Epidemiologic Reviews最新文献

High-density lipoprotein nHDL) is a highly heterogeneous lipoprotein with multiple physiological functions. However, observational studies present conflicting evidence regarding its association with various diseases. This study systematically summarizes evidence from Mendelian randomization (MR) studies to investigate the causal relationships between HDL-related biomarkers and a wide spectrum of disease outcomes. We systematically searched multiple databases up to November 2024. The causal relationship between HDL and 158 diseases was studied. Findings reveal that the role of HDL is highly disease-specific. Genetically predicted higher HDL levels are protective against the majority of circulatory and digestive system diseases. Conversely, they are associated with an increased risk of certain conditions, including breast cancer, intracerebral hemorrhage, and age-related macular degeneration. MR analyses revealed inconsistent and sometimes conflicting findings for several disease outcomes, notably including Alzheimer's disease. This review underscores the context-dependent nature of HDL's effects, which may be driven by factors like HDL particle heterogeneity and functional transformation into a pro-inflammatory state. Future research should move beyond concentration-based metrics to focus on HDL functionality and precise subtyping to fully understand its role in disease etiology.

Administrative data, including electronic health record (EHR) and claims data, are increasingly used to generate real-world evidence for epidemiologic research. Unlike clinical trials, which assess baseline conditions at the initial visit, observational studies using these data must define an appropriate lookback period to identify baseline characteristics. However, no established guidelines exist on the optimal length of lookback periods by clinical outcome. We conducted a scoping review, with a lens on methodological studies, to assess the frequency and variability of lookback periods used in epidemiologic studies. We searched PubMed for studies that employed lookback periods using EHR, claims data, or international registries. Our search yielded 262 studies spanning a broad range of clinical outcomes. We found that lookback periods varied significantly, ranging from 12 hours to 39 years, depending on the clinical outcome. The most common clinical areas included pharmacology, cardiovascular disease, cancer, and healthcare utilization. Our review underscores the need for tailored lookback periods based on the clinical context and suggests that a one-size-fits-all approach may be inadequate. Future research should focus on the impact of lookback periods on less-studied outcomes. This review provides a resource for researchers to make informed decisions on the appropriate lookback periods in epidemiologic studies utilizing administrative data.

Hysterectomy is the most frequently performed non-obstetric surgery in women. While women with disabilities face barriers to reproductive healthcare, little is known about their hysterectomy risk. The objective of this systematic review was to compare hysterectomy risk among women with and without disabilities. We searched MEDLINE, Embase, PsycInfo, and CINAHL Plus from inception to May 2024 using validated search strategies. We included peer-reviewed observational studies that compared hysterectomy in women with physical, sensory, cognitive, and intellectual or developmental disabilities to those without disabilities. Study characteristics and data were extracted using a standardized form, and the Newcastle Ottawa Scale (NOS) was used for quality assessment. Study findings were summarized narratively following Synthesis Without Meta-analysis guidelines. The search yielded 3686 unique records, of which 5 met our criteria. Studies were cross-sectional (n=4) and retrospective cohort studies (n=1) conducted in the US (n=3), Canada (n=1), and South Korea (n=1) and ranging from 881 to 42,842 participants. There was evidence from 4 studies that hysterectomy frequency was higher among women with disabilities (range: 6.1% to 22.8%) compared to those without disabilities (range: 2.2% to 18.6%). Three studies suggested that the disparity in hysterectomy was greatest among pre-menopausal women. Quality assessment scores on the NOS ranged from 0 to 8 (median: 3), with limitations mostly related to measurement of the exposure and outcome. The limited research on this topic points to the need for more studies on hysterectomy among women with disabilities, given historical reproductive injustices faced by this population.

The large number of people infected by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) necessitates estimation of the future healthcare burdens. We updated a systematic review examining associations between SARS-CoV-2 infection and incidence of new diagnoses and exacerbations of chronic conditions (PROSPERO registration CRD42024585278). Updated searches were run September 4, 2024 in MEDLINE and EMBASE for observational studies with a control group, adjustment by sex and comorbidities, and reporting age-stratified data for ≥1 chronic condition category (n=12) or condition type (n=46) of interest. Two human reviewers screened 50% of titles/abstracts, then DistillerAI acted as second reviewer. Two human reviewers assessed full-texts of relevant studies for eligibility based on a priori criteria. One reviewer extracted data and assessed risk of bias using the JBI cohort studies checklist; a second reviewer verified results data and risk of bias assessments. Pooled hazard ratios (HRs) were estimated with inverse-variance weighting. Using GRADE, two reviewers assessed certainty in conclusions of little-to-no association (i.e., HR 0.75 to 1.25), small-to-moderate association (i.e., HR 0.51 to 0.74 or 1.26 to 1.99), or large association (i.e., HR ≤0.50 or ≥2.00). We identified 46 new studies and brought forward 23 studies from the original review. After SARS-CoV-2 infection, there is probably increased risk of new diagnoses for several chronic conditions, especially in adults. Most findings are based on data from earlier pandemic periods; their relevance to contemporary populations is uncertain due to differences in vaccination rates, and circulating variants of concern.

