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Lin YS, Shen TC, Lin CL, Tu CY, Hsia TC, Hsu WH, Cho DY. Risk of sleep disorders in patients with pneumoconiosis: a retrospective cohort study. J Epidemiol Glob Health 2024; 14:860-868. [PMID: 38573463 DOI: 10.1007/s44197-024-00225-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/28/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Pneumoconiosis is associated with pulmonary and cardiovascular diseases; however, the link between pneumoconiosis and sleep disorders is not well understood. This study aimed to investigate the connection between pneumoconiosis and subsequent risk of sleep disorders. METHODS This population-based retrospective cohort study used data from the National Health Insurance database in Taiwan. The pneumoconiosis cohort consisted of 13,329 patients newly diagnosed between 2000 and 2015. The comparison group included 53,316 age-, sex-, and diagnosis date-matched individuals without pneumoconiosis. The development of sleep disorders was monitored until the end of 2018. Cox proportional hazard regression models were used for risk assessment. RESULTS The incidence of sleep disorders was 1.31 times higher in the pneumoconiosis cohort than in the comparison cohort (22.8 vs. 16.2 per 1000 person-years). After controlling for age, sex, comorbidity, and medication, the adjusted hazard ratio (aHR) was 1.24 (95% confidence interval [CI] = 1.17-1.32). Stratified analyses by age group, sex, and comorbidity status showed significant associations between pneumoconiosis and sleep disorders (aHRs, 1.19-1.64). In addition, patients with pneumoconiosis had a significantly increased risk of developing sleep apnea (aHR = 1.71, 95% CI = 1.31-2.22). CONCLUSION This study demonstrates that patients with pneumoconiosis are at a higher risk of developing sleep disorders and sleep apnea. Healthcare professionals should pay close attention to sleep quality and disturbances in patients with pneumoconiosis.
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Affiliation(s)
- Yen-Sung Lin
- Division of Pulmonary and Critical Care Medicine, An Nan Hospital, China Medical University, Tainan, 709, Taiwan
- Department of Nursing, Chung Hwa University of Medical Technology, Tainan, 717, Taiwan
| | - Te-Chun Shen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, No. 2 Yu-De Road, Taichung, 404, Taiwan.
- School of Medicine, College of Medicine, China Medical University, Taichung, 404, Taiwan.
- Division of Critical Care Medicine, Chu Shang Show Chwan Hospital, Nantou, 557, Taiwan.
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, 404, Taiwan
| | - Chih-Yen Tu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, No. 2 Yu-De Road, Taichung, 404, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, 404, Taiwan
| | - Te-Chun Hsia
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, No. 2 Yu-De Road, Taichung, 404, Taiwan
| | - Wu-Huei Hsu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, No. 2 Yu-De Road, Taichung, 404, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, 404, Taiwan
| | - Der-Yang Cho
- Management Office for Health Data, China Medical University Hospital, Taichung, 404, Taiwan
- Department of Neurosurgery, China Medical University Hospital, Taichung, 404, Taiwan
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Lee HM, Liu DY, Hsu HL, Yu TL, Yu TS, Shen TC, Tsai FJ. Risk of depression in patients with pneumoconiosis: A population-based retrospective cohort study. J Affect Disord 2024; 352:146-152. [PMID: 38369263 DOI: 10.1016/j.jad.2024.02.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Pneumoconiosis is an important occupational disease; the association between pneumoconiosis and depression was largely unknown. This study aimed to investigate the relationship between pneumoconiosis and the risk of subsequent depression. METHODS A retrospective cohort study was conducted using Taiwan's National Health Insurance database. The study included 16,795 patients diagnosed with pneumoconiosis between 2008 and 2018 and a comparison cohort of 67,180 individuals without pneumoconiosis, propensity score matched in a 1:4 ratio based on age, sex, monthly income, residential urbanization level, and date of pneumoconiosis diagnosis. The development of depression was monitored until the end of 2019. RESULTS The incidence of depression was 1.68 times higher in the pneumoconiosis cohort than that in the comparison cohort, with an incidence rate of 10.07 versus 5.99 per 1000 person-years (adjusted hazard ratio [aHR] = 1.84, 95 % confidence interval [CI] = 1.70-1.99). The risk of depression increased with an increased mean annual number of emergency department visits for pneumoconiosis, with aHRs of 1.34 (95 % CI = 1.13-1.59) and 2.31 (95 % CI = 1.94-2.76) for 1 ≤ n < 2, and n ≥ 2 compared to n < 1, respectively. LIMITATION The database lacked detailed socioeconomic history, family history, and clinical variables. CONCLUSION This study found that patients with pneumoconiosis have a significantly higher risk of depression than those without pneumoconiosis. Furthermore, the risk of depression increases with the frequency of emergency department visits for pneumoconiosis. Healthcare professionals should pay close attention to the mental health of patients with pneumoconiosis.
