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Macdonald GA, Thomas JA, Dalais C, Kendall BJ, Thrift AP. Joint association of drinking alcohol and obesity in relation to cancer risk: A systematic review and data synthesis. Cancer Epidemiol 2024; 91:102596. [PMID: 38870623 DOI: 10.1016/j.canep.2024.102596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 04/28/2024] [Accepted: 05/27/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Rates of alcohol consumption and obesity are increasing in many Western populations. For some cancer types, both heavy alcohol consumption and obesity are independently associated with increased risk. Whether combined exposure to both synergistically increases an individual's risk of cancer is unclear. We performed a systematic review to assess whether alcohol and obesity interact to confer higher risk for cancer than the additive sum of their effects. METHODS A systematic literature search was conducted from the inception date to 13 February 2024 of PubMed, Embase, Cochrane Library and Web of Science to identify studies of alcohol, obesity, and cancer risk. We aimed to undertake a meta-analysis if there were sufficient data. RESULTS The literature search identified 17,740 potentially eligible studies. After review, 24 studies were included. Eleven reported on the association between alcohol consumption and cancer risk in individuals according to their body mass index (BMI), nine reported on the association between BMI and cancer risk in individuals according to their alcohol consumption, and six studies examined potential synergistic interactions between alcohol consumption and obesity on cancer risk. However, there were insufficient data and significant heterogeneity in the cancers studied to undertake meta-analysis, therefore a systemic review and narrative synthesis was conducted. Overall, there was no consistent pattern of interaction between alcohol use and overweight/obesity on cancer risk across cancer types. CONCLUSIONS While alcohol and obesity are prevalent and important risk factors for a range of cancers, data are lacking on whether their combined exposure may synergistically increase an individual's risk for cancer. Further study across more cancer types is required to better understand the nature of interactions between alcohol use and obesity on cancer risk.
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Affiliation(s)
- Graeme A Macdonald
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - James A Thomas
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Christine Dalais
- University of Queensland Library, University of Queensland, Brisbane, QLD, Australia
| | - Bradley J Kendall
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Aaron P Thrift
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX, USA; Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA.
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Yang J, Qu X, Zheng AJ, Jiang F, Chang H, Zhang JR, Yan LJ, Ning P. The causal effects of genetically predicted alcohol consumption on endometrial cancer risk from a Mendelian randomization study. Sci Rep 2024; 14:3478. [PMID: 38347022 PMCID: PMC10861519 DOI: 10.1038/s41598-024-53926-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 02/06/2024] [Indexed: 02/15/2024] Open
Abstract
Endometrial cancer (EC) is a common gynecological tumor in females with an increasing incidence over the past few decades. Alcohol consumption has been linked to the occurrence of various cancers; However, epidemiological studies have shown inconsistent associations between alcohol consumption and EC risk. In order to avoid the influence of potential confounding factors and reverse causality in traditional epidemiological studies, we used a method based on genetic principles-Mendelian randomization (MR) analysis to test whether there is a causal relationship between alcohol consumption and EC. MR analysis was conducted using publicly available summary-level data from genome-wide association studies (GWAS). Fifty-seven single nucleotide polymorphisms (SNPs) were extracted as instrumental variables for alcohol exposure from the GWAS and Sequencing Consortium of Alcohol and Nicotine GWAS summary data involving 941,287 participants of European ancestry. SNPs for EC were obtained from the Endometrial Cancer Association Consortium, the Endometrial Cancer Epidemiology Consortium, and the UK Biobank, involving 121,885 European participants. The inverse variance weighted (IVW) method was used as the primary method to estimate the causal effect, and the MR-Egger regression and weighted median method were used as supplementary methods. Sensitivity analyses were conducted using the Mendelian Randomization Pleiotropy RESidual Sum and Outlier global test, MR-Egger intercept test, and leave-one-out analysis to evaluate the impact of pleiotropy on causal estimates. An increase of 1 standard deviation of genetically predicted log-transformed alcoholic drinks per day was associated with a 43% reduction in EC risk [odds ratio (OR) = 0.57, 95% confidence interval (CI) 0.41-0.79, P < 0.001]. Subgroup analysis of EC revealed that alcohol consumption was a protective factor for endometrioid endometrial cancer (EEC) (OR = 0.56, 95% CI 0.38-0.83, P = 0.004) but not for non-endometrioid endometrial cancer (NEC) (OR = 1.36, 95% CI 0.40-4.66, P = 0.626). The MR-Egger regression and weighted median method yielded consistent causal effects with the IVW method. The consistent results of sensitivity analyses indicated the reliability of our causal estimates. Additionally, alcohol consumption was associated with decreased human chorionic gonadotropin (HCG) and insulin-like growth factor 1 (IGF1) levels. This MR study suggests that genetically predicted alcohol consumption is a protective factor for EC, particularly for EEC, and this protective effect may be mediated through the reduction of HCG and IGF1.
