A systematic literature review of observational studies of the bilateral association between diabetes and migraine.

BACKGROUND AND AIM: To conduct a systematic literature review and synthesize data from all epidemiological studies investigating the association between diabetes and migraine in adults. METHOD AND MATERIAL: Electronic databases, including Web of Science, PubMed and Scopus in addition to Google Scholar search engine were systematically searched up to Jun 2020 to identify studies reporting the diabetes-migraine association. RESULTS: A total of 15 studies were selected which were published from 2012 to 2019. Five out of 15 studies assessed the presence of migraine in diabetic subjects, while nine studies assessed the presence of diabetes in migraine subjects. The cohort study reported a hazard ratio for diabetes of 1.06 (95% confidence interval (CI): 0.91-1.24) for women with migraine with aura, 1.01 (95% CI: 0.89-1.16) for women without aura, and 1.13 (95% CI: 0.98-1.3) for women with a migraine history, compared with women with no history of migraine. Due to the high degree of heterogeneity, and the lack of statistical estimates of the association in several of the reviewed studies, meta-analysis of the available data was not possible. CONCLUSION: This study is the first review to examine the association between diabetes and migraine. Further longitudinal studies are required to clarify the migraine-diabetes association. There is also a clear need for more studies with larger sample sizes and similar methodologies in order to provide necessary information to conduct a meta-analysis.

Association between dietary total antioxidant capacity and breast cancer: a case-control study in a Middle Eastern country.

OBJECTIVE: The aim of this study was to determine the relationship between dietary total antioxidant capacity (dTAC) and risk of breast cancer among Iranian women. DESIGN: In this hospital-based case-control study, dietary intake of participants was collected using a 168-item validated FFQ. Dietary TAC was assessed using FRAP assay considering. Logistic regression was used to obtain ORs for breast cancer across quartiles of dTAC. SETTING: Cancer Institute, Iran. PARTICIPANTS: We included 412 women with pathologically confirmed breast cancer and 456 apparently healthy controls. RESULTS: Mean dTAC was 11·3 ± 5·8 for cases and 12·1 ± 7·9 for controls. A trend towards significant inverse association was seen between dTAC and odds of breast cancer in the whole population; such that after controlling for several potential confounders, individuals in the highest quartile of dTAC were 0·39 times less likely to have breast cancer than those in the lowest quartile (0·61; 95 % CI: 0·38, 0·99, P < 0·05). In the stratified analysis by menopausal status, we found that postmenopausal women with the greatest dTAC had lower odds for breast cancer, compared with those with the lowest dTAC (0·47; 95 % CI: 0·24, 0·93, P < 0·05). This association strengthened after additional adjustment for BMI (0·28; 95 % CI: 0·11, 0·72, P < 0·05). No significant association was seen between dTAC and odds of breast cancer in premenopausal women. CONCLUSIONS: We found that dietary TAC was inversely associated with risk of breast cancer, in particular among postmenopausal women. Prospective cohort studies are needed to confirm these findings.

Association of physical activity, body mass index and reproductive history with breast cancer by menopausal status in Iranian women.

BACKGROUND: The incidence rate of breast cancer (BC) is increasing in low- and middle-income countries (LMICs), including Iran. We investigated the association between BC risk and physical activity (PA), body mass index (BMI), and reproductive history among Iranian women. METHODS: We conducted a large hospital-based case-control study and compared 958 BC cases with 967 controls at the Cancer Institute of Iran during 2011-2016. We used multiple logistic regression models and adjusted for potential confounders to estimate odds ratios (ORs) and 95% confidence intervals (95%CIs) for the associations between BC and different risk factors, including low physical activity. RESULTS: Women with high levels of physical activity had a lower risk of BC compared to those who were inactive (OR = 0.55, 95%CI: 0.41, 0.75). In premenopausal women, the association was observed only in normal-weight women (OR = 0.31, 95%CI: 0.13, 0.75), while it was limited to obese women in the postmenopausal group (OR = 0.29, 95%CI: 0.12, 0.66). We found a high risk of postmenopausal BC among overweight (OR = 1.69; 95%CI: 1.01, 2.81) and obese women (OR = 1.9; 95%CI: 1.14, 3.14) compared to women with a normal BMI. We observed an inverse association among postmenopausal women who had between three and five children (OR = 0.31, 95%CI 0.14, 0.64) and more than six children (OR = 0.21, 95%CI 0.12, 0.42) compared to nulliparous women. CONCLUSIONS: Low levels of physical activity, low parity, and being overweight or obese were major risk factors for BC. For the first time, we report a strong association between physical activity and BC risk in Iranian women.

Discriminatory Accuracy of the Gail Model for Breast Cancer Risk Assessment among Iranian Women.

