Search

OBJECTIVE: To investigate if there is a reduced risk of type 1 diabetes in children breastfed or exclusively breastfed by performing a pooled analysis with adjustment for recognized confounders. RESEARCH DESIGN AND METHODS: Relevant studies were identified from literature searches using MEDLINE, Web of Science, and EMBASE. Authors of relevant studies were asked to provide individual participant data or conduct prespecified analyses. Meta-analysis techniques were used to combine odds ratios (ORs) and investigate heterogeneity between studies. RESULTS: Data were available from 43 studies including 9,874 patients with type 1 diabetes. Overall, there was a reduction in the risk of diabetes after exclusive breast-feeding for >2 weeks (20 studies; OR = 0.75, 95% CI 0.64-0.88), the association after exclusive breast-feeding for >3 months was weaker (30 studies; OR = 0.87, 95% CI 0.75-1.00), and no association was observed after (nonexclusive) breast-feeding for >2 weeks (28 studies; OR = 0.93, 95% CI 0.81-1.07) or >3 months (29 studies; OR = 0.88, 95% CI 0.78-1.00). These associations were all subject to marked heterogeneity (I(2) = 58, 76, 54, and 68%, respectively). In studies with lower risk of bias, the reduced risk after exclusive breast-feeding for >2 weeks remained (12 studies; OR = 0.86, 95% CI 0.75-0.99), and heterogeneity was reduced (I(2) = 0%). Adjustments for potential confounders altered these estimates very little. CONCLUSIONS: The pooled analysis suggests weak protective associations between exclusive breast-feeding and type 1 diabetes risk. However, these findings are difficult to interpret because of the marked variation in effect and possible biases (particularly recall bias) inherent in the included studies.

OBJECTIVE - To investigate if there is a reduced risk of type 1 diabetes in children breastfed or exclusively breastfed by performing a pooled analysis with adjustment for recognized confounders. RESEARCH DESIGN AND METHODS - Relevant studies were identified from literature searches using MEDLINE, Web of Science, and EMBASE. Authors of relevant studies were asked to provide individual participant data or conduct prespecified analyses. Meta-analysis techniques were used to combine odds ratios (ORs) and investigate heterogeneity between studies. RESULTS - Data were available from 43 studies including 9,874 patients with type 1 diabetes. Overall, there was a reduction in the risk of diabetes after exclusive breast-feeding for >2 weeks (20 studies; OR = 0.75, 95% CI 0.64- 0.88), the association after exclusive breast-feeding for >3 months was weaker (30 studies;OR = 0.87, 95%CI 0.75 -1.00), and no association was observed after (nonexclusive) breast-feeding for >2 weeks (28 studies; OR = 0.93, 95% CI 0.81-1.07) or >3 months (29 studies; OR = 0.88, 95% CI 0.78-1.00). These associations were all subject to marked heterogeneity (I 2 = 58, 76, 54, and 68%, respectively). In studies with lower risk of bias, the reduced risk after exclusive breast-feeding for >2 weeks remained (12 studies; OR = 0.86, 95% CI 0.75-0.99), and heterogeneity was reduced (I 2 = 0%). Adjustments for potential confounders altered these estimates very little. CONCLUSIONS - The pooled analysis suggests weak protective associations between exclusive breast-feeding and type 1 diabetes risk. However, these findings are difficult to interpret because of the marked variation in effect and possible biases (particularly recall bias) inherent in the included studies. © 2012 by the American Diabetes Association.