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Affiliation(s)
- Jie Yang
- Department of Oncology, Baoji Gaoxin Hospital, No.19, Gaoxin 4 Road, Gaoxin District, Baoji, 721000, Shaanxi Province, China
| | - Xiang Qu
- Department of Oncology, Baoji Gaoxin Hospital, No.19, Gaoxin 4 Road, Gaoxin District, Baoji, 721000, Shaanxi Province, China
| | - An-Jie Zheng
- Department of Oncology, Baoji Gaoxin Hospital, No.19, Gaoxin 4 Road, Gaoxin District, Baoji, 721000, Shaanxi Province, China
| | - Fan Jiang
- Department of Oncology, Baoji Gaoxin Hospital, No.19, Gaoxin 4 Road, Gaoxin District, Baoji, 721000, Shaanxi Province, China
| | - Hui Chang
- Department of Oncology, Baoji Gaoxin Hospital, No.19, Gaoxin 4 Road, Gaoxin District, Baoji, 721000, Shaanxi Province, China
| | - Jin-Ru Zhang
- Department of Oncology, Baoji Gaoxin Hospital, No.19, Gaoxin 4 Road, Gaoxin District, Baoji, 721000, Shaanxi Province, China
| | - Li-Juan Yan
- Department of Oncology, Baoji Gaoxin Hospital, No.19, Gaoxin 4 Road, Gaoxin District, Baoji, 721000, Shaanxi Province, China
| | - Peng Ning
- Department of Oncology, Baoji Gaoxin Hospital, No.19, Gaoxin 4 Road, Gaoxin District, Baoji, 721000, Shaanxi Province, China.
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Floud S, Hermon C, Simpson RF, Reeves GK. Alcohol consumption and cancer incidence in women: interaction with smoking, body mass index and menopausal hormone therapy. BMC Cancer 2023; 23:758. [PMID: 37587405 PMCID: PMC10428611 DOI: 10.1186/s12885-023-11184-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/17/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Alcohol consumption has been associated with increased risks of certain site-specific cancers and decreased risks of some other cancers. There is, however, little reliable evidence as to whether the alcohol-associated risks for specific cancers are modified by smoking, body mass index (BMI) and menopausal hormone therapy (MHT) use. METHODS In the prospective UK Million Women Study, 1,233,177 postmenopausal women without prior cancer, mean age 56 (SD 5) years, reported their alcohol consumption in median year 1998 (IQR 1998-1999), and were followed by record-linkage for incident cancer. 438,056 women who drank no alcohol or < 1 drink/week were excluded. Cox regression yielded adjusted relative risks (RRs) and 95% confidence intervals (CIs) for 21 cancers by alcohol amount; statistical significance of interactions with smoking, BMI and MHT use was assessed after allowing for multiple testing. RESULTS In 795,121 participants, mean consumption was 6.7 (SD 6.4) alcoholic drinks/week. During 17 (SD 5) years of follow-up, 140,203 incident cancers were recorded. There was strong evidence for a substantial association between alcohol intake and risk of upper aero-digestive cancers (oesophageal squamous cell carcinoma, oral cavity, pharynx and larynx; RR per 1 drink/day = 1.38 [95% CI 1.31-1.46]). There was also strong evidence for more moderate positive associations with breast, colorectal and pancreatic cancer (RRs per 1 drink/day = 1.12 [1.10-1.14], 1.10 [1.07-1.13], 1.08 [1.02-1.13] respectively), and moderate negative associations with thyroid cancer, non-Hodgkin's lymphoma, renal cell carcinoma and multiple myeloma (RRs per 1 drink/day = 0.79 [0.70-0.89], 0.91 [0.86-0.95], 0.88 [0.83-0.94], 0.90 [0.84-0.97] respectively). Significant interactions between alcohol and smoking were seen for upper aero-digestive cancers (RRs per 1 drink/day = 1.66 [1.54-1.79], 1.23 [1.11-1.36], 1.12 [1.01-1.25] in current, past, and never smokers respectively). BMI and MHT did not significantly modify any alcohol-associated risks. CONCLUSIONS These findings provide robust evidence that greater alcohol intake, even within relatively moderate ranges, increases the risk of cancers of the aerodigestive tract, breast, colorectal and pancreatic cancer, and probably decreases the risk of thyroid cancer, non-Hodgkin's lymphoma, renal cell carcinoma and multiple myeloma. Associations of alcohol intake with cancer risk were not modified by MHT use, adiposity or smoking, except in the case of upper aero-digestive cancers, where the alcohol-associated risk was largely confined to smokers.
