The Impact of Urbanization on the Distribution of Spontaneous Herbaceous Plants in an Ancient City: A Pilot Case Study in Jingzhou, China.

Spontaneous herbaceous plants (SHPs) play an essential role in urban biodiversity. Research on the diversity of SHPs has profound implications for the conservation of urban biodiversity and green space management in the process of urbanization. We investigated the habitat, life form, and growth form of SHPs by combining samples and inspections in Jingzhou, in central southern China. Additionally, we chose three typical regions-Ji'nan, Gucheng, and Shashi-for the examination and comparison of biodiversity. The results showed that diverse habitats provided abundant living space for SHPs of different growth forms and life forms in Jingzhou. Water edges with higher humidity do not significantly support more SHP growth forms and life forms, except for pseudo-rosette, partial-rosette, and perennial plants. In addition, both wasteland and road gaps and slopes support significantly more SHP growth forms, including erect, tussock, and others. Wasteland supported the vast majority of species, both growth forms and life forms. In the diverse habitats, there are 352 plant species belonging to 70 families and 236 genera in Jingzhou (Ji'nan 184 species, Gucheng 157 species, and Shashi 127 species). Plant species diversity differed according to the level of management. The Ji'nan region had a large number of SHP species because of the less disruptive and milder management implemented in this region. SHPs show good performance and can provide wild landscape effects; therefore, they have the potential to be used in many urban landscaping applications. In the process of urbanization expansion, we should implement the concept of protection and coordinated development in new construction areas. Our study has important implications for the support of SHPs in urban areas.

The appropriate expression and coordination of glycolate oxidase and catalase are vital to the successful construction of the photorespiratory metabolic pathway.

Photorespiration has emerged as a hotspot in the evolution of photosynthesis owing to the energy loss during the process. To ensure the physiological functions of photorespiration such as light protection, H2O2 signaling, and stress resistance, separate the photorespiration glycolic acid flow, and minimize photorespiration loss, a balance must be maintained during the construction of photorespiratory metabolic branch. In this study, glycolate oxidase (GLO) and catalase (CAT) were introduced into potato (Solanum tuberosum) chloroplasts through the expression of fusion protein. Through the examination of phenotypic characteristics, photosynthesis, anatomical structure, and enzyme activity, the efficiency of the photorespiration pathway was demonstrated. The results showed that certain transgenic lines plants had shorter plant height and deformed leaves and tubers in addition to the favorable photosynthetic phenotypes of thicker leaves and larger and denser mesophyll cells. By Diaminobenzidine (DAB) staining analysis of the leaves, the intermediate H2O2 could not be decomposed in time to cause biomass decline and malformation, and the excessive glycolate shunt formed by the overexpression of the fusion protein affected other important physiological activities. Hence, the appropriate and coordinated expression of glycolate oxidase and catalase is essential for the establishment of photorespiration pathways in chloroplasts.

The Association Between Dietary Inflammatory Index and Cognitive Performance in Older Adults Aged 60 Years and Older.

Background: Neuroinflammation has been linked to the development of cognitive performance. Epidemiological evidence on dietary inflammatory potential and cognitive performance is scarce. We evaluated the association between dietary inflammatory index (DII) and cognitive performance in older adults. Methods: This study included adults aged 60 years or older from the 2011-2014 National Health and Nutrition Examination Survey. The DII scores were calculated based on 27 nutritional parameters. Cognitive performance was assessed with four cognitive tests: the Digit Symbol Substitution Test (DSST, n = 2,780), the Consortium to Establish a Registry for Alzheimer's Disease Word Learning (CERAD-WL, n = 2,859) and Delayed Recall (CERAD-DR, n = 2,857), and the Animal Fluency (AF, n = 2,844) tests. Restricted cubic splines and logistic regression were adopted to assess the associations. Results: Comparing the highest to lowest tertile of DII scores, the odds ratio (95% CI) of lower cognitive functioning was 1.97 (1.08-3.58) [P-trend = 0.02, per 1 unit increment: 1.17 (1.01-1.38)] on DSST, 1.24 (0.87-1.76) [P-trend = 0.24, per 1 unit increment: 1.09 (0.96-1.23)] on CERAD-WL, 0.93 (0.57-1.51) [P-trend = 0.74, per 1 unit increment: 1.02 (0.87-1.20)] on CERAD-DR, and 1.76 (1.30-2.37) [P-trend < 0.01, per 1 unit increment: 1.17 (1.05-1.29)] on AF. The above-mentioned associations were observed in both men and women. In non-linear dose-response analysis, the association between DII and lower cognitive functioning was not significant at lower DII scores up to 3.0, after which the association was significant and the curve rose steeply. Conclusion: Higher DII is associated with lower scores on DSST and AF tests in older adults.

