Metabolic syndrome and risk of cancer: a study protocol of case–control study using data from the Information System for the Development of Research in Primary Care (SIDIAP) in Catalonia

BackgroundMetabolic syndrome (MS) is defined by the clustering of specific metabolic disorders in one subject. MS is highly prevalent globally and currently considered a growing public health concern. MS comprises obesity, hypertension, dyslipidaemia and insulin resistance. Mechanisms linking MS with cancer are poorly understood, and it is as yet unknown if MS confers a greater risk than the risk entailed by each of its separate components. The main objective of this study is to compare the association between MS and 14 site-specific cancer against the association between one or two individual components of MS and cancer. The secondary objective is to evaluate the time elapsed since the diagnosis of MS and the subsequent onset of cancer within the 2006–2017 period by sex.Methods and analysisA case–control study will be conducted for the main objective and a cohort of patients with MS will be followed for the evaluation of the second objective. Incident cases of fourteen types of cancer in patients ≥40 years of age diagnosed prospectively will be selected from electronic primary care records in the Information System for Research in Primary Care (SIDIAP database;www.sidiap.org). The SIDIAP database includes anonymous data from 6 million people (80% of the Catalan population) registered in 286 primary healthcare centres. Each matched control (four controls for each case) will have the same inclusion date, the same sex and age (±1 year) than the paired case. Logistic regression and a descriptive analysis and Kaplan-Meier analysis will be performed, in accordance with the objectives.Ethics and disseminationThe protocol of the study was approved by the IDIAP Jordi Gol Clinical Research Ethics Committee (protocol P17/212). The study’s findings will be published in a peer-reviewed journal and disseminated at national and international conferences and oral presentations to researchers, clinicians and policy makers.

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Shingles, Zostavax vaccination and risk of developing dementia: a nested case–control study—results from the UK Biobank cohort

BMJ Open ◽

10.1136/bmjopen-2020-045871 ◽

2021 ◽

Vol 11 (10) ◽

pp. e045871

Author(s):

Artitaya Lophatananon ◽

Krisztina Mekli ◽

Rachel Cant ◽

Alistair Burns ◽

Curtis Dobson ◽

...

Keyword(s):

Primary Care ◽

Case Control Study ◽

Case Control ◽

Uk Biobank ◽

Dementia Diagnosis ◽

Study Results ◽

The Uk ◽

Nested Case Control ◽

Incident Cases ◽

Control Study

ObjectivesTo investigate the association between shingles and dementia, and between Zostavax vaccination and dementia.DesignNested case–control study.SettingsData were drawn from the UK Biobank cohort study with a total of 228 223 participants with Hospital Episodes Statistics and primary care linkage health records.ParticipantsThe analyses included 2378 incident dementia cases and 225 845 controls. Inclusion criteria for incident cases were a dementia diagnosis 3 years or more after the first assessment date derived from all sources including International Classification of Diseases (ICD)-10, ICD-9, self-report and primary care linkage records. Subjects with no dementia code from all sources were coded as controls. Both shingles and Zostavax vaccination were investigated for their association with dementia risk.ResultsThere was a small but non-significant increase in the risk of dementia in subjects with shingles diagnosed 3 years or more prior to dementia diagnosis (OR: 1.088 with 95% CI: 0.978 to 1.211). In those subjects who had had Zostavax vaccination, the risk of dementia significantly decreased (OR: 0.808 with 95% CI: 0.657 to 0.993).ConclusionA history of shingles was not associated with an increased risk of dementia. In subjects who were eligible for the immunisation and vaccinated with Zostavax, we saw reduced risk of developing dementia.