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Affiliation(s)
- Sarah Floud
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| | - Carol Hermon
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Gillian K Reeves
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Keyvani V, Kheradmand N, Navaei ZN, Mollazadeh S, Esmaeili SA. Epidemiological trends and risk factors of gynecological cancers: an update. Med Oncol 2023; 40:93. [PMID: 36757546 DOI: 10.1007/s12032-023-01957-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/12/2023] [Indexed: 02/10/2023]
Abstract
Gynecological cancers, the most common cancer among women worldwide, disrupt the function of women's reproductive system, significantly impacting the quality of life. The epidemiological patterns of gynecological cancers differ in various regions and alter over time. The main challenge to deal with women's cancers is focusing on potential plans to improve patient outcomes. The epidemiology and general risk elements of gynecological cancers are important in the management of these cancers, so all of the reported risk factors in gynecological cancers have been evaluated in the present review. Due to the role of gynecological cancers in women's health, preventive measures and modifiable lifestyles together with early detection in high-risk groups are effective strategies that can reduce mortality rates. This review summarizes the epidemiology and global risk factors of gynecological cancers alongside others to better management of these malignancies and improve the quality of life in the affected patients.
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Affiliation(s)
- Vahideh Keyvani
- Department of Biology, Faculty of Science, Shahid Chamran University of Ahvaz, Ahvaz, Iran.,Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nahid Kheradmand
- Department of Medical Genetics and Molecular Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Nasrpour Navaei
- Department of Medical Genetics and Molecular Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Samaneh Mollazadeh
- Natural Products and Medicinal Plants Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Seyed-Alireza Esmaeili
- Immunology Research Center, Bu-Ali Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran. .,Immunology Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Associations of Dietary Intakes with Gynecological Cancers: Findings from a Cross-Sectional Study. Nutrients 2022; 14:nu14235026. [PMID: 36501056 PMCID: PMC9739794 DOI: 10.3390/nu14235026] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/20/2022] [Accepted: 11/23/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Gynecological cancers, including cervical cancer, ovarian cancer and endometrial cancer are leading causes of cancer-related death in women worldwide. Diet plays an important role in cancer development, which is widely accepted. However, the associations between dietary intakes and gynecological cancers remain unclear. Methods: A total of 12,437 women aged over 20 years from the National Health and Nutrition Examination Survey (NHANES), conducted from 2007−2016, were included in this study. The relationships between 30 dietary factors (4 macronutrients, 15 vitamins, 9 minerals, caffeine and alcohol) and gynecological cancers were assessed. Results: We observed negative correlations of intakes of phosphorus (odds ratio (OR), 95% confidence interval (CI); 0.998 (0.996, 0.999), p = 0.002) with cervical cancer, and intakes of vitamin B12 (0.812 (0.714, 0.925), p = 0.002), phosphorus (0.997 (0.996, 0.999), p < 0.001) and alcohol (0.971 (0.950, 0.992), p = 0.009) with endometrial cancer. The data showed positive associations of intake of caffeine (1.002 (1.001, 1.003), p = 0.003) with cervical cancer, and intake of copper (2.754 (1.313, 5.778), p = 0.009) with endometrial cancer. In addition, we found potential negative correlations between intake of vitamin B1 (p = 0.025) and cervical cancer; zinc (p = 0.048) and ovarian cancer; and potassium (p = 0.032) and endometrial cancer. Potential positive associations were found between intake of calcium and cervical cancer (p = 0.026) and endometrial cancer (p = 0.034), and between sodium (p = 0.042) and endometrial cancer. Intakes of protein, total sugars, total fat, cholesterol, vitamin A, alpha-carotene, beta-carotene, beta-cryptoxanthin, lycopene, vitamin B2, niacin, vitamin B6, food folate, vitamin C, vitamin D, vitamin E, vitamin K, magnesium, iron and selenium showed no relationship with gynecological cancers (p > 0.05). Conclusions: Specific dietary factors were associated with gynecological cancers. More epidemiological studies are needed to validate our results.
