This study examined whether exposure to nitrate in drinking water is associated with increased risk for bladder cancer by conducting a comprehensive literature research. A meta-analysis was performed with and without ...This study examined whether exposure to nitrate in drinking water is associated with increased risk for bladder cancer by conducting a comprehensive literature research. A meta-analysis was performed with and without adjustment for confounding factors. Three groups (reference, intermediate and high groups) were established in terms of different nitrate concentrations in each included study. Separate relative risk measures were calculated for intermediate and high groups. Heterogeneity was assessed by using the Q statistics. Publication bias was evaluated by Egger’s and Begg’s test. Quality assessment for studies was performed by using the Newcastle-Ottawa scale. Two cohorts, two case-controls, and one ecological study were included in this study. The adjusted data showed that the combined risk ratios (RRs) were 1.13 (95% CI: 0.81 to 1.57) and 1.27 (95% CI: 0.75 to 2.15) for inter-mediate and high groups respectively. For unadjusted data, the corresponding RRs were 1.18 (95% CI: 0.89 to 1.57) and 1.29 (95% CI: 0.81 to 2.07). Sensitivity test indicated that results were significantly underestimated when Ward’s study was included. No significant publication bias was found. There was heterogeneity among studies. The results suggested that there was no sufficient evidence that nitrate in drinking water is associated with increased risks for bladder cancer.展开更多
目的探讨中国城乡老年人慢性病共病模式及其影响因素的差异,为制定城乡慢性病管理策略提供科学依据。方法利用2018年中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)中11005名≥60岁老年人的数据,分析...目的探讨中国城乡老年人慢性病共病模式及其影响因素的差异,为制定城乡慢性病管理策略提供科学依据。方法利用2018年中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)中11005名≥60岁老年人的数据,分析老年人慢性病共病患病现状。采用R 4.0.0统计软件进行Wilcoxon秩和检验、Kruskal-Wallis H检验和χ^(2)检验;利用R语言的arules程序包进行关联规则的Apriori算法挖掘城乡老年人慢性病共病的常见模式;采用多分类logistic回归分别探讨城乡老年人共病相关影响因素。结果中国城乡老年人64.9%处于共病状态,城镇老年人慢性病共病患病率为69.4%,农村老年人慢性病共病患病率为63.3%。关联规则的Apriori算法共筛选出14条较强关联的慢性疾病共病模式,城镇老年人最常见的3种共病模式为血脂异常和高血压、心脏病和高血压、糖尿病或血糖升高和高血压,农村老年人最常见的3种共病模式为胃部疾病或消化系统疾病和关节炎或风湿病、血脂异常和高血压、心脏病和高血压。多分类logistic回归分析结果显示,无论城镇还是农村,年龄70~<80岁(农村OR=1.64,95%CI:1.40~1.92;城镇OR=1.48,95%CI:1.13~1.94)、患有残疾(农村OR=2.33,95%CI:2.03~2.67;城镇OR=2.70,95%CI:2.07~3.54)与慢性病共病高风险相关;睡眠时间在6~<8 h(农村OR=0.63,95%CI:0.67~0.97;城镇OR=0.64,95%CI:0.49~0.84)及≥8 h(农村OR=0.52,95%CI:0.44~0.61;城镇OR=0.57,95%CI:0.42~0.77)与慢性病共病低风险相关;农村女性(OR=1.71,95%CI:1.40~2.08)与慢性病共病高风险相关。结论慢性病共病在老年人中普遍存在,慢性病共病模式和相关影响因素在城镇和农村地区存在差异。慢性病的预防和控制需转变为共病管理模式,根据城乡老年人慢性病共病的特点制定有针对性的慢性病管理策略,提高慢性病防治及管理的成效。展开更多
文摘This study examined whether exposure to nitrate in drinking water is associated with increased risk for bladder cancer by conducting a comprehensive literature research. A meta-analysis was performed with and without adjustment for confounding factors. Three groups (reference, intermediate and high groups) were established in terms of different nitrate concentrations in each included study. Separate relative risk measures were calculated for intermediate and high groups. Heterogeneity was assessed by using the Q statistics. Publication bias was evaluated by Egger’s and Begg’s test. Quality assessment for studies was performed by using the Newcastle-Ottawa scale. Two cohorts, two case-controls, and one ecological study were included in this study. The adjusted data showed that the combined risk ratios (RRs) were 1.13 (95% CI: 0.81 to 1.57) and 1.27 (95% CI: 0.75 to 2.15) for inter-mediate and high groups respectively. For unadjusted data, the corresponding RRs were 1.18 (95% CI: 0.89 to 1.57) and 1.29 (95% CI: 0.81 to 2.07). Sensitivity test indicated that results were significantly underestimated when Ward’s study was included. No significant publication bias was found. There was heterogeneity among studies. The results suggested that there was no sufficient evidence that nitrate in drinking water is associated with increased risks for bladder cancer.
文摘目的探讨中国城乡老年人慢性病共病模式及其影响因素的差异,为制定城乡慢性病管理策略提供科学依据。方法利用2018年中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)中11005名≥60岁老年人的数据,分析老年人慢性病共病患病现状。采用R 4.0.0统计软件进行Wilcoxon秩和检验、Kruskal-Wallis H检验和χ^(2)检验;利用R语言的arules程序包进行关联规则的Apriori算法挖掘城乡老年人慢性病共病的常见模式;采用多分类logistic回归分别探讨城乡老年人共病相关影响因素。结果中国城乡老年人64.9%处于共病状态,城镇老年人慢性病共病患病率为69.4%,农村老年人慢性病共病患病率为63.3%。关联规则的Apriori算法共筛选出14条较强关联的慢性疾病共病模式,城镇老年人最常见的3种共病模式为血脂异常和高血压、心脏病和高血压、糖尿病或血糖升高和高血压,农村老年人最常见的3种共病模式为胃部疾病或消化系统疾病和关节炎或风湿病、血脂异常和高血压、心脏病和高血压。多分类logistic回归分析结果显示,无论城镇还是农村,年龄70~<80岁(农村OR=1.64,95%CI:1.40~1.92;城镇OR=1.48,95%CI:1.13~1.94)、患有残疾(农村OR=2.33,95%CI:2.03~2.67;城镇OR=2.70,95%CI:2.07~3.54)与慢性病共病高风险相关;睡眠时间在6~<8 h(农村OR=0.63,95%CI:0.67~0.97;城镇OR=0.64,95%CI:0.49~0.84)及≥8 h(农村OR=0.52,95%CI:0.44~0.61;城镇OR=0.57,95%CI:0.42~0.77)与慢性病共病低风险相关;农村女性(OR=1.71,95%CI:1.40~2.08)与慢性病共病高风险相关。结论慢性病共病在老年人中普遍存在,慢性病共病模式和相关影响因素在城镇和农村地区存在差异。慢性病的预防和控制需转变为共病管理模式,根据城乡老年人慢性病共病的特点制定有针对性的慢性病管理策略,提高慢性病防治及管理的成效。