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Affiliation(s)
- Hsiu-Ming Lee
- Department of Education, China Medical University Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - De-Yi Liu
- Department of Education, China Medical University Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Hsiang-Li Hsu
- Department of Education, China Medical University Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Tsai-Ling Yu
- Department of Education, China Medical University Hospital, Taichung, Taiwan; School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Teng-Shun Yu
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Te-Chun Shen
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Division of Critical Care Medicine, Chu Shang Show Chwan Hospital, Nantou, Taiwan.
| | - Fuu-Jen Tsai
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
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Wang YT, Shen TC, Lin CL, Tu CY, Hsia TC, Hsu WH. Real-world practice of idiopathic pulmonary fibrosis: Results from a 2000-2016 cohort. Open Med (Wars) 2023; 18:20230852. [PMID: 38025536 PMCID: PMC10655681 DOI: 10.1515/med-2023-0852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/02/2023] [Accepted: 10/31/2023] [Indexed: 12/01/2023] Open
Abstract
The study aimed to investigate comorbidities, major adverse respiratory events, and mortality in patients with idiopathic pulmonary fibrosis (IPF). We established an IPF cohort and a comparative cohort matched for sex, age, and the date of IPF diagnosis. We recorded the most frequent comorbidities, the proportions, and time durations to the episode of major adverse respiratory events and death. Both cohorts were followed up to the end of 2016. We included 921 patients in the IPF cohort and 3,677 individuals in the comparative cohort. Comorbidities associated with IPF included pulmonary hypertension, chronic obstructive pulmonary disease, heart failure, asthma, and gastroesophageal reflux disease. The IPF cohort was more likely to have pneumonia (47.6 vs 12.0%), acute respiratory failure (17.8 vs 4.30%), chronic respiratory failure (4.23 vs 0.63%), and death (36.3 vs 15.0%) than the comparative cohort. The time durations to the first episode of pneumonia, acute respiratory failure, chronic respiratory failure, and death were 2.09 ± 2.98, 3.12 ± 3.62, 3.20 ± 4.03, and 3.27 ± 3.03 years in the IPF cohort. In conclusion, patients with IPF had significant comorbidities, particularly pulmonary and cardiovascular comorbidities. The duration from diagnosis to the major adverse respiratory events or death was short.
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Affiliation(s)
- Ying-Tso Wang
- Department of Laboratory Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Te-Chun Shen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, No. 2 Yu-De Road, Taichung404, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
- Division of Critical Care Medicine, Chu Shang Show Chwan Hospital, Nantou, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Yen Tu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, No. 2 Yu-De Road, Taichung404, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Te-Chun Hsia
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, No. 2 Yu-De Road, Taichung404, Taiwan
| | - Wu-Huei Hsu
- School of Medicine, China Medical University, Taichung, Taiwan
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Chang JH, Shen TC, Chen KW, Lin CL, Hsu CY, Wen YR, Chang KC. Risk of Acute Myocardial Infarction in Pneumoconiosis: Results from a Retrospective Cohort Study. Biomedicines 2023; 11:biomedicines11030897. [PMID: 36979875 PMCID: PMC10046008 DOI: 10.3390/biomedicines11030897] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/21/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
Background: Pneumoconiosis (PCN) has several comorbidities, most notably pulmonary and cardiovascular diseases. However, much is still unknown about the relationship between PCN and acute myocardial infarction (AMI). The present study aimed to clarify the association between PCN and subsequent AMI risk using a retrospective cohort study design. Methods: This was a population-based, retrospective cohort study that used data from Taiwan’s National Health Insurance Database. A total of 7556 newly diagnosed patients with PCN and 7556 individuals without PCN were included in the PCN and comparison cohort (PC and CC), respectively, between 2008 and 2018, with propensity score matching for age, gender, comorbidity, medication, and date of PCN diagnosis. The occurrence of AMI was monitored until the end of 2019, and AMI risk was assessed using Cox proportional hazard regression models. Results: The overall incidence of AMI was 1.34-fold higher in the PC than in the CC (4.33 vs. 3.23 per 1000 person-years, respectively, p < 0.05), with an adjusted hazard ratio (aHR) of 1.36 (95% confidence interval (CI): 1.08–1.72) after controlling for age, gender, comorbidity, and medication. Further analyses showed a higher risk of AMI with increased annual number of emergency department visits among patients with PCN (aHR: 1.30, 95% CI: 1.01–1.66 (<1) and aHR: 1.68, 95% CI: 1.13–2.50 (≥1)). Conclusion: Patients with PCN had a significantly higher risk of developing AMI than those without PCN. Clinicians should pay more attention to prevent AMI episodes in patients with PCN.
