. The pooled ORs (95 % CI) for allele 2 versus 1 were 1.08 (1.05-1.12), 1.17 (1.12-1.23), 1.26 (1.18-1.36), 1.17 (1.10-1.24), 1.30 (1.17-1.44), and 1.25 (1.11-1.40), respectively. All six SNPs were significantly associated with RA in Asian populations. Three SNPs (PADI4_104, 90, 89) showed significant associations, while the other three SNPs (PADI4_94, 92, 100) exhibited no associations in the European population. A dose-response relationship between allele 2 of PADI4 and the risk of RA was also identified. In conclusion, this meta-analysis suggests that PADI4 polymorphisms represent a significant risk factor for RA, especially in Asians.