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Selection of men for investigation of possible testicular cancer in primary care: a large case–control study using electronic patient records

British Journal of General Practice ◽

10.3399/bjgp18x697949 ◽

2018 ◽

Vol 68 (673) ◽

pp. e559-e565 ◽

Cited By ~ 1

Author(s):

Elizabeth A Shephard ◽

William T Hamilton

Keyword(s):

Primary Care ◽

Testicular Cancer ◽

Clinical Features ◽

Case Control Study ◽

Case Control ◽

Clinical Practice Research Datalink ◽

Predictive Values ◽

Risk Of Cancer ◽

Control Study ◽

Selection Of

BackgroundTesticular cancer incidence has risen over the last two decades and is expected to continue to rise. There are no primary care studies on the clinical features of testicular cancer, with recent National Institute for Health and Care Excellence (NICE) guidance based solely upon clinical consensus.AimTo identify clinical features of testicular cancer and to quantify their risk in primary care patients, with the aim of improving the selection of patients for investigation.Design and settingA matched case–control study in males aged ≥17 years, using Clinical Practice Research Datalink records.MethodPutative clinical features of testicular cancer were identified and analysed using conditional logistic regression. Positive predictive values (PPVs) were calculated for those aged <50 years.ResultsIn all, 1398 cases were available, diagnosed between 2000 and 2012, with 4956 age-, sex-, and practice-matched controls. Nine features were independently associated with testicular cancer, the top three being testicular swelling (odds ratio [OR] 280, 95% confidence interval [CI] = 110 to 690), testicular lump (OR 270, 95% CI = 100 to 740), and scrotal swelling (OR 170, 95% CI = 35 to 800). The highest PPV for 17–49-year-olds was testicular lump, at 2.5% (95% CI = 1.1 to 5.6). Combining testicular lump with testicular swelling or testicular pain produced PPVs of 17% and 10%, respectively.ConclusionTesticular enlargement carries a risk of cancer of 2.5% — close to the current 3% threshold in UK referral guidance. Contrary to traditional teaching, painful testicular enlargement may signify cancer. Some initial hydrocele diagnoses appear to be wrong, with missed cancers, suggesting an ultrasound may be useful when a hydrocele diagnosis is uncertain. These results support the existing NICE guidelines, and help to characterise when an ultrasound should be considered in symptomatic men.

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Individual risk factors of metabolic syndrome in adult patients with GH deficiency: a cross-sectional case-control study

Endocrine Abstracts ◽

10.1530/endoabs.35.p939 ◽

2014 ◽

Author(s):

Ivayla Uzunova ◽

Georgi Kirilov ◽

Sabina Zacharieva ◽

Alexander Shinkov ◽

Anna-Maria Borissova ◽

...

Keyword(s):

Risk Factors ◽

Metabolic Syndrome ◽

Case Control Study ◽

Gh Deficiency ◽

Case Control ◽

Adult Patients ◽

Individual Risk ◽

Cross Sectional ◽

Individual Risk Factors ◽

Control Study

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Descriptive analysis of body composition and phase angle (PA) in achondroplastic patients: Case-control study

Endocrine Abstracts ◽

10.1530/endoabs.70.aep475 ◽

2020 ◽

Author(s):

Vegas-Aguilar Isabel Mª ◽

Cornejo Pareja Isabel Maria ◽

Gea Antonio Leiva ◽

Francisco J Tinahones ◽

García-Almeida Jose Manuel

Keyword(s):

Body Composition ◽

Phase Angle ◽

Case Control Study ◽

Descriptive Analysis ◽

Case Control ◽

Control Study

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0708 Cognitive impairment in the metabolic syndrome: a case-control study in the Spanish population

Journal of the Neurological Sciences ◽

10.1016/s0022-510x(05)81072-x ◽

2005 ◽

Vol 238 ◽

pp. S280

Keyword(s):

Metabolic Syndrome ◽

Cognitive Impairment ◽

Case Control Study ◽

Case Control ◽

Spanish Population ◽

The Metabolic Syndrome ◽

Control Study

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OP0234 RISK OF ACUTE MYOCARDIAL INFARCTION AMONG NEW USERS OF CHONDROITIN SULPHATE: A NESTED CASE-CONTROL STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.123 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 144.1-144

Author(s):

R. Mazzucchelli ◽

S. Rodriguez-Martin ◽

A. García-Vadillo ◽

M. Gil ◽

A. Rodríguez-Miguel ◽

...