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Affiliation(s)
- Ju-Hsin Chang
- Graduate Institute of Clinical Medicine Science, China Medical University, No. 91, Xue-Shi Road, Taichung 404, Taiwan
- Department of Anesthesia, China Medical University Hospital, Taichung 404, Taiwan
| | - Te-Chun Shen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung 404, Taiwan
- School of Medicine, China Medical University, Taichung 404, Taiwan
- Department of Critical Care Medicine, Chu Shang Show Chwan Hospital, Nantou 557, Taiwan
| | - Ke-Wei Chen
- Graduate Institute of Clinical Medicine Science, China Medical University, No. 91, Xue-Shi Road, Taichung 404, Taiwan
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, No. 2 Yu-De Road, Taichung 404, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan
| | - Chung Y. Hsu
- Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan
| | - Yeong-Ray Wen
- Graduate Institute of Clinical Medicine Science, China Medical University, No. 91, Xue-Shi Road, Taichung 404, Taiwan
- Department of Anesthesia, China Medical University Hospital, Taichung 404, Taiwan
- Correspondence: (Y.-R.W.); (K.-C.C.); Tel.: +886-4-2205-3366 (Y.-R.W.); +886-4-2205-2121 (K.-C.C.)
| | - Kuan-Cheng Chang
- School of Medicine, China Medical University, Taichung 404, Taiwan
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, No. 2 Yu-De Road, Taichung 404, Taiwan
- Correspondence: (Y.-R.W.); (K.-C.C.); Tel.: +886-4-2205-3366 (Y.-R.W.); +886-4-2205-2121 (K.-C.C.)
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Risk of Chronic Kidney Disease in Pneumoconiosis: Results from a Retrospective Cohort Study (2008-2019). Biomedicines 2023; 11:biomedicines11010150. [PMID: 36672657 PMCID: PMC9856191 DOI: 10.3390/biomedicines11010150] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
Background: Pneumoconiosis has considerable comorbidities, most notably pulmonary and cardiovascular diseases. However, the relationship between pneumoconiosis and chronic kidney disease (CKD) is largely unknown. The present study aimed to use a retrospective cohort study design to further clarify the association between pneumoconiosis and subsequent CKD risk. Methods: This is a nationwide, population-based, retrospective cohort study that used data from Taiwan’s National Health Insurance Database. Between 2008 and 2018, 17,952 newly diagnosed patients were included in the pneumoconiosis cohort, while 71,808 individuals without pneumoconiosis were included in the comparison cohort, with a propensity score matching for age, gender, and date of pneumoconiosis diagnosis. The development of CKD was monitored until the end of 2019. The risk was assessed using Cox proportional hazard regression models. Results: After controlling for age, gender, and comorbidity, the overall incidence of CKD was 1.69-fold higher in the pneumoconiosis cohort than in the comparison cohort (19.71 vs. 11.76 per 1000 person-years, respectively, p < 0.001), with an adjusted hazard ratio of 1.83 (95% confidence interval: 1.73−1.93). Stratified analyses by age group, gender, and presence of comorbidity revealed that the adjusted hazard ratios of CKD associated with pneumoconiosis remained significant (8/9). Furthermore, pneumoconiosis and tri-high (hypertension, hyperglycemia, and hyperlipidemia) interact positively with CKD development (p < 0.001). Conclusion: Patients with pneumoconiosis had a significantly higher risk of developing CKD than those without. Pneumoconiosis combined with hypertension, hyperglycemia, or hyperlipidemia would increase the risk even further. More studies are required to understand the possible pathophysiological mechanisms.
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Lai SW, Kuo YH, Lin CL, Liao KF. Risk of herpes zoster among patients with predialysis chronic kidney disease in a cohort study in Taiwan. Int J Clin Pract 2020; 74:e13566. [PMID: 32479686 DOI: 10.1111/ijcp.13566] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 04/02/2020] [Accepted: 05/26/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND/OBJECTIVE Patients on chronic dialysis are at risk of developing herpes zoster, but little systematic research focuses on the association between predialysis chronic kidney disease and herpes zoster. The objective of the study was to explore the association between predialysis chronic kidney disease and herpes zoster in Taiwan. METHODS A nation-based retrospective cohort study was performed using the 2005-2012 database of the Taiwan National Health Insurance Program. There were 16 655 subjects aged 20-84 years with newly diagnosed predialysis chronic kidney disease as the study group and 33 310 randomly selected subjects without chronic kidney disease as the comparison group. Both groups were matched with sex, age, comorbidities and the year of the index date. The incidence rates of herpes zoster in both groups were calculated. The multivariable Cox proportional hazards regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for herpes zoster associated with predialysis chronic kidney disease. RESULTS The overall incidence rate of herpes zoster was 1.4-fold higher in the predialysis chronic kidney disease group than that in the non-chronic kidney disease group (8.76 vs 6.27 per 1000 person-years, 95% CI 1.27-1.54; P < .001). After controlling for co-variables, the adjusted HR of herpes zoster was 1.38 (95% CI 1.25-1.53; P < .001) for subjects with predialysis chronic kidney disease compared with non-chronic kidney disease subjects. The adjusted HR increased to 1.65 for subjects with predialysis chronic kidney disease and with any comorbidity (95% CI 1.42-1.92; P < .001). CONCLUSIONS Patients with predialysis chronic kidney disease correlate with approximately 1.4-fold increased hazard of developing herpes zoster.