Association between serum iron concentrations and cognitive impairment in older adults aged 60 years and older: A dose-response analysis of National Health and Nutrition Examination Survey.

Epidemiological evidence on peripheral iron and cognitive impairment in older adults is sparse and limited. Results on serum iron and cognitive impairment in older adults from the National Health and Nutrition Examination Survey have not been reported. Data on serum iron and cognitive impairment from individuals ≥ 60 years of age were obtained from the 2011-2014 NHANES (N = 3,131). Serum iron concentrations were determined with DcX800 method. Cognitive impairment was assessed with four cognitive tests: the Digit Symbol Substitution Test (DSST), the Animal Fluency (AF), the Consortium to Establish a Registry for Alzheimer's Disease Delayed Recall (CERAD-DR) and Word Learning (CERAD-WL) tests. Logistic regression and restricted cubic splines were adopted to explore the dose-response relationship between serum iron concentrations and cognitive impairment. Comparing the highest to lowest tertile of serum iron concentrations, the multivariate-adjusted odds ratios of scoring low on the DSST were 0.70 (0.49-1.00), 0.88 (0.65-1.20) for CERAD-WL, 0.65 (0.48-0.88) for CERAD-DR, and 0.78 (0.53-1.15) for AF. Stratified analyses by sex showed that the above-mentioned associations were mainly found in men; however, the interaction with sex was not significant. Dose-response analysis showed that relationships between serum iron and cognitive impairment evaluated by DSST and CERAD-DR were linear, respectively.

Associations between family characteristics and influenza vaccination coverage among children.

BACKGROUND: To assess the associations between family characteristics and influenza vaccination coverage among children. METHODS: Data were used from the National Health Interview Survey 2011-2016. RESULTS: The number of children ranged from 10 720 to 12 991 per year from 2011 to 2016. After adjustment for the high-risk status of influenza complications, sex, age, region, race and office visits of children, children of adults who received influenza vaccination were 3.83-4.79 times (the lowest and the highest odds ratios from 2011 to 2016) more likely to be immunized for influenza. Health insurance (1.36-1.61) was also associated with vaccination in children. However, the education level of family adults (0.59-0.79) and marital status of being widowed/divorced/separated (0.74-0.79) were negatively associated with vaccination uptake in children. The following characteristics were not major concerns with influenza vaccination in children: class of worker, years on the job, physical activity, drinking, smoking, hepatitis B immunization, number of family members aged ≥65 years and the ratio of family income to the poverty threshold. Overall, results from the pooled analysis (2011-2016) were consistent with the above-mentioned findings. CONCLUSIONS: Promoting parental influenza immunization and access to health insurance may be the most effective tools to promote the coverage of influenza vaccine among children.

Characteristics associated with human papillomavirus vaccination initiation and completion among young adults.