Keyword(s):

Myocardial Infarction ◽

Cardiovascular Disease ◽

Acute Myocardial Infarction ◽

Cardiovascular Risk ◽

Case Control Study ◽

Chondroitin Sulphate ◽

Case Control ◽

Nested Case Control ◽

Incident Cases ◽

Control Study

Background:There is some evidence from epidemiological studies suggesting that CS and glucosamine could play a role in cardiovascular disease (CVD) prevention (1-4).Studies to date have included prevalent users, therefore a bias that overestimates protection cannot be excluded.Objectives:To test the hypothesis that chondroitin sulphate (CS) or glucosamine reduce the risk of acute myocardial infarction (AMI).Methods:Case-control study nested in a primary cohort composed of patients aged 40 to 99 years, with at least one year of follow-up in the BIFAP database during the 2002-2015 study period. From this cohort of patients, we identified incident cases of AMI and randomly selected five controls per case, matched by exact age, gender, and index date. Adjusted odds ratios (AOR) and their corresponding 95% confidence interval (CI)) were calculated through a conditional logistic regression. Only new users of CS or glucosamine were considered.Results:A total of 23,585 incident cases of AMI and 117,405 controls were included. The mean age was 67.0 (SD 13.4) years and 71.75% were male, in both groups. 558 (2.37%) cases and 3,082 (2.62%) controls used or had used CS. The current use of CS was associated with a lower risk of AMI (AOR 0.57; 95%CI: 0.46–0.72) and disappeared after discontinuation (recent and past users). The reduced risk among current users was observed in both short-term (<365 days AOR 0.58; 95%CI: 0.45-0.75) and long-term users (>364 days AOR 0.56; 95%CI 0.36-0.87), in both sexes (men, AOR=0.52; 95%CI:0.38-0.70; women, AOR=0.65; 95%CI: 0.46-0.91), in individuals over or under 70 years of age (AOR=0.54; 95%CI:0.38-0.77, and AOR=0.61; 95%CI:0.45-0.82, respectively) and in individuals at intermediate (AOR=0.65; 95%CI:0.48-0.91) and high cardiovascular risk (AOR=0.48;95%CI:0.27-0.83), but not in those at low risk (AOR=1.11; 95%CI:0.48-2.56). In contrast, the current use of glucosamine was not associated with either increased or decreased risk of AMI (AOR= 0.86; CI95% 0.66-1.08)Conclusion:Our results support a cardioprotective effect of CS, while no effect was observed with glucosamine. The highest protection was found among subgroups at higher cardiovascular risk.References:[1]Ma H, Li X, Sun D, Zhou T, Ley SH, Gustat J, et al. Association of habitual glucosamine use with risk of cardiovascular disease: prospective study in UK Biobank. BMJ. 2019;365(Journal Article):l1628.[2]de Abajo FJ, Gil MJ, Garcia Poza P, Bryant V, Oliva B, Timoner J, et al. Risk of nonfatal acute myocardial infarction associated with non-steroidal antiinflammatory drugs, non-narcotic analgesics and other drugs used in osteoarthritis: a nested case-control study. PharmacoepidemiolDrug Saf. 2014;23(11):1128–38.[3]Li Z-H, Gao X, Chung VC, Zhong W-F, Fu Q, Lv Y-B, et al. Associations of regular glucosamine use with all-cause and cause-specific mortality: a large prospective cohort study. Ann Rheum Dis. 2020 Apr 6;annrheumdis-2020-217176.[4]King DE, Xiang J. Glucosamine/Chondroitin and Mortality in a US NHANES Cohort. J Am Board Fam Med. 2020 Dec;33(6):842–7.Disclosure of Interests:Ramón Mazzucchelli Speakers bureau: UCB, Lilly, Grant/research support from: Pfizer, Roche, Amgen, Sara Rodriguez-Martin: None declared, Alberto García-Vadillo: None declared, Miguel Gil: None declared, Antonio Rodríguez-Miguel: None declared, Diana Barreira-Hernández: None declared, Alberto García-Lledó: None declared, Francisco de Abajo: None declared

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Relation of severe COVID-19 to polypharmacy and prescribing of psychotropic drugs: the REACT-SCOT case-control study

BMC Medicine ◽

10.1186/s12916-021-01907-8 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Paul M. McKeigue ◽

◽

Sharon Kennedy ◽

Amanda Weir ◽

Jen Bishop ◽

...

