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☐ ☆ ✇ BMJ Open

Use of drugs for hyperlipidaemia and diabetes and risk of primary and secondary brain tumours: nested case-control studies using the UK Clinical Practice Research Datalink (CPRD)

Por: Robinson · J. W. · Martin · R. · Ozawa · M. · Elwenspoek · M. M. C. · Redaniel · M. T. · Kurian · K. · Ben-Shlomo · Y. — Febrero 9th 2024 at 17:00
Objectives

Previous studies have suggested that fibrates and glitazones may have a role in brain tumour prevention. We examined if there is support for these observations using primary care records from the UK Clinical Practice Research Datalink (CPRD).

Design

We conducted two nested case–control studies using primary and secondary brain tumours identified within CPRD between 2000 and 2016. We selected cases and controls among the population of individuals who had been treated with any anti-diabetic or anti-hyperlipidaemic medication to reduce confounding by indication.

Setting

Adults older than 18 years registered with a general practitioner in the UK contributing data to CPRD.

Results

We identified 7496 individuals with any brain tumour (4471 primary; 3025 secondary) in total. After restricting cases and controls to those prescribed any anti-diabetic or anti-hyperlipidaemic medication, there were 1950 cases and 7791 controls in the fibrate and 480 cases with 1920 controls in the glitazone analyses. Longer use of glitazones compared with all other anti-diabetic medications was associated with a reduced risk of primary (adjusted OR (aOR) 0.89 per year, 95% CI 0.80 to 0.98), secondary (aOR 0.87 per year, 95% CI 0.77 to 0.99) or combined brain tumours (aOR 0.88 per year, 95% CI 0.81 to 0.95). There was little evidence that fibrate exposure was associated with risk of either primary or secondary brain tumours.

Conclusions

Longer exposure to glitazones was associated with reduced primary and secondary brain tumour risk. Further basic science and population-based research should explore this finding in greater detail, in terms of replication and mechanistic studies.

☐ ☆ ✇ BMJ Open

Association between kimchi consumption and obesity based on BMI and abdominal obesity in Korean adults: a cross-sectional analysis of the Health Examinees study

Por: Jung · H. · Yun · Y.-R. · Hong · S. W. · Shin · S. — Enero 31st 2024 at 00:30
Objective

Previous animal studies have shown the anti-obesity effect of kimchi-derived probiotic lactic acid bacteria. However, only a few epidemiological studies have investigated the association between kimchi consumption and obesity. Therefore, we aim to assess this relationship in Korean adults.

Design

Cross-sectional study.

Setting

The Health Examinees study was conducted from 2004 to 2013.

Participants

This study analysed 115 726 participants aged 40–69 years enrolled in the Health Examinees study in Korea.

Primary and secondary outcome measures

Obesity was defined as body mass index ≥25 kg/m2, and abdominal obesity was defined as waist circumference ≥90 cm in men and ≥85 cm in women. Kimchi consumption was assessed by the validated food frequency questionnaire.

Results

In men, total kimchi consumption of 1–3 servings/day was related to a lower prevalence of obesity (OR: 0.875 in 1–2 servings/day and OR: 0.893 in 2–3 servings/day) compared with total kimchi consumption of

Conclusions and relevance

Consumption of 1–3 servings/day of total kimchi was associated with a lower risk of obesity in men. Baechu kimchi was associated with a lower prevalence of obesity in men, and kkakdugi was associated with a lower prevalence of abdominal obesity in both men and women. However, since all results showed a ‘J-shaped’ association, it is recommended to limit excessive kimchi intake.

☐ ☆ ✇ BMJ Open

Energy drink consumption and sleep parameters in college and university students: a national cross-sectional study

Por: Kaldenbach · S. · Hysing · M. · Strand · T. A. · Sivertsen · B. — Enero 23rd 2024 at 11:27
Objectives

To investigate the frequency of energy drink (ED) consumption, and the association between ED consumption and selected sleep characteristics and parameters in Norwegian college and university students. We also explored whether these associations varied based on sex.

Design

Cross-sectional.

Setting

Data were gathered from the SHOT2022 study (Students’ Health and Well-being Study), a national survey.

Participants

53 266 students, aged 18–35 years, enrolled in higher education in Norway (2022).

Main outcome measures

Estimated marginal means were computed from general linear models investigating the association between ED consumption and continuous sleep outcomes, while log-link binomial regression analysis was used for dichotomous sleep outcomes of sleep measures. All models were adjusted for age.

Results

Among the participants, 4.7% of men and 3.3% of women reported consuming ED daily. The frequency of ED consumption was inversely associated with sleep duration and sleep efficiency, while a direct association was observed with the frequency of ED consumption and sleep patterns such as sleep onset latency and wake after sleep onset across sexes. The strongest association was found between daily ED consumption and short sleep duration where men had a risk ratio (RR) of 2.07; 95% CI 1.77 to 2.42, and women had a RR of 1.87; 95% CI 1.64 to 2.14.

Conclusion

ED consumption was a strong determinant for negative sleep outcomes. Even small amounts of ED were associated with poorer sleep outcomes, which warrant more attention towards the consequences of consuming ED among college and university students.

☐ ☆ ✇ BMJ Open

Is male gynaecomastia associated with an increased risk of death? A nationwide register-based cohort study

Por: Bräuner · E. V. · Uldbjerg · C. · Lim · Y.-H. · Beck · A. · Hueg · T. · Juul · A. — Enero 17th 2024 at 00:30
Objective

Recent evidence supports that gynaecomastia may predict long-term morbidity, but evidence on the association with death and causes of death in males with gynaecomastia is lacking. The objective of this work is to estimate the risk of death in men diagnosed with gynaecomastia and evaluate whether this was conditional on underlying aetiologies of gynaecomastia.