BACKGROUND: Human papillomavirus (HPV) vaccination has been recommended for young adults aged 18-26 years. METHODS: Data from the 2016 and 2017 National Health Interview Survey were pooled. RESULTS: The prevalence of HPV vaccination initiation (≥1 dose) was 32.54% in 2016 and 37.92% in 2017, and the prevalence of HPV vaccination completion (≥3 doses) was 17.05% in 2016 and 19.38% in 2017 among young adults aged 18-26 years. Being female sex (odds ratio: 4.74) was the leading indicator for receiving the HPV vaccine, followed by receipt of other recommended vaccines (pneumococcal, hepatitis B, and hepatitis A), begin born in the United States, being gay/lesbian, having a greater number of physician visits, being younger, not being married, living in the Northeast, ever having had a pap smear, higher education, being not Hispanic ethnicity, and having more physical activity. Meanwhile, being female sex (odds ratio: 7.23) was the leading indicator for completing the HPV vaccination, followed by receipt of other recommended vaccines (pneumococcal, hepatitis B, and hepatitis A), having a greater number of physician visits, being younger, being born in the United States, being gay/lesbian, living in the Northeast, and current drinking. CONCLUSIONS: HPV vaccination coverage remains low among young adults, and HPV vaccine coverage was associated with a number of characteristics.

Temporal Cross-Correlations between Ambient Air Pollutants and Seasonality of Tuberculosis: A Time-Series Analysis.

The associations between ambient air pollutants and tuberculosis seasonality are unclear. We assessed the temporal cross-correlations between ambient air pollutants and tuberculosis seasonality. Monthly tuberculosis incidence data and ambient air pollutants (PM2.5, PM10, carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), sulfur dioxide (SO2)) and air quality index (AQI) from 2013 to 2017 in Shanghai were included. A cross-correlogram and generalized additive model were used. A 4-month delayed effect of PM2.5 (0.55), PM10 (0.52), SO2 (0.47), NO2 (0.40), CO (0.39), and AQI (0.45), and a 6-month delayed effect of O3 (-0.38) on the incidence of tuberculosis were found. The number of tuberculosis cases increased by 8%, 4%, 18%, and 14% for a 10 µg/m3 increment in PM2.5, PM10, SO2, and NO2; 4% for a 10 unit increment in AQI; 8% for a 0.1 mg/m3 increment in CO; and decreased by 4% for a 10 µg/m3 increment in O3. PM2.5 concentrations above 50 µg/m3, 70 µg/m3 for PM10, 16 µg/m3 for SO2, 47 µg/m3 for NO2, 0.85 mg/m3 for CO, and 85 for AQI, and O3 concentrations lower than 95 µg/m3 were positively associated with the incidence of tuberculosis. Ambient air pollutants were correlated with tuberculosis seasonality. However, this sort of study cannot prove causality.

Characteristics associated with hepatitis B vaccination initiation and completion among adults traveling to a country of high or intermediate endemicity.

BACKGROUND: The hepatitis B (HepB) vaccine is recommended for adults traveling to a country of high or intermediate endemicity. METHODS: Data from the 2016 and 2017 National Health Interview Surveys were pooled. RESULTS: The weighted prevalence of HepB vaccination initiation (≥1 dose) was 37.67% in 2016 (weighted number: 30,581,813/81,192,803) and 40.20% in 2017 (weighted number: 34,509,993/85,849,427). The weighted prevalence of HepB vaccination completion (≥3 doses) was 29.97% in 2016 (weighted number: 24,331,218/81,192,803) and 31.78% in 2017 (weighted number: 27,282,536/ 85,849,427). Characteristics independently associated with HepB vaccination initiation (in descending order by odds ratio) included age, receipt of influenza vaccine, education, ever having lived with someone with hepatitis, class of worker, number of physician visits in the past 12 months, ratio of family income to the poverty threshold, region, sexual orientation, gender, heath insurance, computer use, physical activity, and Hispanic ethnicity. Similar results were found in the analysis for HepB vaccination completion, except that subjects born in the United States showed a higher likelihood of HepB vaccination completion. CONCLUSIONS: HepB vaccination initiation and completion were associated with a number of characteristics that can be utilized to develop strategies to increase HepB vaccination coverage among adults traveling to a country of high or intermediate endemicity.

Characteristics associated with hepatitis A vaccination initiation and completion among adults traveling to a country of high or intermediate endemicity.