BACKGROUND: The Gail model is the most well-known tool for breast cancer risk assessment worldwide. Although it was validated in various Western populations, inconsistent results were reported from Asian populations. We used data from a large case-control study and evaluated the discriminatory accuracy of the Gail model for breast cancer risk assessment among the Iranian female population. METHODS: We used data from 942 breast cancer patients and 975 healthy controls at the Cancer Institute of Iran, Tehran, Iran, in 2016. We refitted the Gail model to our case-control data (the IR-Gail model). We compared the discriminatory power of the IR-Gail with the original Gail model, using ROC curve analyses and estimation of the area under the ROC curve (AUC). RESULTS: Except for the history of biopsies that showed an extremely high relative risk (OR=9.1), the observed ORs were similar to the estimates observed in Gail's study. Incidence rates of breast cancer were extremely lower in Iran than in the USA, leading to a lower average absolute risk among the Iranian population (2.78, ±SD 2.45). The AUC was significantly improved after refitting the model, but it remained modest (0.636 vs. 0.627, ΔAUC = 0.009, bootstrapped P=0.008). We reported that the cut-point of 1.67 suggested in the Gail study did not discriminate between breast cancer patients and controls among the Iranian female population. CONCLUSION: Although the coefficients from the local study improved the discriminatory accuracy of the model, it remained modest. Cohort studies are warranted to evaluate the validity of the model for Iranian women.

Trend and Seasonal Patterns of Injuries and Mortality Due to Motorcyclists Traffic Accidents; A Hospital-Based Study.

OBJECTIVE: To investigate trend and seasonal pattern of occurrence and mortality of motorcycle accidents in patients referred to hospitals of Isfahan. METHODS: This cross-sectional study was carried out using traffic accidents data of Isfahan province, extracted from Ministry of Health (MOH) database from 2006 to 2010. During the study period, 83648 people injured due to motorcycle traffic accidents were referred to hospitals, all of them entered in the study. Logistic regression model was used to calculate the hospital mortality odds ratio, and Cochrane-Armitage test was used for assessment of linear trend. RESULTS: During the study period, the hospital admission for motorcycle accident was 83,648 and 89.3% (74743) of them were men. Mean age in accidents time was 26.41±14.3 years. The injuries and death sex ratio were 8.4 and 16.9, respectively. Lowest admission rate was during autumn and highest during summer. The injury mortality odds ratio was 1.01 (CI 95% 0.73-1.39) in the Spring, 1.34 (CI95% 1.01-1.79) in summer and 1.17 (CI95% 0.83-1.63). It was also calculated to be 2.51 (CI95% 1.36-4.64) in age group 40-49, 2.39 (CI95% 1.51-5.68) in 50-59 and 4.79 (CI95% 2.49-9.22) in 60-69 years. The mortality odds ratio was 3.53 (CI95% 2.77-4.5) in rural place, 1.33 (CI95% 1.15-1.54) in men, and 2.44 (CI95% 2.09-2.85) in the road out of town and village. In addition, trend of motorcycle accidents mortality was increasing (p<0.001). CONCLUSION: Motorcycle accidents injuries are more common in men, summer, young age and rural roads. These high risk groups need more attention, care and higher training.

The Trend in Histological Changes and the Incidence of Esophagus Cancer in Iran (2003-2008).

BACKGROUND: Esophageal cancer is the sixth cause of death in the world, there was a lack of population-based information on the trend and incidence rate of esophagus cancer, so this study aimed to determine the incidence and pathological changes of esophagus cancer in Iran. METHODS: In this study, data were extracted from annual cancer registry reports of Iranian ministry of health between 2003 and 2008. Standardized incidence rates were calculated using the world standard population, and incidence rate was calculated by age groups, sex, and histological type. Data on epidemiologic trend and histology were analyzed using Joinpoint software package. RESULTS: In this study, there were 18,177 recorded cases of esophagus cancer. Of all cases, 45.72% were females and 54.28% were males. Sex ratio was 1.19. The most common histological types related to squamous cell carcinoma NOS and adenocarcinoma NOS were 64.53% and 10.37%, respectively. The trend of annual changes of incidence rate significantly increased in both sexes. The annual percentage changes, the incidence rate was 7.9 (95% confidence interval [CI]: 3.3-12.6) for women and 9.6 (95% CI: 6.0-13.2) for men. The histology type of SCC, large cell, nonkeratinizing and SCC, keratinizing and SCC, NOS had a significant decreasing trend in total population (P < 0.05). CONCLUSIONS: According to this study, the trend of age-standardized incidence rate of esophagus cancer in Iran is rising. Hence, to prevent and control this cancer, it is necessary to investigate related risk factors and implement prevention programs in Iran.