Keyword(s):

Primary Care ◽

Rate Ratio ◽

Case Control Study ◽

Fatal Outcome ◽

Case Control ◽

Care Practice ◽

Drug Classes ◽

Increased Risk ◽

Co Morbidity ◽

Control Study

Abstract Background The objective of this study was to investigate the relation of severe COVID-19 to prior drug prescribing. Methods Severe cases were defined by entry to critical care or fatal outcome. For this matched case-control study (REACT-SCOT), all 4251 cases of severe COVID-19 in Scotland since the start of the epidemic were matched for age, sex and primary care practice to 36,738 controls from the population register. Records were linked to hospital discharges since June 2015 and dispensed prescriptions issued in primary care during the last 240 days. Results Severe COVID-19 was strongly associated with the number of non-cardiovascular drug classes dispensed. This association was strongest in those not resident in a care home, in whom the rate ratio (95% CI) associated with dispensing of 12 or more drug classes versus none was 10.8 (8.8, 13.3), and in those without any of the conditions designated as conferring increased risk of COVID-19. Of 17 drug classes postulated at the start of the epidemic to be “medications compromising COVID”, all were associated with increased risk of severe COVID-19 and these associations were present in those without any of the designated risk conditions. The fraction of cases in the population attributable to exposure to these drug classes was 38%. The largest effect was for antipsychotic agents: rate ratio 4.18 (3.42, 5.11). Other drug classes with large effects included proton pump inhibitors (rate ratio 2.20 (1.72, 2.83) for = 2 defined daily doses/day), opioids (3.66 (2.68, 5.01) for = 50 mg morphine equivalent/day) and gabapentinoids. These associations persisted after adjusting for covariates and were stronger with recent than with non-recent exposure. Conclusions Severe COVID-19 is associated with polypharmacy and with drugs that cause sedation, respiratory depression, or dyskinesia; have anticholinergic effects; or affect the gastrointestinal system. These associations are not easily explained by co-morbidity. Measures to reduce the burden of mortality and morbidity from COVID-19 should include reinforcing existing guidance on reducing overprescribing of these drug classes and limiting inappropriate polypharmacy. Registration ENCEPP number https://EUPAS35558

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Association of cystatin C levels with metabolic syndrome incidence: a nested case-control study with propensity score matching

Journal of International Medical Research ◽

10.1177/0300060520986311 ◽

2021 ◽

Vol 49 (1) ◽

pp. 030006052098631

Author(s):

Tengfei Yang ◽

Dongmei Pei

Keyword(s):

Metabolic Syndrome ◽

Propensity Score ◽

Physical Examination ◽

Propensity Score Matching ◽

Case Control Study ◽

Case Control ◽

Chinese Adults ◽

Biochemical Profiles ◽

Nested Case Control ◽

Control Study

Objective Metabolic syndrome (MetS) involves multiple metabolic disorders and seriously affects human health. Identification of key biological factors associated with MetS incidence is therefore important. We explored the association between MetS and the biochemical profiles of Chinese adults in Shenyang City in a nested case-control study. Methods We included adult participants who underwent physical examination at our hospital for 2 consecutive years. Participants’ biochemical profiles and other MetS components were tested and monitored continuously. Propensity score matching was used to adjust confounding factors between participants with and without MetS. We analyzed the association between incidence of MetS and the biochemical profiles of participants. Results Of 5702 participants who underwent physical examination between 1 January 2017 and 1 December 2018, 538 had confirmed newly developed MetS. After successfully matching 436 pairs of participants, mean cystatin C (Cys-C) level was significantly higher in the MetS group than in the non-MetS group. Logistic regression analysis indicated that age (years) and γ-glutamate transpeptidase, creatinine, uric acid, and Cys-C levels were significantly associated with MetS incidence; among these, the odds ratio of Cys-C was highest (3.03; 95% confidence interval, 1.02–9.00). Conclusions Cys-C levels were significantly associated with the incidence of MetS among Chinese adults.

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