BACKGROUND: Hepatitis A (HepA) vaccine is recommended for adults traveling to a country of high or intermediate endemicity. METHODS: The data from the 2016 and 2017 National Health Interview Survey were pooled in this analysis, and the weighted logistic regression model was adopted. RESULTS: Characteristics independently associated with HepA vaccination initiation (≥1 dose) (in descending order by odds ratio) include age, receipt of pneumococcal and influenza vaccine, education, sexual orientation, region, number of physician visits in the past 12 months, physical activity, marital status, computer use, ratio of family income to the poverty threshold, Hispanic ethnicity, and class of worker. Characteristics independently associated with HepA vaccination completion (≥2 doses) (in descending order by odds ratio) include age, receipt of pneumococcal and influenza vaccine, sexual orientation, education, region, marital status, number of physician visits in the past 12 months, ratio of family income to the poverty threshold, physical activity, Hispanic ethnicity, and computer use. CONCLUSIONS: HepA vaccination initiation and completion was associated with a number of characteristics, which can be used to develop strategies to increase HepA vaccination coverage among adults traveling to a country of high or intermediate endemicity.

Influenza vaccination coverage among US children from 2004/2005 to 2015/2016.

BACKGROUND: Quantify the influenza vaccine coverage is essential to identify emerging concerns and to immunization programs for targeting interventions. METHODS: Data from National Health Interview Survey were used to estimate receipt of at least one dose of influenza vaccination among children 6 months to 17 years of age. RESULTS: Influenza vaccination coverage increased from 16.70% during 2004/2005 to 49.43% during 2015/2016 (3.18% per year, P < 0.001); however, the coverage increased slightly after 2010/2011. Children at high risk of influenza complications had higher influenza vaccination coverage than non at-risk children. Boys and girls had similar coverage each year. While the coverage increased from 2004/2005 to 2015/2016 for all age groups, the coverage decreased with age each year (-0.64 to -1.58% per age group). There was a higher and rapid increase of coverage in Northeast than Midwest, South and West. American Indian or Alaskan Native and Asian showed higher coverage than other race groups (White, Black/African American, Multiple race). Multivariable analysis showed that high-risk status and region had the greatest associations with levels of vaccine coverage. CONCLUSIONS: Although the influenza vaccination coverage among children had increased remarkably since 2004/2005, establishing more effective immunization programs are warranted to achieve the Healthy People 2020 target.

Characteristics associated with influenza vaccination uptake among adults.

BACKGROUND: Annual influenza vaccination has been recommended for all adults since 2010. This study aimed to identify characteristics associated with influenza vaccination among adults. METHODS: Data from the National Health Interview Survey from 2011 to 2016 were analyzed. RESULTS: Influenza vaccination coverage among adults increased from 38.28% in 2011 to 44.75% in 2016 (1.50% per year on average). In multivariate analysis, the largest magnitude of association was found with pneumococcal vaccine (lowest and highest odds ratios from 2011 to 2016: 3.37-3.78), followed by physician visits ≥4 in the past 12 months (2.33-3.03), age ≥65 years (1.69-2.07), having a usual place for sick care (1.41-1.94), insurance coverage (1.52-1.79), hepatitis B vaccine (1.48-1.71), ratio of family income to the poverty threshold ≥4 (1.19-1.54), race of Asian (1.24-1.47), number of years on the job ≥21 (1.21-1.41), class of worker (Federal government: 1.23-1.32, State government: 1.15-1.38), high-risk conditions (1.13-1.26), physical activity ≥5 times/week (1.11-1.25) and being female (1.13-1.20). However, adults living in West, and adults of Black/African American, never married, high school education, self-employed and current smokers had lower vaccine uptake. CONCLUSIONS: Several characteristics were identified to be associated with influenza vaccination uptake, which could be useful for targeted efforts to improve influenza vaccination coverage among adults.

Blood pressure effects of adiposity in non-overweight children aged 6-17 years.