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Affiliation(s)
- Shih-Wei Lai
- College of Medicine, and College of Public Health, China Medical University, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Hung Kuo
- Department of Research, Taichung Tzu Chi Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien, Taiwan
- Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi Hospital, Taichung, Taiwan
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Abstract
Increasing hospital admissions for pneumonia have been reported recently but it is not known whether pneumonia incidence rates have increased in the community. To determine whether incidence rates of pneumonia increased in primary care in the United Kingdom from 2002 to 2017, an open cohort study was conducted using electronic health records from the UK Clinical Practice Research Datalink. Clinically diagnosed pneumonia, influenza pneumonia, pleural infection and clinically suspected pneumonia, defined as chest infection treated with antibiotics, were evaluated. Age-standardised and age-specific rates were estimated. Joinpoint regression models were fitted and annual percentage changes (APC) were estimated. There were 70.7 million person-years of follow-up with 120 662 episodes of clinically diagnosed pneumonia, 1 831 005 of clinically suspected pneumonia, 23 814 episodes of influenza pneumonia and 2644 pleural infections over 16 years. The incidence of clinically diagnosed pneumonia increased from 1.50 per 1000 person-years in 2002 to 2.22 per 1000 in 2017. From 2010 to 2017, the APC in age-standardised incidence was 5.1% (95% confidence interval 3.4-6.9) compared with 0.3% (-0.6 to 1.2%) before 2010. Clinically suspected pneumonia incidence rates increased from 2002 to 2008 with an APC 3.8% (0.8-6.9) but decreased with an APC -4.9% (-6.7 to -3.1) from 2009 to 2017. Influenza pneumonia increased in the epidemic year of 2009. There was no overall trend in pleural infection. The results show that clinically diagnosed pneumonia has increased in primary care but there was a contemporaneous decline in recording of clinically suspected pneumonia or 'chest infection'. Changes in disease labelling practice might partly account for these trends.
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Lai SW, Lin CL, Liao KF. Association between tamoxifen use and acute myocardial infarction in women with breast cancer. Medicine (Baltimore) 2019; 98:e13925. [PMID: 30653098 PMCID: PMC6370151 DOI: 10.1097/md.0000000000013925] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 11/20/2018] [Accepted: 12/09/2018] [Indexed: 01/01/2023] Open
Abstract
The relationship between tamoxifen use and acute myocardial infarction in women with breast cancer remains uncertain. The goal of the study was to assess whether tamoxifen use could be associated with acute myocardial infarction in women with breast cancer in Taiwan.A population-based case-control study was conducted to analyze the database of the Taiwan National Health Insurance Program. Totally, 489 women with breast cancer aged 20 to 84 years having the first episode of acute myocardial infarction from 2000 to 2011 were found as the cases. In addition, 1718 women with breast cancer aged 20 to 84 years without any type of ischemic heart disease were selected as the matched controls. Ever use of tamoxifen was classified as the studied women who had at least a prescription for tamoxifen before the index date. Never use of tamoxifen was classified as the studied women who never had a prescription for tamoxifen before the index date. We used the multivariable logistic regression model to estimate the odds ratio (OR) and 95% confidence interval (CI) for acute myocardial infarction associated with tamoxifen use.In a multivariable-adjusted analysis, women with acute myocardial infarction were 1.71 times more likely to be exposed to tamoxifen than those women without acute myocardial infarction (adjusted OR 1.71, 95% CI 1.38-2.13).The odds of tamoxifen use are 1.71 times higher in women with acute myocardial infarction versus those women without acute myocardial infarction in Taiwan.