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Shi J, Swanson SA, Kraft P, Rosner B, De Vivo I, Hernán MA. Instrumental variable estimation for a time-varying treatment and a time-to-event outcome via structural nested cumulative failure time models. BMC Med Res Methodol 2021; 21:258. [PMID: 34823502 PMCID: PMC8620657 DOI: 10.1186/s12874-021-01449-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/21/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND In many applications of instrumental variable (IV) methods, the treatments of interest are intrinsically time-varying and outcomes of interest are failure time outcomes. A common example is Mendelian randomization (MR), which uses genetic variants as proposed IVs. In this article, we present a novel application of g-estimation of structural nested cumulative failure models (SNCFTMs), which can accommodate multiple measures of a time-varying treatment when modelling a failure time outcome in an IV analysis. METHODS A SNCFTM models the ratio of two conditional mean counterfactual outcomes at time k under two treatment strategies which differ only at an earlier time m. These models can be extended to accommodate inverse probability of censoring weights, and can be applied to case-control data. We also describe how the g-estimates of the SNCFTM parameters can be used to calculate marginal cumulative risks under nondynamic treatment strategies. We examine the performance of this method using simulated data, and present an application of these models by conducting an MR study of alcohol intake and endometrial cancer using longitudinal observational data from the Nurses' Health Study. RESULTS Our simulations found that estimates from SNCFTMs which used an IV approach were similar to those obtained from SNCFTMs which adjusted for confounders, and similar to those obtained from the g-formula approach when the outcome was rare. In our data application, the cumulative risk of endometrial cancer from age 45 to age 72 under the "never drink" strategy (4.0%) was similar to that under the "always ½ drink per day" strategy (4.3%). CONCLUSIONS SNCFTMs can be used to conduct MR and other IV analyses with time-varying treatments and failure time outcomes.
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Affiliation(s)
- Joy Shi
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- The CAUSALab, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Sonja A Swanson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- The CAUSALab, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Bernard Rosner
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Immaculata De Vivo
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Miguel A Hernán
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- The CAUSALab, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Association between Age at Menarche and Hypertension among Females in Southern China: A Cross-Sectional Study. Int J Hypertens 2019; 2019:9473182. [PMID: 31781383 PMCID: PMC6875309 DOI: 10.1155/2019/9473182] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 09/04/2019] [Accepted: 09/12/2019] [Indexed: 12/25/2022] Open
Abstract
Background Association between age at menarche (AAM) and hypertension remains a controversial topic, and data in China were sparse. Therefore, we aimed to investigate the association between AAM and hypertension in Chinese female population. Methods In this cross-sectional study, 5,102 females aged ≥15 years were enrolled. Self-reported AAM was assessed by the questionnaire. Multiple linear regression analysis was used to evaluate the association between systolic blood pressure (SBP), diastolic blood pressure (DBP), and AAM. Logistic regression analysis was performed to evaluate the association between hypertension and AAM. Generalized additive model (GAM) and smooth curve fitting (penalized spline method) were conducted to explore the exact shape of curve between them. Results The overall mean of AAM was 15.5 years. Each additional year of AAM was associated with a 15% higher risk of hypertension (odds ratio (OR) = 1.15, 95% confidence interval (CI): 1.11-1.19). Among females with hypertension, there was a significant positive association between AAM and SBP (β = 0.88, 95% CI: 0.29-1.46) and DBP (β = 0.80, 95% CI: 0.47-1.13). A significantly higher risk of hypertension was found in younger subjects (15-44 y: OR = 1.37, 95% CI: 1.21-1.55; P for interaction = 0.009) compared with those aged between 62 and 97 y. Conclusions AAM was positively associated with hypertension and blood pressure, especially among females in early adulthood from southern China.