BACKGROUND: Obesity is a well-established risk factor of elevated blood pressure; however, the relationships between normal weight status and the risk of hypertension and pre-hypertension are not clear. AIM: The aim of this study is to describe the blood pressure effects of adiposity in non-overweight children. METHODS AND RESULTS: In total, 588 097 non-overweight children aged 6-17 years were included from the National Surveys on Students' Constitution and Health. A non-linear relationship was found between age- and gender-standardised body mass index (BMI) z-score and pre-hypertension and hypertension, respectively. The odds ratios and 95% confidence intervals [ORs (95% CIs)] of pre-hypertension were 0.61 (0.59-0.63), 0.67 (0.65-0.68), 0.83 (0.83-0.84), 1.00 (reference), 1.13 (1.12-1.14), 1.18 (1.16-1.20) and 1.20 (1.18-1.22) for BMI z-scores of -1.2, -1.0, -0.5, 0 (reference), 0.5, 0.7 and 0.8, respectively. The ORs (95% CIs) of hypertension were 0.56 (0.54-0.58), 0.62 (0.61-0.64), 0.81 (0.80-0.82), 1.00 (reference), 1.17 (1.16-1.18), 1.23 (1.22-1.5) and 1.27 (1.24-1.29) for BMI z-scores of -1.2, -1.0, -0.5, 0 (reference), 0.5, 0.7 and 0.8, respectively. The above-mentioned associations were consistent in sub-group analysis by age, gender and height. CONCLUSIONS: Non-linear relationships of BMI z-scores with pre-hypertension and hypertension were found in non-overweight children. Interventions to control blood pressure are also important in non-overweight children.

Prevalence of pre-high blood pressure and high blood pressure among non-overweight children and adolescents using international blood pressure references in developed regions in China.

BACKGROUND: There is a lack of data on the prevalence of pre-high blood pressure (PreHBP) and high blood pressure (HBP), based on recent international blood pressure references, in non-overweight children and adolescents. AIM: To describe the prevalence of PreHBP and HBP in non-overweight children and adolescents in developed regions of China. SUBJECTS AND METHODS: In total, 588 097 non-overweight children and adolescents aged 6-17 years from the National Surveys on Chinese Students' Constitution and Health in 2015 were included. RESULTS: The prevalence of PreHBP was 13.41% and subjects in urban areas had a higher prevalence of PreHBP (14.14%) than those in rural areas (12.92%). Subjects in regions with a high (13.56%) or moderate (13.61%) socioeconomic status showed a higher prevalence of PreHBP than those in regions with a relatively low socioeconomic status (12.76%). A similar pattern was found for the prevalence of HBP, and the prevalence of HBP was 18.25% for all participants, 20.55% for subjects in urban areas, 16.71% in rural areas, 18.76% in high socioeconomic areas, 18.62% in moderate socioeconomic areas and 16.70% in relatively low socioeconomic areas. CONCLUSION: A large proportion of non-overweight children and adolescents had elevated blood pressure and there were urban-rural and socioeconomic disparities in the prevalence of elevated blood pressure.

Coffee consumption and risk of colorectal cancer: a dose-response analysis of observational studies.

Coffee consumption has been linked to risk of colorectal cancer theoretically, but the findings were conflicting from observational studies. Results from the recent meta-analysis suggested a moderate favorable effect of coffee consumption on colorectal cancer risk, especially for colon cancer. However, the relationship, if exists, between coffee consumption and colorectal cancer risk is unclear. Thus, the dose-response relationship was assessed by restricted cubic spline model and multivariate random-effect meta-regression. The results suggested that a significant association was found between coffee consumption and decreased risk of colorectal and colon cancer among subjects consuming ≥4 cups of coffee per day. A potential nonlinear relationship should be assessed before assuming a linear relationship.

GPX1 gene Pro200Leu polymorphism, erythrocyte GPX activity, and cancer risk.

