Obesity and the Risk of Colonic Diverticulosis: A Meta-analysis.

BACKGROUND: The possible relationship between obesity and the risk of colonic diverticulosis has been suggested by recent epidemiologic studies, although the results were inconsistent. OBJECTIVE: This systematic review and meta-analysis was conducted to summarize all of the available data. DATA SOURCES: A comprehensive literature review was conducted using the MEDLINE and EMBASE databases through January 2017. STUDY SELECTION: Studies that compared the risk of colonic diverticulosis among subjects with obesity versus those without obesity were included. MAIN OUTCOME MEASURES: Effect estimates from each study were extracted and combined together using a random-effect, generic inverse variance method. RESULTS: Of 2989 potentially eligible articles, 10 studies (9 cross-sectional studies and 1 prospective cohort study) with 53,520 participants met the eligibility criteria and were included in the meta-analysis. The risk of colonic diverticulosis in obese subjects was significantly higher than in those without obesity, with a pooled OR of 1.41 (95% CI, 1.20-1.65). The statistical heterogeneity was high, with an I of 75%. LIMITATIONS: High statistical heterogeneity and publication bias in favor of positive studies may have been present in this meta-analysis. CONCLUSIONS: A significant association between colonic diverticulosis and obesity was shown in this study. However, additional studies are still required to determine the causality. See Video Abstract at http://links.lww.com/DCR/A500.

Hyperuricemia is associated with nonalcoholic fatty liver disease activity score in patients with nonalcoholic fatty liver disease: a systematic review and meta-analysis.

BACKGROUND: Hyperuricemia is a significant risk factor for nonalcoholic fatty liver disease (NAFLD). It may also have an impact on the histologic severity of NAFLD. However, data on this association are limited. We conducted this meta-analysis to investigate the relationship of serum uric acid with liver histologic severity as determined by NAFLD activity score (NAS) in patients with NAFLD. PATIENTS AND METHODS: MEDLINE and EMBASE databases were searched through August 2016 for studies that investigated the association between hyperuricemia and NAS among patients with biopsy-proven NAFLD. Pooled odds ratio and 95% confidence interval were calculated using a random-effects model (generic inverse variance method). The between-study heterogeneity of effect size was quantified using the Q statistic and I. RESULTS: Five observational studies with 777 NAFLD patients were identified. Patients with NAFLD who had hyperuricemia had a high NAS (defined as score of ≥5) significantly more often than did those without hyperuricemia with a pooled odds ratio of 2.17 (95% confidence interval: 1.51-3.12). The statistical heterogeneity was low, with I of 16% (Pheterogeneity=0.31). CONCLUSION: In patients with NAFLD, hyperuricemia is associated with a higher degree of histological liver damage. Further studies are required to establish the role of uric acid-lowering therapy among these patients.

Vitamin D and histologic severity of nonalcoholic fatty liver disease: A systematic review and meta-analysis.

BACKGROUND: NAFLD and vitamin D deficiency often coexist and epidemiologic evidence has shown that both of these conditions share several risk factors. Recent studies investigating the relationship between vitamin D levels and severity of NAFLD showed conflicting results. Thus we conducted a systematic review and meta-analysis to evaluate association between vitamin D and NAFLD histologic severity. METHODS: A comprehensive search of the databases of the MEDLINE and EMBASE was performed from inception through November 2016. Observational studies compared serum vitamin D levels among NAFLD patients with high and low histologic severity, which was determined by NAFLD activity score (NAS) and fibrosis score. We calculated pooled mean difference (MD) of 25-hydroxyvitamin D levels with 95% confidence intervals (CI) using random-effects model. RESULTS: Data were extracted from 6 studies involving 974 NAFLD patients. There was no difference in 25-hydroxyvitamin D levels among NAFLD patients with high NAS (score of ≥5) versus low NAS (pooled MD=-0.93, 95%CI -2.45 to 0.58, I2=0%) and also high fibrosis score (score of ≥3) versus low fibrosis score (pooled MD=0.88, 95%CI -2.65 to 4.42, I2=64%). CONCLUSIONS: Despite evidence implicating vitamin D in NAFLD pathogenesis, serum 25-hydroxyvitamin D may not be associated with NAFLD histologic severity.

Hyperuricemia is not associated with severity of liver fibrosis in patients with nonalcoholic fatty liver disease: a systematic review and meta-analysis.

BACKGROUND: Uric acid is a natural antioxidant. Previous studies have suggested a protective role of hyperuricemia against liver fibrosis among patients with nonalcoholic fatty liver disease (NAFLD). However, the results were conflicting. METHODS: MEDLINE and EMBASE databases were searched through August 2016 for studies that investigated the association between hyperuricemia and fibrosis stage among patients with biopsy-proven NAFLD. Pooled odds ratio and 95% confidence interval were calculated using a random-effects model, generic inverse variance method of DerSimonian and Laird. The between-study heterogeneity of effect size was quantified using the Q statistic and I. RESULTS: A total of five observational studies with 749 NAFLD patients were identified. Patients with NAFLD who had hyperuricemia were not significantly more likely or less likely to have advanced liver fibrosis (defined as fibrosis stage of ≥3) compared with patients with NAFLD who had normal serum uric with the pooled odds ratio of 0.72 (95% confidence interval: 0.34-1.53). The statistical heterogeneity was low with an I of 22% (Pheterogeneity=0.27). CONCLUSION: Significant protective role of hyperuricemia against the development of advanced liver fibrosis in patients with NAFLD was not observed in this meta-analysis.

Coronary artery disease in primary biliary cirrhosis: A systematic review and meta-analysis of observational studies.

AIM: To investigate the association between primary biliary cirrhosis (PBC) and risk of coronary artery disease (CAD). METHODS: We conducted a systematic review and meta-analysis of published observational studies that reported relative risks, odd ratios, hazard ratios or standardized incidence ratios with 95% confidence intervals (CI) comparing CAD risk in patients with PBC versus non-PBC controls. Pooled risk ratios and 95% confidence intervals were combined using a random-effect model and generic inverse variance of DerSimonian and Laird methods. RESULT: Four studies with 3362 patients with PBC were identified and included in our data analysis. The pooled risk ratio of CAD in patients with PBC was 1.57 (95% CI, 1.21-2.06). The statistical heterogeneity was low with an I(2) of 38%. CONCLUSION: Our study demonstrated a statistically significant increased risk of CAD among patients with PBC.

Risk of ischemic stroke in patients with polymyositis and dermatomyositis: a systematic review and meta-analysis.

Several chronic inflammatory disorders, such as rheumatoid arthritis and systemic lupus erythematosus, have been demonstrated to increase ischemic stroke risk, but the data on polymyositis (PM) and dermatomyositis (DM) remain unclear. We conducted a systematic review and meta-analysis of observational studies that reported odds ratio, relative risk, hazard ratio or standardized incidence ratio comparing ischemic risk in patients with PM/DM versus non-PM/DM participants. Pooled risk ratio and 95 % confidence intervals were calculated using a random-effect, generic inverse variance method of DerSimonian and Laird. Three cohort studies were identified and included in our data analysis. The pooled risk ratio of ischemic stroke in patients with PM/DM was 1.61 (95 % CI 1.28-2.02). The statistical heterogeneity of this meta-analysis was insignificant with an I (2) of 0 %. Our study demonstrated a statistically significant increased ischemic stroke risk among patients with PM/DM.