Purpose: Thyroid cancer patients have favorable prognosis. The aim of this study was to analyze changing trends in mortality of thyroid cancer in Belgrade, during the period between 1987 and 2006 Methods: Mortality data were obtained from the Belgrade Office of Statistics. Mortality rates per 100,000 inhabitants were standardized according to the Segi's world population. Regression analysis was used to estimate the thyroid cancer mortality trend for the period 1987-2006. Results: The average percent of deaths due to thyroid cancer among all deaths was almost 2-fold higher in females (0.11%) than in males (0.6%), as well as among deaths due to all malignancies (females 0.54% and males 0.27%). During this 20-year period, the average standardized mortality rate was 1.5 times higher in females (0.74 per 100.000) than in males (0.51 per 100.000). In the observed period, the mortality rates for thyroid cancer were increased (+0.40%) in women and decreased (-0.42%) in men. In particular, in the 60-69 years age group in males, a significant trend for mortality decrease of 3.5%/year was detected. Conclusion: Belgrade is classified in the regions with low risk of dying due to thyroid malignancies. The increasing trend of thyroid cancer mortality in females during the examined period calls for improvement of methods for early detection of disease and differential diagnosis of thyroid nodules, so that surgical treatment of thyroid cancer could be performed at a stage when it is not life threatening.

since an association between prostate cancer and some foods or food groups like meat, milk and dairy products, tomato foods, and allium vegetables, has been suggested, we analyzed the possibility that some food items or some food groups could be related to prostate cancer in some other way and not only through their nutrients. The purpose of this study was to test some hypotheses about diet as risk factor for prostate cancer.this case-control study comprised 101 cases of prostate cancer and 202 hospital controls individually matched for age (± 2 years), hospital admission and place of residence. Dietary information of 150 food items was obtained by a quantitative history approach.multivariate logistic regression analysis indicated as risk factors for prostate cancer high intake of fruit, processed meat, fish (most frequently canned) and butter. High intake of chicken, potato and rice exhibited a protective effect.these results support the hypothesis that consumption of meat and fat play a role in the development of prostate cancer. The findings that consumption of processed meat only (not fresh) and fish increased the risk of prostate cancer, as well as the protective effect of chicken, potato and rice consumption should be corroborated by other investigators.

OBJECTIVE-To investigate if there is a reduced risk of type 1 diabetes in children breastfed or exclusively breastfed by performing a pooled analysis with adjustment for recognized confounders. less thanbrgreater than less thanbrgreater thanRESEARCH DESIGN AND METHODS-Relevant studies were identified from literature searches using MEDLINE, Web of Science, and EMBASE. Authors of relevant studies were asked to provide individual participant data or conduct prespecified analyses. Meta-analysis techniques were used to combine odds ratios (ORs) and investigate heterogeneity between studies. less thanbrgreater than less thanbrgreater thanRESULTS-Data were available from 43 studies including 9,874 patients with type 1 diabetes. Overall, there was a reduction in the risk of diabetes after exclusive breast-feeding for andgt;2 weeks (20 studies; OR = 0.75, 95% CI 0.64-0.88), the association after exclusive breast-feeding for andgt;3 months was weaker (30 studies; OR = 0.87, 95% CI 0.75-1.00), and no association was observed after (nonexclusive) breast-feeding for andgt;2 weeks (28 studies; OR = 0.93, 95% CI 0.81-1.07) or andgt;3 months (29 studies; OR = 0.88, 95% CI 0.78-1.00). These associations were all subject to marked heterogeneity (I-2 = 58, 76, 54, and 68%, respectively). In studies with lower risk of bias, the reduced risk after exclusive breast-feeding for andgt;2 weeks remained (12 studies; OR = 0.86, 95% CI 0.75-0.99), and heterogeneity was reduced (I-2 = 0%). Adjustments for potential confounders altered these estimates very little. less thanbrgreater than less thanbrgreater thanCONCLUSIONS-The pooled analysis suggests weak protective associations between exclusive breast-feeding and type 1 diabetes risk. However, these findings are difficult to interpret because of the marked variation in effect and possible biases (particularly recall bias) inherent in the included studies. Funding Agencies|National Institutes of Health|R01-DK-46498R01-DK-42316|Chinese Foundation of Health||Department of Health, Executive Yuan, Republic of China|DOH91-TD1167|Ministry for Science and Technology of the Republic of Serbia|175042|German Research Foundation|HE 234/1-1|Research Council of Norway|148359/330