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Koshiyama M. The Effects of the Dietary and Nutrient Intake on Gynecologic Cancers. Healthcare (Basel) 2019; 7:healthcare7030088. [PMID: 31284691 PMCID: PMC6787610 DOI: 10.3390/healthcare7030088] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 06/23/2019] [Accepted: 07/03/2019] [Indexed: 12/19/2022] Open
Abstract
The contribution of diet to cancer risk has been considered to be higher in advanced countries than in developing countries. In this paper, I review the current issues (a review of the relevant literature), and the effects of the dietary and nutrient intake on three types of gynecologic cancer (cervical, endometrial and ovarian cancers). In cervical cancer, the most important roles of diet/nutrition in relation to cancer are prophylaxis and countermeasures against human papillomavirus (HPV) infection. The main preventive and reductive factors of cervical cancer are antioxidants, such as vitamin A, C, D and E, carotenoids, vegetables and fruits. These antioxidants may have different abilities to intervene in the natural history of diseases associated with HPV infection. For endometrial cancer, the increase in peripheral estrogens as a result of the aromatization of androgens to estrogens in adipose tissue in obese women and insulin resistance are risk factors. Thus, we must mainly take care to avoid the continuous intake of fat energy and sugar. In ovarian cancer, the etiology has not been fully understood. To the best of our knowledge, the long-term consumption of pro-inflammatory foods, including saturated fat, carbohydrates and animal proteins is a risk factor. The intake of acrylamide is also a risk factor for both endometrial and ovarian cancer. Most papers have been epidemiological studies. Thus, further research using in vitro and in vivo approaches is needed to clarify the effects of the dietary and nutrient intake in detail.
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Affiliation(s)
- Masafumi Koshiyama
- Department of Women's Health, Graduate School of Human Nursing, The University of Shiga Prefecture, Shiga 522-8533, Japan.
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Yu L, Liang Q, Zhou W, Huang X, Hu L, You C, Li J, Wu Y, Li P, Wu Q, Wang Z, Gao R, Bao H, Cheng X. Association between physical activity and stroke in a middle-aged and elderly Chinese population. Medicine (Baltimore) 2018; 97:e13568. [PMID: 30572457 PMCID: PMC6319969 DOI: 10.1097/md.0000000000013568] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Accumulating evidence has reported that physical activity (PA) is effective in reducing stroke and mortality. However, whether PA levels are associated with stroke in middle-aged and elderly people in Jiangxi Province of China remains unclear. In the present study, we evaluated the association between PA and the risk of stroke in Jiangxi Province of China. METHODS A cross-sectional survey was conducted in Jiangxi Province of China from November 2013 to August 2014, using standardized questionnaire forms and physical measurements. Self-reported PA was assessed using the international PA questionnaire. A history of stroke was self-reported by answering the questionnaire. Multivariate logistic regression analysis was performed to evaluate the association between PA levels and the risk of stroke after adjustment for sociodemographic characteristics, lifestyle factors, and disease-related risk factors. RESULTS A total of 10,398 participants (4240 men and 6158 women, aged 45 to 97 years) completed the International Physical Activity Questionnaire (IPAQ). Compared with low-intensity PA, vigorous PA was associated with graded reduction in the risk of stroke (odds ratio [OR] of 0.763, 95% confidence interval [CI] 0.717-0.812, P < .001 for trend). However, there were no significant differences between individuals in the low-intensity PA and moderate-intensity PA group (P > 0.05). CONCLUSIONS Compared with low PA, vigorous PA, but not moderate PA, was associated with a lower risk of stroke in middle aged and elderly people in southern China, specifically among men. These findings suggested that increasing PA is beneficial.