A meta-analysis was conducted to assess the effect of glutathione peroxidase1 (GPX1) gene Pro200Leu (rs1050450) polymorphism on cancer risk. A comprehensive search was performed to identify all studies on the association of GPX1 gene Pro200Leu polymorphism with cancer risk. The fixed or random effect pooled measure was selected based on homogeneity test among studies. Heterogeneity among studies was evaluated using the I (2). Potential sources of between-study heterogeneity were explored by meta-regression and the sensitivity analysis. Publication bias was estimated using Egger's linear regression test. 35 published articles with 36 results were identified involving 16,920 cases and 19,946 controls. Results from the articles that both obeyed Hardy-Weinberg equilibrium in controls and met high quality design, showed no significant association of GPX1 gene Pro200Leu polymorphism with cancer risk in any of dominant (OR = 1.05, 95 %CI = 0.98-1.12), recessive (OR = 1.04 (0.95-1.13), and TT versus CC (OR = 1.05, 95 %CI = 0.97-1.15) models, and the findings were consistent considering the stratified analysis by cancer type. However, multivariate-adjusted ORs from articles that both obeyed Hardy-Weinberg equilibrium in controls and met high quality design, showed a significant association considering dominant (OR = 1.22, 95 %CI = 1.06-1.41), TT versus CC (OR = 1.16, 95 %CI = 1.02-1.32) models, and a marginally significant association was found considering TC versus CC (OR = 1.11, 95 %CI = 0.99-1.25) model. And compared with the CC genotype, the erythrocyte GPX activity was significantly lower for TT genotype: the standardized mean difference (SMD) = -0.37, 95 %CI = (-0.624, -0.118), and CT genotype: SMD = -0.19, 95 %CI = (-0.37, -0.002). The association of GPX1 gene Pro200Leu polymorphism with cancer risk might be influenced by confounders.

Dietary calcium intake, vitamin D levels, and breast cancer risk: a dose-response analysis of observational studies.

Results from the recent meta-analysis suggested a favorable effect of dietary calcium and vitamin D levels on breast cancer risk. However, the relationship of dietary calcium and vitamin D levels with breast cancer risk is unclear. Thus, the dose-response relationship was assessed by restricted cubic spline model and multivariate random-effect meta-regression. Results suggested that women might suffer from the lowest risk of breast cancer with dietary calcium intake of about 600 mg/day, dietary vitamin D intake of about 400 IU/day, and serum vitamin D levels of about 30 ng/ml.

Association of fish and n-3 fatty acid intake with the risk of type 2 diabetes: a meta-analysis of prospective studies.

Results from observational studies on the association of fish and n-3 fatty acid consumption with type 2 diabetes mellitus (T2DM) risk are conflicting. Hence, a meta-analysis was performed to investigate this association from cohort studies. A comprehensive search was then conducted to identify cohort studies on the association of fish and/or n-3 fatty acid intake with T2DM risk. In the highest v. lowest categorical analyses, the fixed or random-effect model was selected based on the homogeneity test among studies. Linear and non-linear dose-response relationships were also assessed by univariate and bivariate random-effect meta-regression with restricted maximum likelihood estimation. In the highest v. lowest categorical analyses, the pooled relative risk (RR) of T2DM for intake of fish and n-3 fatty acid was 1·146 (95 % CI 0·975, 1·346) and 1·076 (95 % CI 0·955, 1·213), respectively. In the linear dose-response relationship, the pooled RR for an increment of one time (about 105 g)/week of fish intake (four times/month) and of 0·1 g/d of n-3 fatty acid intake was 1·042 (95 % CI 1·026, 1·058) and 1·057 (95 % CI 1·042, 1·073), respectively. The significant non-linear dose-response associations of fish and n-3 fatty acid intake with T2DM risk were not observed. The present evidence from observational studies suggests that the intake of both fish and n-3 fatty acids might be weakly positively associated with the T2DM risk. Further studies are needed to confirm these results.

Association of serum ferritin with coronary artery disease.