Previous research has highlighted the role of social determinants of health on mental health, but their impact on suicide is less understood. The aim of this umbrella review was to systematically examine the association between 10 social determinants of health, as defined by the World Health Organization, and suicide mortality. A key word search of titles and abstracts was conducted in six digital databases for studies published up to August 24, 2023. Inclusion criteria were peer-reviewed systematic reviews and meta-analyses examining the association between these determinants and suicide. Methodological quality was assessed using an adapted AMSTAR-2 tool. A narrative synthesis, structured by social determinant, was conducted. A total of 49 records (n = 25 meta-analyses and 24 systematic reviews) were included in this review. Determinants with the most available evidence were housing, basic amenities and the environment (n = 21); income and social protection (n = 13); unemployment (n = 8); and early childhood development (n = 6). Limited evidence was identified for education (n = 3), social inclusion and nondiscrimination (n = 3), and working-life conditions (n = 3). No reviews examined the relationship between affordable health care services, structural conflict, or food insecurity and suicide. There was evidence of a modest effect of social determinants on suicide mortality. Most evidence related to unemployment, job insecurity, income and social protection, and childhood adversity. The methodological quality of the included reviews varied considerably. High-quality research fully exploring the relationship between social and environmental factors and suicide risk is needed.

Dietary fiber plays a key role in preventing chronic diseases, but sex disparities in its health effects remain unclear. This meta-analysis examined the associations between fiber intake and chronic disease risk in men and women; cohort studies reported on in published articles found in the PubMed, Web of Science, and Embase databases were reviewed up to July 2025. Among 2 408 576 participants (n = 1 035 449 men and 1 392 820 women) from 20 studies, higher fiber intake was linked to reduced chronic disease risk in both sexes, with a pooled hazard ratio (HR) of 0.80 (95% CI, 0.75-0.84) for men and 0.83 (95% CI, 0.76-0.91) for women. Notably, fiber significantly lowered cancer risk only in men (HR = 0.81; 95% CI, 0.75-0.87). Grains and vegetable fiber reduced chronic disease risk in men (HR = 0.90 and 0.86, respectively), whereas no specific fiber source had significant benefits for women. In conclusion, although dietary fiber significantly reduced the risk of chronic diseases for both sexes, the threshold for observing beneficial effects is lower in men compared with women, in whom its impact may be more susceptible to confounding factors. More research is needed to clarify sex-specific dietary recommendations for chronic disease prevention.

Epidemiologic studies have linked several modifiable factors to the risk of sleep apnea (SA). However, which specific factors affect the risk of SA and the strength of these effects are unclear. We conducted meta-analyses based on cross-sectional, cohort, and case-control studies found in the PubMed, Scopus, and Web of Science databases up to August 1, 2023. Studies that reported 1 of the associations of education level, physical activity, sedentary behavior, smoking status, alcohol consumption, or coffee consumption with SA were included. Two independent investigators assessed the risk of bias using the Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality scale. Two-sample Mendelian randomization (MR) studies then were conducted to clarify the causality further. A total of 49 studies were included in the meta-analysis (N = 429 809 study participants). Compared with the other categorial groups, lower level of education (odds ratio [OR] = 1.58; 95% CI, 1.28-1.96), higher level of sedentary behavior (OR = 1.22; 95% CI, 1.01-1.47), current smoking status (OR = 1.33; 95% CI, 1.17-1.51), and current alcohol consumption (OR = 1.40; 95% CI, 1.33-1.48) were associated with higher risk of SA. Higher level of physical activity (OR = 0.77; 95% CI, 0.70-0.83) was associated with lower risk of SA. In the MR study, years of educational attainment were associated with a lower risk of SA (OR = 0.83; 95% CI, 0.78-0.88), and smoking initiation was associated with a higher risk of SA (OR = 1.10; 95% CI, 1.05-1.15). Prevention strategies for SA should focus on modifying these risk factors, especially reducing education inequalities and smoking initiation. Trial registration: PROSPERO identifier: CRD42022319988.