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Affiliation(s)
- Shih-Wei Lai
- College of Medicine, China Medical University
- Department of Family Medicine, and
| | - Cheng-Li Lin
- College of Medicine, China Medical University
- Management Office for Health Data, China Medical University Hospital, Taichung
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien
- Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi Hospital, Taichung, Taiwan
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Lai SW, Lin CL, Liao KF. Weight loss might be an early clinical manifestation of undiagnosed cancer: a nation-based cohort study. Biomedicine (Taipei) 2018; 8:25. [PMID: 30474606 PMCID: PMC6254098 DOI: 10.1051/bmdcn/2018080425] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 04/19/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND/AIM No published nation-based study has examined the relationship between weight loss and cancer in Taiwan. The aim of this study was to investigate whether weight loss is an early clinical manifestation of cancer in Taiwan. METHODS We conducted a nation-based, retrospective cohort study that analyzed the database of the Taiwan National Health Insurance Program. There were 8210 subjects aged 20 to 84 years with newly diagnosed weight loss selected as the weight loss group from 2000 to 2012, and 32826 randomly selected subjects without weight loss as the non-weight loss group. The weight loss and non-weight loss groups were matched along sex, age, and comorbidities. The incidence of cancer at the end of 2013 was examined in both groups. RESULTS The weight loss group had a significantly higher incidence of cancer than the non-weight loss group during the first 3 months of follow-up (25.1 vs. 8.39 per 1000 person-years, with an incidence rate ratio 2.99, 95% CI 2.82, 3.18). The multivariable Cox proportional hazards regression model revealed that the adjusted HR of cancer was 1.05 for the weight loss group (95% CI 1.04, 1.05) as compared with the non-weight loss group. CONCLUSION Weight loss is associated with a small but statistically significant increase in the hazard of cancer. Weight loss might be an early clinical manifestation of undiagnosed cancer. Physicians should keep in mind the possibility of cancer when people present with weight loss and other possible cancer-related symptoms, particularly during the first 3 months of follow-up.
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Affiliation(s)
- Shih-Wei Lai
- College of Medicine, China Medical University Taichung 404 Taiwan
- Department of Family Medicine, China Medical University Hospital Taichung 404 Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical University Taichung 404 Taiwan
- Management Office for Health Data, China Medical University Hospital Taichung 404 Taiwan
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University Hualien 970 Taiwan
- Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi Hospital Taichung 427 Taiwan
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Lai SW, Lin CL, Lin CH. Long-Term Trend of Polypharmacy in Older People in Taiwan From 2000 to 2013. J Am Geriatr Soc 2018; 67:408-409. [PMID: 30423198 DOI: 10.1111/jgs.15646] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Shih-Wei Lai
- College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung, Taiwan.,Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Hsueh Lin
- College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
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Lai S, Lin C, Liao K. Real‐world database examining the association between hydroxychloroquine and retinopathy in Taiwan. Br J Dermatol 2018; 180:670-671. [PMID: 30276804 DOI: 10.1111/bjd.17264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- S.‐W. Lai
- College of Medicine China Medical University Taichung Taiwan
- Department of Family Medicine China Medical University Hospital TaichungTaiwan
| | - C.‐L. Lin
- College of Medicine China Medical University Taichung Taiwan
- Management Office for Health Data China Medical University Hospital TaichungTaiwan
| | - K.‐F. Liao
- College of Medicine Tzu Chi University Hualien Taiwan
- Division of Hepatogastroenterology Department of Internal Medicine Taichung Tzu Chi Hospital Taichung Taiwan
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Lai SW, Lin CL, Liao KF. Association between cirrhosis and hip fracture in older people in a population-based cohort study. J Hepatol 2018; 69:970-972. [PMID: 30041969 DOI: 10.1016/j.jhep.2018.05.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 05/09/2018] [Accepted: 05/11/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Shih-Wei Lai
- College of Medicine, China Medical University, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien, Taiwan; Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan.
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13
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Lai SW, Lin CL, Liao KF. Weight loss might be an early clinical feature of undiagnosed human immunodeficiency virus infection in Taiwan. Biomedicine (Taipei) 2018; 8:19. [PMID: 30141406 PMCID: PMC6108225 DOI: 10.1051/bmdcn/2018080319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 04/24/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND/OBJECTIVE Little research is available on the relationship between weight loss and human immunodeficiency virus (HIV) infection in Taiwan. We hope to evaluate whether weight loss could be an early clinical feature of undiagnosed HIV infection in Taiwan. METHODS We conducted a retrospective population-based cohort study using the database of the Taiwan National Health Insurance (NHI) Program. There were 4748 male subjects aged 1-84 with newly diagnosed weight loss as the weight loss group from 1998-2012 and 18982 age-matched male subjects without weight loss as the non-weight loss group. The incidence of HIV infection at the end of 2013 was measured in both groups. The multivariable Cox proportional hazards regression model was used to measure the hazard ratio (HR) and 95% confidence interval (CI) for HIV risk associated with weight loss. RESULTS The overall incidence of HIV infection was 3.79-fold higher in the weight loss group than in the non-weight loss group (6.83 vs. 1.80 per 10000 person-years, 95% CI 3.41, 4.21). The incidence was the highest during the first 6 months of follow-up in the weight loss group (39.0 per 10000 person-years). After adjusting for confounding factors, the adjusted HR of HIV infection was 3.63 (95% CI 1.77, 7.44) for the weight loss group, compared with the non-weight loss group. CONCLUSION Weight loss might be an early clinical feature of undiagnosed HIV infection in Taiwan. Male patients with weight loss who have risk factors for HIV infection should be recommended to regularly be tested for HIV infection.