BACKGROUND: Published results regarding the association of serum ferritin with coronary artery disease (CAD) were conflicting, thus a case-control study and a meta-analysis were performed to assess the association between serum ferritin and CAD risk. METHODS: A hospital-based case-control study was conducted with 258 CAD cases and 282 healthy controls. The restricted cubic spline (RCS) function with three knots was used to assess the concentration-risk association between serum ferritin and CAD risk. A meta-analysis was performed including 20 outcomes. Fixed or random effect pooled measure was selected on the basis of homogeneity test among studies. RESULTS: In our case-control study, compared with serum ferritin concentrations less than 200 µg/L as the reference, the trend of CAD risk increased by 4.2% for every 50 µg/L increase in serum ferritin (OR=1.042, 95% CI=0.946-1.147). In the meta-analysis and after excluding articles that were the key contributors to between-study heterogeneity, the standardized mean difference (SMD) of serum ferritin was associated with increased CAD risk (FEM: SMD=0.119, 95% CI=0.073-0.165). And the concentration-risk meta-analysis suggested that, for every 50 µg/L increase of serum ferritin, the risk of CAD increases by 2.4% (OR=1.024, 95% CI=1.001-1.048). CONCLUSION: These findings indicate that serum ferritin is weakly positively associated with CAD risk. This risk needs to be confirmed by further studies.

Association of total iron binding capacity with coronary artery disease.

OBJECTIVE: A case-control study and a meta-analysis were conducted to assess the association between total iron binding capacity (TIBC) and coronary artery disease (CAD) risk. METHODS: A hospital-based case-control study was conducted with 258 CAD cases and 282 healthy controls. Logistic regression was utilized to estimate odds ratio (OR) with 95% confidence interval (CI) and adjust potential confounders. Dose-response relation was investigated between TIBC and CAD risk by dividing TIBC concentration into quartiles. A meta-analysis was performed on the standardized mean difference (SMD) as well as OR. RESULTS: In our case-control study, TIBC was found associated with decreased CAD risk both in univariate (OR=0.981, 95% CI=0.975, 0.986) and multivariate (OR=0.979, 95% CI=0.972, 0.986) adjusted logistic regressions. The multivariate-adjusted OR for the highest quartile compared with the lowest quartile was 0.087 (95% CI=0.042, 0.181). After sensitivity analysis, the meta-analysis on SMD showed that TIBC was associated with decreased CAD risk (SMD=-0.211, 95% CI=-0.318, -0.104). The results of pooled measure on OR (OR=0.970, 95% CI=0.946, 0.995) were consistent with those of SMD analysis. CONCLUSION: A weak association was found between TIBC levels and decreased CAD risk, further investigations are necessary to clarify the dose-response relationship.

A dose-response meta-analysis of coffee consumption and bladder cancer.

BACKGROUND: A number of studies have examined the association between coffee consumption and risk of bladder cancer, but uncertainty about the dose-response relationship remains. MATERIALS AND METHODS: A comprehensive search was performed to identify all observational studies providing quantitative estimates between bladder cancer risk and coffee consumption. Dose-response relationship was assessed by restricted cubic spline model and bivariate random-effect meta-regression. RESULTS: 23 case-control studies with 7690 cases and 13,507 controls, and 5 cohort studies with 700 cases and 229,099 participants, met the inclusion criteria. Compared with non-drinkers and for case-control studies, the pooled smoking-adjusted RRs(95% CI) of bladder cancer were 1.07(1.02-1.13) for 1 cup/day, 1.15(1.05-1.26) for 2 cups/day, 1.22(1.08-1.38) for 3 cups/day, and 1.29(1.12-1.48) for 4 cups/day. For cohort studies, the pooled smoking-adjusted RRs of bladder cancer were 1.09(95% CI, 0.89-1.34) for 1 cup/day, 1.13(95% CI, 0.82-1.55) for 2 cups/day, 1.09(95% CI, 0.77-1.56) for 3 cups/day, and 1.01(95% CI, 0.69-1.48) for 4 cups/day. CONCLUSIONS: Although data from case-control studies suggested that coffee was a risk factor for bladder cancer, there was no conclusive evidence on this association because of inconsistencies between case-control and cohort studies.