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Affiliation(s)
| | - Qian Liang
- Key Laboratory of Molecular Biology in Jiangxi Province, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi
| | - Wei Zhou
- Department of Cardiovascular Medicine
| | | | - Lihua Hu
- Department of Cardiovascular Medicine
| | | | | | | | - Ping Li
- Department of Cardiovascular Medicine
| | | | - Zengwu Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Fengcunxili, Mentougou District
| | - Runlin Gao
- Department of Cardiology, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beilishilu, Xicheng District, Beijing, China
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Yu L, Liang Q, Zhou W, Huang X, Hu L, You C, Li J, Wu Y, Li P, Wu Q, Bao H, Cheng X. Sedentary behavior and the risk of cardiac-cerebral vascular diseases in southern China. Medicine (Baltimore) 2018; 97:e12838. [PMID: 30383636 PMCID: PMC6221627 DOI: 10.1097/md.0000000000012838] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Accumulating evidence has reported that prolonged periods of sedentary time have been recognized as a risk factor for cardiocerebrovascular disease. However, whether high levels of sedentary behavior are associated with an increased risk of cardiocerebrovascular disease in different regions remains unclear.The aim of this study was to evaluate the association between sedentary behavior and the risk of myocardial infarction (MI) and stroke in Jiangxi Province of China.A cross-sectional survey was conducted among 15,364 participants in Jiangxi Province of China from November 2013 to August 2014, using standardized questionnaire forms and physical measurements. Self-reported sedentary behavior in daily life and a history of MI and stroke were conducted by answering the questionnaire. The participants were examined for weight, height, waist circumference (WC), body fat percentage (BFP), visceral fat index (VAI), basal metabolic rate (BMR), and blood pressure (BP). Multivariate logistic regression analysis was performed to evaluate the association between sedentary behavior and the risk of MI and stroke after adjustment for sociodemographic characteristics, lifestyle factors, and disease-related risk factors.Of the 15,364 eligible participants, 13,710 participants (5604 men and 8106 women, aged 15-97 years) completed the questionnaire. Subjects who had longer sedentary behavior were significantly associated with an increased risk of MI and stroke [odds ratio (OR) = 1.22, 95% confidence interval (95% CI): 1.168-1.281, P < .001; OR = 1.59, 95% CI: 1.50-1.67, P < .001]. After stratification by the categorical variable of sedentary behavior, individuals with a longer time of sedentary behavior (≥8 hours) were also related to a higher risk of MI and stroke than those in the sedentary behavior (<4 hours) group (OR = 176.62, 95% CI: 43.33-719.90, P < .001; OR = 478.52, 95% CI: 118.50-1932.36, P < .001). However, there were no significant differences between individuals in the short time of sedentary behavior (<4 hours) group and the middle time (4-8 hours) group (p > 0.05).Excessive time spent in sedentary behavior was associated with a higher risk of MI and stroke. The results provide robust evidence to support the guideline recommendations regarding reduction of sedentary behavior in daily life.
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Affiliation(s)
| | - Qian Liang
- Key Laboratory of Molecular Biology in Jiangxi Province, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China
| | - Wei Zhou
- Department of Cardiovascular Medicine
| | | | - Lihua Hu
- Department of Cardiovascular Medicine
| | | | | | | | - Ping Li
- Department of Cardiovascular Medicine
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Lyu Y, LaPointe G, Zhong L, Lu J, Zhang C, Lu Z. Heterologous Expression of Aldehyde Dehydrogenase in Lactococcus lactis for Acetaldehyde Detoxification at Low pH. Appl Biochem Biotechnol 2017; 184:570-581. [DOI: 10.1007/s12010-017-2573-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 07/31/2017] [Indexed: 11/28/2022]
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12
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Barbhaiya M, Lu B, Sparks JA, Malspeis S, Chang SC, Karlson EW, Costenbader KH. Influence of Alcohol Consumption on the Risk of Systemic Lupus Erythematosus Among Women in the Nurses' Health Study Cohorts. Arthritis Care Res (Hoboken) 2017; 69:384-392. [PMID: 27273851 DOI: 10.1002/acr.22945] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 04/08/2016] [Accepted: 05/24/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Moderate alcohol consumption has antiinflammatory properties and is associated with reduced cardiovascular disease and rheumatoid arthritis risks. We investigated the association between alcohol consumption and systemic lupus erythematosus (SLE) risk among women followed in the Nurses' Health Study (NHS) cohorts. METHODS We conducted a prospective cohort analysis among 204,055 women in NHS (1980-2012) and NHSII (1989-2011) who were free of connective tissue disease and provided alcohol information at baseline. Alcohol consumption was assessed using a semiquantitative food frequency questionnaire every 2-4 years. We validated incident SLE through medical record review after self-report. Cox proportional hazards models estimated hazard ratios (HRs) for SLE based on cumulative average alcohol intake, adjusting for potential confounders. Results were meta-analyzed using DerSimonian and Laird random-effects models. We further investigated SLE risk associated with wine, beer, and liquor intake. RESULTS We identified 125 incident SLE cases in NHS and 119 in NHSII. Mean ± SD age at SLE diagnosis was 55.8 ± 9.5 years in NHS and 43.4 ± 7.7 years in NHSII. Compared to no alcohol intake, the meta-analyzed multivariable HR for cumulative alcohol consumption ≥5 gm/day was 0.61 (95% confidence interval [95% CI] 0.41-0.89). When limiting alcohol exposure to >4 years prior to SLE diagnosis, the multivariable HR was similar: 0.61 (95% CI 0.41-0.91). Women who drank ≥2 servings/week of wine had significantly decreased SLE risk (HR 0.65, 95% CI 0.45-0.96) compared to women who did not drink wine. CONCLUSION In these large prospective cohorts, we demonstrated an inverse association between moderate alcohol consumption (≥5 grams or 0.5 drink/day) and SLE risk in women.