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Affiliation(s)
- Shih-Wei Lai
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College of Medicine, China Medical University Taichung
404 Taiwan
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Department of Family Medicine, China Medical University Hospital Taichung
404 Taiwan
| | - Cheng-Li Lin
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College of Medicine, China Medical University Taichung
404 Taiwan
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Management Office for Health Data, China Medical University Hospital Taichung
404 Taiwan
| | - Kuan-Fu Liao
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College of Medicine, Tzu Chi University Hualien
970 Taiwan
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Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi General Hospital Taichung
427 Taiwan
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14
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Lai SW, Lin CL, Liao KF. Case-control study examining the association between allopurinol use and ischemic cerebrovascular disease. J Investig Med 2018; 67:48-51. [PMID: 30042112 DOI: 10.1136/jim-2018-000774] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2019] [Indexed: 12/25/2022]
Abstract
Few studies focus on the relationship between allopurinol and ischemic cerebrovascular disease. The goal of the study was to investigate the association of long-term therapy of allopurinol with the first-time attack of ischemic cerebrovascular disease in Taiwan. We performed a case-control study using the database of the Taiwan National Health Insurance Program. The case group included 14,937 subjects aged 20-84 years with the first-time attack of ischemic cerebrovascular disease from 2000 to 2013. The control group included 14,937 sex-matched and age-matched subjects aged 20-84 years without any type of cerebrovascular disease. Ever use of allopurinol was defined as subjects who had at least a prescription for allopurinol before the index date. The OR and the 95% CI for ischemic cerebrovascular disease associated with allopurinol use were measured by the multivariable logistic regression model. The adjusted OR of ischemic cerebrovascular disease was 0.992 (95% CI 0.989 to 0.996) for subjects with increasing cumulative duration of allopurinol use for every 1 month, compared with never use. In a further analysis, the adjusted OR of ischemic cerebrovascular disease was 0.74 (95% CI 0.57 to 0.96) for cumulative duration of allopurinol use >3 years, compared with never use. Our findings suggest that lone-term therapy of allopurinol >3 years is associated with decreased risk of the first-time attack of ischemic cerebrovascular disease, compared with no allopurinol therapy.
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Affiliation(s)
- Shih-Wei Lai
- College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung, Taiwan.,Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien, Taiwan.,Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan
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15
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Lai SW, Lin CL, Liao KF. Population-based cohort study examining the association between weight loss and pulmonary tuberculosis in adults. Biomedicine (Taipei) 2018; 8:12. [PMID: 29806590 PMCID: PMC5992951 DOI: 10.1051/bmdcn/2018080212] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 02/01/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND/PURPOSE Little research is currently available on the relationship between weight loss and pulmonary tuberculosis in Taiwan. This study aimed to evaluate whether weight loss is an early clinical feature of pulmonary tuberculosis in Taiwan. METHOD This population-based retrospective cohort study was conducted using the Taiwan National Health Insurance Program database. There were 6051 subjects aged 20 to 84 years with newly diagnosed weight loss from 2000 to 2012 as the weight loss group, and 24081 randomly selected subjects without weight loss from the same period as the non-weight loss group. The weight loss and the non-weight loss groups were matched by sex, age, and comorbidities. The incidence of pulmonary tuberculosis at the end of 2013 was evaluated in both groups. A multivariable Cox proportional hazards regression model was used to evaluate the hazard ratio (HR) and 95% confidence interval (CI) for association of pulmonary tuberculosis with weight loss. RESULTS The incidence of pulmonary tuberculosis was 15.2-fold higher in the weight loss group than in the non-weight loss group during the first 3 months of follow-up (22.8 vs. 1.50 per 1000 person-years, 95% CI 13.7, 16.9). After adjusting for covariables, the subsequent HR of pulmonary tuberculosis was 2.36 for the weight loss group (95 % CI 1.88, 2.97), compared with the non-weight loss group. CONCLUSION Although our finding is not novel, it does support the notion that weight loss is significantly associated with increased hazard of pulmonary tuberculosis in Taiwan. The risk was found to be particularly high during the first 3 months of follow-up.