Czech Republic Ministry of Education Department of Health of Taiwan Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Swedish Child Diabetes Foundation NHS National Coordinating Centre for Research Capacity Development UK Australian National Health and Medical Research Council (NHMRC) Research Council of Norway German Research Foundation Ministry for Science and Technological Development of Serbia European Commission Health Information Strand Diabetes UK Northern Ireland Department of Health and Social Services Background the incidence rates of childhood onset type 1 diabetes are almost universally increasing across the globe but the aetiology of the disease remains largely unknown. We investigated whether birth order is associated with the risk of childhood diabetes by performing a pooled analysis of previous studies.Methods Relevant studies published before January 2010 were identified from MEDLINE, Web of Science and EMBASE. Authors of studies provided individual patient data or conducted pre-specified analyses. Meta-analysis techniques were used to derive combined odds ratios (ORs), before and after adjustment for confounders, and investigate heterogeneity.Results Data were available for 6 cohort and 25 case-control studies, including 11 955 cases of type 1 diabetes. Overall, there was no evidence of an association prior to adjustment for confounders. After adjustment for maternal age at birth and other confounders, a reduction in the risk of diabetes in second- or later born children became apparent [fully adjusted OR = 0.90 95% confidence interval (CI) 0.83-0.98; P = 0.02] but this association varied markedly between studies (I(2) = 67%). An a priori subgroup analysis showed that the association was stronger and more consistent in children < 5 years of age (n = 25 studies, maternal age adjusted OR = 0.84 95% CI 0.75, 0.93; I(2) = 23%).Conclusion Although the association varied between studies, there was some evidence of a lower risk of childhood onset type 1 diabetes with increasing birth order, particularly in children aged < 5 years. This finding could reflect increased exposure to infections in early life in later born children. Queens Univ Belfast, Ctr Publ Hlth, Sch Med Dent & Biomed Sci, Belfast BT12 6BJ, Antrim, North Ireland Norwegian Inst Publ Hlth, Div Epidemiol, Oslo, Norway Oslo Univ Hosp, Oslo Diabet Res Ctr, Oslo, Norway Univ Oslo, Inst Hlth Management & Hlth Econ, Oslo, Norway Univ Western Australia, Telethon Inst Child Hlth Res, Ctr Child Hlth Res, Perth, WA 6009, Australia Univ Notre Dame, Inst Hlth & Rehabil Res, Fremantle, Australia Charles Univ Prague, Sch Med 2, Prague, Czech Republic Univ Dusseldorf, Leibniz Inst, Inst Biometr & Epidemiol, German Diabet Ctr, Dusseldorf, Germany Linkoping Univ, Dept Paediat, Linkoping, Sweden Linkoping Univ, Diabet Res Ctr, Linkoping, Sweden Glostrup Univ Hosp, Dept Pediat, Glostrup, Denmark Univ Oxford, Dept Publ Hlth, Oxford, England Med Univ Vienna, Dept Epidemiol, Vienna, Austria Med Univ Silesia, Dept Pediat Endocrinol & Diabet, Katowice, Poland Universidade Federal de São Paulo, Dept Prevent Med, São Paulo, Brazil Natl Taiwan Univ Hosp, Dept Internal Med, Taipei 100, Taiwan Univ Sydney, Kolling Inst Med Res, Sydney, NSW 2006, Australia Univ Leeds, Paediat Epidemiol Grp, Leeds, W Yorkshire, England Cardiff Univ, Ctr Occupat & Hlth Psychol, Cardiff, S Glam, Wales Univ Lancaster, Dept Math & Stat, Lancaster, England Riga Stradins Univ, Dept Publ Hlth & Epidemiol, Riga, Latvia Kaunas Univ Med, Inst Endocrinol, Kaunas, Lithuania Univ Belgrade, Sch Med, Inst Epidemiol, Belgrade, Serbia Med Univ Vienna, Dept Paediat, Vienna, Austria Univ Lecce, Dept Social Sci & Commun, I-73100 Lecce, Italy N Paulescu Inst Diabet, Nutr & Metab Dis Clin, Bucharest, Romania Pediat Clin, Luxembourg, Luxembourg Childrens Diabet Ctr, Sofia, Bulgaria Rigshosp, Bartholin Inst, DK-2100 Copenhagen, Denmark Hosp LMU Munich, Inst Occupat & Environm Med, Munich, Germany Hosp LMU Munich, Outpatient Clin Occupat & Environm Med, Munich, Germany Sir Charles Gairdner Hosp, Perth, WA, Australia Universidade Federal de São Paulo, Dept Prevent Med, São Paulo, Brazil Czech Republic Ministry of Education: MSM 0021620814 Department of Health of Taiwan: DOH 90-TD1028 FAPESP: 94/0943-0 Australian National Health and Medical Research Council (NHMRC): 457302 German Research Foundation: HE 234/1-1 Ministry for Science and Technological Development of Serbia: 145084 European Commission Health Information Strand: 2007115 Web of Science