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Affiliation(s)
- Medha Barbhaiya
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Bing Lu
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jeffrey A Sparks
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Susan Malspeis
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Shun-Chiao Chang
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Elizabeth W Karlson
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Karen H Costenbader
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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Does alcohol consumption modify the risk of endometrial cancer? A dose-response meta-analysis of prospective studies. Arch Gynecol Obstet 2016; 295:467-479. [PMID: 27975130 DOI: 10.1007/s00404-016-4263-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 12/02/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND Epidemiological studies have provided controversial evidence of an association between alcohol intake and endometrial cancer (EC) risk. The World Cancer Research Fund/American Institute for Cancer Research classifies alcohol as having a "limited-no conclusion" grade of evidence in the Endometrial Cancer 2013 Report (the latest version). OBJECTIVE The purpose of this meta-analysis is to systematically analyze the effect of alcohol intake on EC risk. METHODS We conducted a dose-response meta-analysis of prospective cohort studies identified from the PubMed, Embase, Cochrane Library and China Biological Medicine databases. Categorical and dose-response meta-analyses were conducted to estimate the effects of alcohol on EC risk. RESULTS A total of 10 studies involving 9766 cases and 1,612,798 participants were included in this meta-analysis. Overall, the relative risk(RR) for alcohol intake on EC was 1.04 (95% CI 0.88-1.22). The RRs for alcohol intake from wine, beer, and liquor were 1.10 (95% CI 0.80-1.51), 0.94 (95% CI 0.72-1.22), and 1.04 (95% CI 0.86-1.27), respectively). When alcohol consumption was stratified by drinking level, the RRs for moderate and heavy alcohol intake were 0.95 (95% CI 0.89-1.01) and 1.00 (95% CI 0.88-1.13), respectively. In the subgroup analyses, this association was not modified by other lifestyle factors or the characteristics of the study design and population. No significant associations were detected in the dose-response meta-analyses. CONCLUSIONS Alcohol intake is not associated with EC regardless of the beverage choice and alcohol consumption level. More studies are warranted in other populations, such as Asians and Africans.
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Lim HS, Kim TH, Lee HH, Kim SW. Comments on the relationship between green tea consumption and the risk of endometrial cancer. Arch Gynecol Obstet 2015; 293:465-6. [PMID: 26603038 DOI: 10.1007/s00404-015-3970-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 11/17/2015] [Indexed: 11/25/2022]
Affiliation(s)
- Hee-Sook Lim
- Department of Interdisciplinary Program in Biomedical Science, Soonchunhyang University Graduate School, Asan, Republic of Korea.,Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea
| | - Tae-Hee Kim
- Department of Obstetrics and Gynecology, Soonchunhyang University College of Medicine, 170 Jomaru-ro, Wonmi-gu, Bucheon, Gyeonggi, 14584, Republic of Korea.