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Affiliation(s)
- Shih-Wei Lai
- College of Medicine, China Medical University Taichung 404 Taiwan
- Department of Family Medicine, China Medical University Taichung 404 Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical University Taichung 404 Taiwan
- Management Office for Health Data, China Medical University Hospital Taichung 404 Taiwan
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University Hualien 970 Taiwan
- Department of Internal Medicine, Taichung Tzu Chi General Hospital Taichung 427 Taiwan
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16
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Lai SW, Lin CL, Liao KF. Association between oral corticosteroid use and pyogenic liver abscesses in a case-control study. Biomedicine (Taipei) 2018; 8:5. [PMID: 29480800 PMCID: PMC5825916 DOI: 10.1051/bmdcn/2018080105] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 11/05/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND AIM There are no epidemiological studies focusing on the association between oral corticosteroid use and pyogenic liver abscesses. The aim of the study was to assess whether oral corticosteroid use is associated with increased odds of pyogenic liver abscesses in adults in Taiwan. METHODS This retrospective population-based case-control study was conducted to analyze the database of the Taiwan National Health Insurance Program from 2000 to 2013. Subjects aged 20 to 84 years with their first episode of pyogenic liver abscesses were assigned as the cases (n = 881). Randomly selected subjects without pyogenic liver abscesses aged 20 to 84 years were selected as the controls (n = 3207). A multivariable logistic regression model was used to assess the odds ratio and 95% confidence interval for the correlation of oral corticosteroid use with pyogenic liver abscesses. RESULTS After regulating for confounders, the adjusted odds ratio of pyogenic liver abscesses was 1.40 for subjects currently using oral corticosteroids (95% confidence interval 1.14, 1.70), compared with subjects who never used them. Upon further analysis, the adjusted odds ratio of pyogenic liver abscesses was 1.03 for subjects with current use of oral corticosteroids when increasing dosage for every one mg (95% CI 1.01, 1.06). CONCLUSION Although the findings are not unexpected, they are important because they suggest that current use of oral corticosteroids is significantly associated with increased odds of developing pyogenic liver abscesses in adults in Taiwan, with a dose-dependent effect.
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Affiliation(s)
- Shih-Wei Lai
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College of Medicine, China Medical University Taichung 404 Taiwan
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Department of Family Medicine, China Medical University Hospital Taichung 404 Taiwan
| | - Cheng-Li Lin
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College of Medicine, China Medical University Taichung 404 Taiwan
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Management Office for Health Data, China Medical University Hospital Taichung 404 Taiwan
| | - Kuan-Fu Liao
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College of Medicine, Tzu Chi University Hualien 970 Taiwan
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Department of Internal Medicine, Taichung Tzu Chi General Hospital Taichung 427 Taiwan
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17
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Lai SW, Liao KF, Lin CL, Lin HF. Case-Control Study Examining the Association between Selective Serotonin Reuptake Inhibitors Use and Hepatocellular Carcinoma. Front Pharmacol 2017; 8:861. [PMID: 29213242 PMCID: PMC5702852 DOI: 10.3389/fphar.2017.00861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 11/09/2017] [Indexed: 12/23/2022] Open
Abstract
Objectives: The purpose of the study was to assess the relationship between selective serotonin reuptake inhibitors use and hepatocellular carcinoma in Taiwan. Methods: Using the database of the Taiwan National Health Insurance Program, we conducted a case-control study to identify 4901 subjects aged 20 years and more with newly diagnosed hepatocellular carcinoma in 2000–2013 as the cases. We randomly selected 19604 subjects aged 20 years and more without hepatocellular carcinoma as the controls. Both cases and controls were matched with sex and age. Ever use of selective serotonin reuptake inhibitors was defined as a subject who had at least a prescription for selective serotonin reuptake inhibitors before index date. Never use was defined as a subject who never had a prescription for selective serotonin reuptake inhibitors before index date. The odds ratio (OR) and 95% confidence interval (CI) for hepatocellular carcinoma associated with selective serotonin reuptake inhibitors use was estimated by the multivariable logistic regression model. Results: Among subjects with any one of the comorbid conditions associated with hepatocellular carcinoma, the adjusted OR of hepatocellular carcinoma was 0.89 (95% CI 0.75, 1.06) for subjects with ever use of selective serotonin reuptake inhibitors, comparing with never use. Conclusion: The findings indicate that among subjects with any one of the comorbid conditions associated with hepatocellular carcinoma, no significant association can be detected between selective serotonin reuptake inhibitors use and hepatocellular carcinoma.
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Affiliation(s)
- Shih-Wei Lai
- Department of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Fu Liao
- Department of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- Department of Medicine, China Medical University, Taichung, Taiwan.,Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Hsien-Feng Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.,Department of Chinese Medicine, China Medical University, Taichung, Taiwan
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18
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Lin HF, Liao KF, Chang CM, Lin CL, Lai SW. Statin use correlates with reduced risk of chronic osteomyelitis: a nationwide case-control study in Taiwan. Curr Med Res Opin 2017; 33:2235-2240. [PMID: 28699801 DOI: 10.1080/03007995.2017.1354831] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVE Potential association between prior statin use and chronic osteomyelitis is examined. METHODS A nationwide case-control study was conducted based on data taken from the Taiwan National Health Insurance program. The case group includes 2338 subjects aged 20-84 years newly diagnosed for chronic osteomyelitis from 2000 to 2013; the control group included 2338 randomly selected subjects without chronic osteomyelitis matched for sex, age, and index year. Statin use was respectively defined as "current", "recent" or "past" if the most recent statin prescription was filled <3 months, 3-6 months or ≥6 months prior to the chronic osteomyelitis diagnosis. Relative risk of chronic osteomyelitis associated with statin use was measured by the odds ratio (OR) with 95% confidence interval (CI) using the conditional logistic regression model. RESULTS After controlling for potential confounders, the adjusted ORs of chronic osteomyelitis were 0.57 for subjects with current statin use (95% CI 0.45, 0.72), 0.80 for subjects with recent statin use (95% CI 0.48, 1.33), and 1.00 for subjects with past statin use (95% CI 0.83, 1.20), compared patients with no prior statin use. In further analysis, the adjusted ORs of chronic osteomyelitis were 0.70 for subjects with cumulative statin use <12 months (95% CI 0.47, 1.07), and 0.56 for subjects with cumulative statins use ≥12 months (95% CI 0.41, 0.77), compared with those with no prior statin use. CONCLUSIONS Current statin use is associated with reduced concurrent diagnosis of chronic osteomyelitis, particularly for a cumulative statin use ≥12 months.
