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Metabolic syndrome is associated with increased risk of Barrett esophagus: A meta-analysis.

He Q, Li JD, Huang W, Zhu WC, Yang JQ - Medicine (Baltimore) (2016)

Bottom Line: The pooled results showed MS was closely associated with increased risk of BE (OR = 1.23; 95%CI 1.03-1.47; P = 0.024), and yet DM did not significantly increase the risk of BE (OR = 1.07; 95%CI 0.82-1.38; P = 0.627).No significant publication bias was detected by Egger's test (P = 0.23).Based on the results of current meta-analysis, MS is associated with increased risk of BE.

View Article: PubMed Central - PubMed

Affiliation: aDepartment of Gastroenterology, The First Affiliated Hospital of Jinan University bDepartment of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, China.

ABSTRACT

Background: Barrett esophagus (BE) is considered precursor condition of esophageal adenocarcinoma. Its incidence and prevalence are increasing in general population. Studies reported that metabolic syndrome (MS) or diabetes mellitus (DM) is related to increased risk of BE. Current study was to assess and better understand the relationship between MS /DM and BE.

Methods: Electronic search was conducted in the database Pubmed/Medline (-December, 2015), Embase (-December, 2015), Cochrane Library (-December, 2015), and Web of Knowledge (-December, 2015). Studies included were assessed with summary odds ratios (ORs) with 95% confidence intervals (CIs) and compared exposure group with control group. The heterogeneity was examined by the funnel plot and the Egger's test. Subgroup analyses and sensitive analyses were performed for the detection of possible heterogeneity and impact on stability of analysis results.

Results: Twelve publications met the criteria and included 355,311 subjects were analyzed. The pooled results showed MS was closely associated with increased risk of BE (OR = 1.23; 95%CI 1.03-1.47; P = 0.024), and yet DM did not significantly increase the risk of BE (OR = 1.07; 95%CI 0.82-1.38; P = 0.627). Substantial heterogeneities were detected. No significant publication bias was detected by Egger's test (P = 0.23).

Conclusions: Based on the results of current meta-analysis, MS is associated with increased risk of BE. Further long-term follow-up prospective study needs to verify the current results, and definite pathophysiological mechanism needs to be further investigated and clearly elucidated.

No MeSH data available.


Related in: MedlinePlus

Publication bias detected by Egger test.
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Figure 3: Publication bias detected by Egger test.

Mentions: Subgroup analyses were further conducted by stratifying publication type, study design, and study setting (Table 2). As far as 2 publication types were concerned, no significant statistical differences were detected (abstracts: OR 1.26, 95%CI 0.86–1.85, P = 0.232 vs full text: OR 1.11, 95%CI 0.98–1.25, P = 0.113). Considering inclusion of overwhelming majority case–control studies (12 studies) and only 1 cohort study, subgroup analyses revealed markedly significance was observed in case–control group (OR = 1.16, 95%CI 1.03–1.32, P = 0.019 vs OR = 1.16, 95%CI 1.03–1.31, P = 0.871). In addition, based on different study settings, analysis result including population-based studies showed statistically significant difference (OR = 1.21, 95%CI 1.07–1.36, P = 0.003). Significant heterogeneity was observed in the overall effect analysis (χ2 = 32.26; P = 0.001, I2 = 62.8%). The results were stable according to subgroup interaction heterogeneity analysis (Table 2). Sensitive analysis by omitting 1 study in each turn indicated the results were unaffected. No single study notably affected the overall summary estimate or P value for heterogeneity. Publication bias was evaluated by a funnel plot and Egger's test. Asymmetry was observed by inspection of the funnel plot. Trim and fill method was subsequently analyzed, and the results had no obvious changes (data no shown). No significant publication bias was detected by Egger's test in the meta-analysis (P = 0.23) (Fig. 3).


Metabolic syndrome is associated with increased risk of Barrett esophagus: A meta-analysis.

He Q, Li JD, Huang W, Zhu WC, Yang JQ - Medicine (Baltimore) (2016)

Publication bias detected by Egger test.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4979793&req=5

Figure 3: Publication bias detected by Egger test.
Mentions: Subgroup analyses were further conducted by stratifying publication type, study design, and study setting (Table 2). As far as 2 publication types were concerned, no significant statistical differences were detected (abstracts: OR 1.26, 95%CI 0.86–1.85, P = 0.232 vs full text: OR 1.11, 95%CI 0.98–1.25, P = 0.113). Considering inclusion of overwhelming majority case–control studies (12 studies) and only 1 cohort study, subgroup analyses revealed markedly significance was observed in case–control group (OR = 1.16, 95%CI 1.03–1.32, P = 0.019 vs OR = 1.16, 95%CI 1.03–1.31, P = 0.871). In addition, based on different study settings, analysis result including population-based studies showed statistically significant difference (OR = 1.21, 95%CI 1.07–1.36, P = 0.003). Significant heterogeneity was observed in the overall effect analysis (χ2 = 32.26; P = 0.001, I2 = 62.8%). The results were stable according to subgroup interaction heterogeneity analysis (Table 2). Sensitive analysis by omitting 1 study in each turn indicated the results were unaffected. No single study notably affected the overall summary estimate or P value for heterogeneity. Publication bias was evaluated by a funnel plot and Egger's test. Asymmetry was observed by inspection of the funnel plot. Trim and fill method was subsequently analyzed, and the results had no obvious changes (data no shown). No significant publication bias was detected by Egger's test in the meta-analysis (P = 0.23) (Fig. 3).

Bottom Line: The pooled results showed MS was closely associated with increased risk of BE (OR = 1.23; 95%CI 1.03-1.47; P = 0.024), and yet DM did not significantly increase the risk of BE (OR = 1.07; 95%CI 0.82-1.38; P = 0.627).No significant publication bias was detected by Egger's test (P = 0.23).Based on the results of current meta-analysis, MS is associated with increased risk of BE.

View Article: PubMed Central - PubMed

Affiliation: aDepartment of Gastroenterology, The First Affiliated Hospital of Jinan University bDepartment of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, China.

ABSTRACT

Background: Barrett esophagus (BE) is considered precursor condition of esophageal adenocarcinoma. Its incidence and prevalence are increasing in general population. Studies reported that metabolic syndrome (MS) or diabetes mellitus (DM) is related to increased risk of BE. Current study was to assess and better understand the relationship between MS /DM and BE.

Methods: Electronic search was conducted in the database Pubmed/Medline (-December, 2015), Embase (-December, 2015), Cochrane Library (-December, 2015), and Web of Knowledge (-December, 2015). Studies included were assessed with summary odds ratios (ORs) with 95% confidence intervals (CIs) and compared exposure group with control group. The heterogeneity was examined by the funnel plot and the Egger's test. Subgroup analyses and sensitive analyses were performed for the detection of possible heterogeneity and impact on stability of analysis results.

Results: Twelve publications met the criteria and included 355,311 subjects were analyzed. The pooled results showed MS was closely associated with increased risk of BE (OR = 1.23; 95%CI 1.03-1.47; P = 0.024), and yet DM did not significantly increase the risk of BE (OR = 1.07; 95%CI 0.82-1.38; P = 0.627). Substantial heterogeneities were detected. No significant publication bias was detected by Egger's test (P = 0.23).

Conclusions: Based on the results of current meta-analysis, MS is associated with increased risk of BE. Further long-term follow-up prospective study needs to verify the current results, and definite pathophysiological mechanism needs to be further investigated and clearly elucidated.

No MeSH data available.


Related in: MedlinePlus