The Gulf Cooperation Council (GCC) countries face a substantial impact from the increasing prevalence of diabetes mellitus, which experts identify as a major public health challenge in the region. Despite the escalating burden of diabetes mellitus and its related complications, including diabetic foot disease (DFD), there are noteworthy knowledge gaps concerning the prevalence and trends of DFD in the GCC countries. Furthermore, there is insufficient understanding of the management of DFD within health care settings in this region. The objective of this scoping review is to comprehensively assess the extent and nature of DFD management across different health care settings in GCC countries. The study will use the population, concept, and context framework: the population of interest is individuals with DFD, the concept is the management or treatment of DFD or its complications, and the context includes the GCC countries. The review will include published articles and unpublished quantitative and qualitative research papers, from 1981 onward, aligning with the establishment of the first multidisciplinary team diabetic foot clinic at King's College Hospital, London. The scoping review will follow guidelines from Joanna Briggs Institute (JBI) and be reported following the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews Checklist. A comprehensive search will be conducted, across various databases including CINAHL, MEDLINE (Ovid), Embase, Scopus, Cochrane CENTRAL, PsycINFO, Global Health, and the Arabic database Al Manhal, and gray literature sources. Studies in Arabic and English language will be included. A data extraction tool will be used to extract the data and will enable a chronological narrative synthesis of results.

Although COVID-19 vaccines are generally very safe, the risks of myocarditis and pericarditis after receiving an messenger RNA (mRNA) vaccine have been established, with the highest risk in young men. Most systematic reviews and meta-analyses of the risk of myocarditis or pericarditis have included passive surveillance data, which is subject to reporting errors. Accurate measures of age-, sex-, and vaccine dose- and type-specific risks are crucial for assessment of the benefits and risks of the vaccination. A systematic review and meta-analysis of the risks of myocarditis and pericarditis attributable COVID-19 vaccines were conducted, stratified by age groups, sex, vaccine type, and vaccine dose. Five electronic databases and gray literature sources were searched on November 21, 2023. Article about studies that compared a COVID-19-vaccinated group with an unvaccinated group or time period (eg, self-controlled) were included. Passive surveillance data were excluded. Meta-analyses were conducted using random-effects models. A total of 4030 records were identified; ultimately, 17 articles were included in this review. Compared with unvaccinated groups or unvaccinated time periods, the highest attributable risk of myocarditis or pericarditis was observed after the second dose in boys aged 12-17 years (10.18 per 100 000 doses [95% CI, 0.50-19.87]) of the BNT162b2 vaccine and in young men aged 18-24 years (attributable risk, 20.02 per 100 000 doses [95% CI, 10.47-29.57]) for the mRNA-1273 vaccine. The stratified results based on active surveillance data provide the most accurate available estimates of the risks of myocarditis and pericarditis attributable to specific COVID-19 vaccinations for specific populations. Trial registration: International Prospective Register of Systematic Reviews (PROSPERO) Identifier: CRD42023443343.

Dengue fever, caused by the dengue virus (DENV) and transmitted by Aedes aegypti mosquitos, remains a global health concern with no definitive treatment. Given the challenges in vaccine development and disease management, micronutrients such as vitamin D have emerged as potential adjunctive therapies because of their immunomodulatory properties. The effectiveness of vitamin D in the prevention and control of dengue fever was assessed in this systematic review by evaluating vitamin D's impact on immune responses, viral replication, and clinical outcomes. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, relevant studies were retrieved from the PubMed, Web of Science, and Scopus databases. Inclusion criteria encompassed studies examining the association between vitamin D and DENV infection, disease severity, and immune modulation. Six studies met the inclusion criteria. Findings indicated that vitamin D supplementation reduced pro-inflammatory cytokine levels, enhanced macrophage responses, and modulated toll-like receptor activity. Higher vitamin D levels were associated with lower viral replication and milder clinical manifestations of dengue fever. Vitamin D demonstrates potential as an adjunctive therapy for dengue fever by modulating immune responses and reducing disease severity. More clinical trials are required to validate its therapeutic efficacy and determine optimal supplementation strategies. Trial registration: International Prospective Register of Systematic Review identifier: CRD42021231605.