Design

A nationwide register-based cohort study.

Setting

Nationwide Danish national health registries.

Participants

Males were diagnosed with incident gynaecomastia (n=23 429) from 1 January 1995 to 30 June 2021, and each was age and calendar matched to five randomly population-based males without gynaecomastia (n=117 145).

Interventions

Not applicable.

Primary and secondary outcomes

Gynaecomastia was distinguished between males without (idiopathic) and males with a known pre-existing risk factor. Cox regression models and Kaplan-Meier analyses estimated associations between gynaecomastia and death (all cause/cause specific).

Results

We identified a total of 16 253 males with idiopathic gynaecomastia and 7176 with gynaecomastia and a known pre-existing risk factor. Of these, 1093 (6.7%) and 1501 (20.9%) died during follow-up, respectively. We detected a 37% increased risk of all-cause death in males with gynaecomastia in the entire cohort (HR 1.37; 95% CI 1.31 to 1.43). Death risk was highest in males diagnosed with gynaecomastia and a known pre-existing risk factor (HR 1.75; 95% CI 1.64 to 1.86) compared with males with idiopathic gynaecomastia (HR 1.05; 95% CI 0.98 to 1.13). Specific causes of increased death were malignant neoplasms and circulatory, pulmonary and gastrointestinal diseases. Of the latter, an over fivefold risk of death from liver disease was detected (HR 5.05; 95% CI 3.97 to 6.42).

Conclusions

Males diagnosed with gynaecomastia are at higher risk of death, observed mainly in males with a known pre-existing risk factor of gynaecomastia. These findings will hopefully stimulate more awareness among healthcare providers to potentially apply interventions that aid in alleviating underlying risk factors in males with this condition.

☐ ☆ ✇ BMJ Open

Is the awarding gap at UK medical schools influenced by ethnicity and medical school attended? A retrospective cohort study

Por: Brown · C. · Goss · C. · Sam · A. H. — Diciembre 13th 2023 at 00:31
Objectives

To better characterise the Awarding Gap (AG) between black, Asian and other minority ethnic (BAME) and white students in UK undergraduate medical education by examining how it affects eight minority ethnicity subgroups (Bangladeshi, black, Chinese, Indian, Pakistani, mixed, other Asian background and other ethnic background) and whether the AG varies by medical school attended.

Design

Retrospective cohort study.

Setting

Data extracted from the UK Medical Education Database on students enrolled at 33 UK medical schools in the academic years starting 2012, 2013 and 2014.

Participants

16 020 ‘Home’ tuition fee status students who sat the University Clinical Aptitude Test on entry to university and obtained a UK Foundation Programme (UKFP) application score on exit.

Primary outcome measure

UKFP Z-scores on exit from medical school.

Results

There were significant differences in UKFP Z-scores between ethnicity subgroups. After white students, mixed ethnicity students performed best (coefficient –0.15 standard deviations [SD]) compared with white students, (95% confidence interval [CI] –0.23 to –0.08, p

Conclusions

BAME students are significantly disadvantaged by the current UK medical education system. There are clear differences in medical school outcomes between students from different ethnicity subgroups, and the size of the AG also varies by medical school attended. Urgent and effective action must be taken to address the AG and achieve an equal learning environment for our future doctors.

☐ ☆ ✇ BMJ Open

Association between leisure sedentary behaviour and uterine fibroids in non-menopausal women: a population-based study

Por: Sun · Y. · Han · X. · Hou · Z. · Deng · H. · Cheng · N. · Zhang · N. · Zhang · J. · Li · Y. · Wang · Q. · Yin · J. · Meng · Q. — Noviembre 29th 2023 at 00:30
Objective

Sedentary behaviour is associated with a variety of adverse health outcomes, including obesity, oestrogen metabolism and chronic inflammation, all of which are related to the pathogenesis of uterine fibroids (UFs). This study aimed to explore the relationship between leisure sedentary time (LST) and UFs.

Design

Cross-sectional.

Setting

We conducted a cross-sectional analysis of data from patients from the Yunnan region in the China Multi-Ethnic Cohort Study.

Participants

A total of 6623 non-menopausal women aged 30–55 years old were recruited. Menstrual status was self-reported. Participants who lacked a unique national identity card, suffered from serious mental illness, did not have a clear diagnosis of UFs, or provided incomplete information were excluded.

Primary and secondary outcome

UFs were diagnosed by abdominal B-ultrasound. Leisure sedentary behaviour was assessed by using a face-to-face questionnaire interview. Logistic regression and restricted cubic spline were employed to explore the relationship between LST and UFs.

Results

A total of 562 participants had UFs, with a prevalence rate of 8.5% (7.8%, 9.2%). Multivariate adjusted logistic regression analysis showed that the risk of UFs in women with LST≥6 hour/day was 2.008 times that in women with LST0.05). According to the results of the stratified analysis for menstrual status and body mass index (BMI), there was a correlation between LST and the prevalence of UFs only in women with a BMI2 or perimenopause.

Conclusion

LST was independently associated with the prevalence of UFs, and a linear dose-response relationship was observed. Our study provides evidence on the factors influencing UFs, and further research is needed to propose feasible measures for UFs prevention.

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