| | - Hae-Hyeog Lee
- Department of Obstetrics and Gynecology, Soonchunhyang University College of Medicine, 170 Jomaru-ro, Wonmi-gu, Bucheon, Gyeonggi, 14584, Republic of Korea
| | - Sung-Whan Kim
- Institute for Bio-Medical Convergence, College of Medicine, Catholic Kwandong University, Gangneung, Republic of Korea.,Innovative Cell and Gene Therapy Center, International St. Mary's Hospital, Incheon, Republic of Korea
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Mu X, Du X, Yao K, Zhao J, Bian C, Wang Q, Ma H, Yi T, Wu Y, Zhao X. Association between HSD17B1 rs605059 polymorphisms and the risk of uterine diseases: a systemic review and meta-analysis. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:6012-8. [PMID: 26261478 PMCID: PMC4525812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 05/29/2015] [Indexed: 06/04/2023]
Abstract
The aim of this study was to evaluate the HSD17B1 gene polymorphisms in the risks of endometrial cancer, endometriosis and uterine leiomyoma by meta-analysis. A comprehensive electronic search was conducted in PubMed, Medline (Ovid), Embase, Weipu, Wanfang and CNKI. The pooled ORs were performed using the Revman 5.2 softerware. 8 case-control studies were included: 3 were about endometrial cancer, 4 were about endometriosis and 1 was about uterine leiomyoma. The result showed no significant association between HSD17B1 rs605059 gene polymorphisms and risks of endometrial cancer (AA vs. AG+GG: OR = 1.11, 95% CI = 0.94-1.32; AA+AG vs. GG: OR = 1.79, 95% CI = 0.42-7.52; AG vs. AA+ GG: OR = 0.87, 95% CI = 0.76-1.00; AA vs. GG: OR = 1.43, 95% CI = 0.62-3.30; A vs. G: OR = 1.00, 95% CI = 0.91-1.11) or endometriosis (AA vs. AG+GG: OR = 0.99, 95% CI = 0.75-1.32; AA+AG vs. GG: OR = 1.73, 95% CI = 0.92-3.25; AG vs. AA+ GG: OR = 1.24, 95% CI = 1.00-1.53; AA vs. GG: OR = 1.54, 95% CI = 0.79-2.97; A vs. G: OR = 1.23, 95% CI = 0.90-1.68). No association was found in a subgroup analysis based on Asian ethnicity for endometriosis. This meta-analysis suggested that HSD17B1 rs605059 polymorphisms were not associated with the risks of endometrial cancer and endometriosis. Further studies are needed to validate the conclusion and clarify the relationship between HSD17B1 rs605059 polymorphisms and the risk of uterine leiomyoma.
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Affiliation(s)
- Xiyan Mu
- Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan UniversityChengdu 610041, Sichuan, P. R. China
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for BiotherapyChengdu 610041, Sichuan, P. R. China
| | - Xue Du
- Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan UniversityChengdu 610041, Sichuan, P. R. China
| | - Kui Yao
- Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan UniversityChengdu 610041, Sichuan, P. R. China
| | - Jitong Zhao
- Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan UniversityChengdu 610041, Sichuan, P. R. China
| | - Ce Bian
- Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan UniversityChengdu 610041, Sichuan, P. R. China
| | - Qiao Wang
- Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan UniversityChengdu 610041, Sichuan, P. R. China
| | - Hongwei Ma
- Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan UniversityChengdu 610041, Sichuan, P. R. China
| | - Tao Yi
- Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan UniversityChengdu 610041, Sichuan, P. R. China
| | - Yang Wu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, and Collaborative Innovation Center for BiotherapyChengdu 610041, Sichuan, P. R. China
| | - Xia Zhao
- Department of Gynecology and Obstetrics, West China Second Hospital, Sichuan UniversityChengdu 610041, Sichuan, P. R. China
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Je Y, Park T. Tea Consumption and Endometrial Cancer Risk: Meta-Analysis of Prospective Cohort Studies. Nutr Cancer 2015; 67:825-30. [PMID: 25996185 DOI: 10.1080/01635581.2015.1040521] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Several lines of evidence suggest that tea consumption may reduce the risk of endometrial cancer due to antioxidant properties of tea, but the results of prospective data to date are inconsistent. We thus conducted a meta-analysis of prospective cohort studies to examine the relationship between tea consumption and endometrial cancer risk, using a random-effects model. We identified 5 eligible cohort studies, which included 231,870 female participants and 1831 cases for endometrial cancer. The pooled relative risk (RR) for the highest (median 2 cups/day) vs. no/lowest category of tea consumption on endometrial cancer risk was 0.95 [95% confidence interval (CI): 0.80-1.12] with no significant heterogeneity (P for heterogeneity = 0.68, I(2) = 0.0%). By country of origin, the pooled RR of 3 studies conducted in the United States was 1.00 (95% CI: 0.83-1.21), in which black tea was consumed by most people. Because of limited data on Asian population, the association of green tea on endometrial cancer was not calculated separately. There was no indication of publication bias (Begg's P = 0.46; Egger's P = 0.43). Our findings from prospective data do not support a role of tea consumption in endometrial carcinogenesis. More prospective cohort studies with green tea consumption should be conducted.
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Affiliation(s)
- Youjin Je
- a Department of Food and Nutrition , Kyung Hee University , Seoul , South Korea
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Je Y. Dietary acrylamide intake and risk of endometrial cancer in prospective cohort studies. Arch Gynecol Obstet 2014; 291:1395-401. [DOI: 10.1007/s00404-014-3595-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 12/09/2014] [Indexed: 10/24/2022]
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