OBJECTIVE The aim if the study was to investigate whether children born to older mothers have an increased risk of type 1 diabetes by performing a pooled analysis of previous studies using individual patient data to adjust for recognized confounders. RESEARCH DESIGN AND METHODS Relevant studies published before June 2009 were identified from MEDLINE, Web of Science, and EMBASE. Authors of studies were contacted and asked to provide individual patient data or conduct prespecified analyses. Risk estimates of type 1 diabetes by maternal age were calculated for each study, before and after adjustment for potential confounders. Meta-analysis techniques were used to derive combined odds ratios and to investigate heterogeneity among studies. RESULTS Data were available for 5 cohort and 25 case-control studies, including 14,724 cases of type 1 diabetes. Overall, there was, on average, a 5% (95% CI 2–9) increase in childhood type 1 diabetes odds per 5-year increase in maternal age (P = 0.006), but there was heterogeneity among studies (heterogeneity I2 = 70%). In studies with a low risk of bias, there was a more marked increase in diabetes odds of 10% per 5-year increase in maternal age. Adjustments for potential confounders little altered these estimates. CONCLUSIONS There was evidence of a weak but significant linear increase in the risk of childhood type 1 diabetes across the range of maternal ages, but the magnitude of association varied between studies. A very small percentage of the increase in the incidence of childhood type 1 diabetes in recent years could be explained by increases in maternal age.

AIMS/HYPOTHESIS: The aim of this study was to investigate the evidence of an increased risk of childhood-onset type 1 diabetes in children born by Caesarean section by systematically reviewing the published literature and performing a meta-analysis with adjustment for recognised confounders. METHODS: After MEDLINE, Web of Science and EMBASE searches, crude ORs and 95% CIs for type 1 diabetes in children born by Caesarean section were calculated from the data reported in each study. Authors were contacted to facilitate adjustments for potential confounders, either by supplying raw data or calculating adjusted estimates. Meta-analysis techniques were then used to derive combined ORs and to investigate heterogeneity between studies. RESULTS: Twenty studies were identified. Overall, there was a significant increase in the risk of type 1 diabetes in children born by Caesarean section (OR 1.23, 95% CI 1.15-1.32, p < 0.001). There was little evidence of heterogeneity between studies (p = 0.54). Seventeen authors provided raw data or adjusted estimates to facilitate adjustments for potential confounders. In these studies, there was evidence of an increase in diabetes risk with greater birthweight, shorter gestation and greater maternal age. The increased risk of type 1 diabetes after Caesarean section was little altered after adjustment for gestational age, birth weight, maternal age, birth order, breast-feeding and maternal diabetes (adjusted OR 1.19, 95% CI 1.04-1.36, p = 0.01). CONCLUSIONS/INTERPRETATION: This analysis demonstrates a 20% increase in the risk of childhood-onset type 1 diabetes after Caesarean section delivery that cannot be explained by known confounders.