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Affiliation(s)
- Hsien-Feng Lin
- a School of Chinese Medicine , China Medical University , Taichung , Taiwan
- b Department of Family Medicine , China Medical University Hospital , Taichung , Taiwan
| | - Kuan-Fu Liao
- c Department of Internal Medicine , Taichung Tzu Chi General Hospital , Taichung , Taiwan
- d College of Medicine , Tzu Chi University , Hualien , Taiwan
- e Graduate Institute of Integrated Medicine, China Medical University , Taichung , Taiwan
| | - Ching-Mei Chang
- f Department of Nursing , Tungs' Taichung Metro Habor Hospital , Taichung , Taiwan
| | - Cheng-Li Lin
- g College of Medicine , China Medical University , Taichung , Taiwan
- h Management Office for Health Data, China Medical University Hospital , Taichung , Taiwan
| | - Shih-Wei Lai
- b Department of Family Medicine , China Medical University Hospital , Taichung , Taiwan
- g College of Medicine , China Medical University , Taichung , Taiwan
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19
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Lai SW, Lin CL, Liao KF. Population-based cohort study investigating the association between weight loss and pyogenic liver abscesses. Biomedicine (Taipei) 2017; 7:26. [PMID: 29130451 PMCID: PMC5682981 DOI: 10.1051/bmdcn/2017070426] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 08/17/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND AND AIM Few systematic studies focus on the association between weight loss and pyogenic liver abscesses. The objective of the study was to assess the association between weight loss and pyogenic liver abscesses in adults in Taiwan. METHODS This population-based cohort study utilized the database of the Taiwan National Health Insurance Program. Totally, 8453 subjects aged 20 to 84 years with newly diagnosed weight loss between 2000 and 2012 were assigned as the weight loss group, and 33777 randomly selected subjects without weight loss were assigned as the non-weight loss group. Both the weight loss and the non-weight loss groups were matched according to sex, age, and comorbidities. The incidence of pyogenic liver abscesses at the end of 2013 was measured in both groups. RESULTS A multivariable Cox proportional hazards regression model was done and presented evidence that the adjusted HR of pyogenic liver abscess was 2.47 (95 %CI 1.21, 5.02) for those subjects with weight loss and without comorbidities, as compared with those subjects without weight loss and without comorbidities. Among the weight loss group, 5% developed pyogenic liver abscesses within 3 months. CONCLUSION Weight loss is associated with pyogenic liver abscesses in adults. Yet weight loss might not be an early clinical symptom of undiagnosed pyogenic liver abscesses.
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Affiliation(s)
- Shih-Wei Lai
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College of Medicine, China Medical University Taichung 404 Taiwan
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Department of Family Medicine, China Medical University Hospital Taichung 404 Taiwan
| | - Cheng-Li Lin
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College of Medicine, China Medical University Taichung 404 Taiwan
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Management Office for Health Data, China Medical University Hospital Taichung 404 Taiwan
| | - Kuan-Fu Liao
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College of Medicine, Tzu Chi University Hualien 970 Taiwan
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Department of Internal Medicine, Taichung Tzu Chi General Hospital Taichung 427 Taiwan
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Graduate Institute of Integrated Medicine, China Medical University Taichung 404 Taiwan
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20
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Lai SW, Liao KF, Lin CL, Lin HF. Dipeptidyl Peptidase-4 Inhibitors Use and Relative Risk of Ischemic Cerebrovascular Disease in Type 2 Diabetic Patients in a Case-Control Study. Front Pharmacol 2017; 8:859. [PMID: 29213240 PMCID: PMC5702655 DOI: 10.3389/fphar.2017.00859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 11/09/2017] [Indexed: 12/14/2022] Open
Abstract
Background and Objectives: Limited research focuses on the risk of ischemic cerebrovascular disease associated with use of dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors) in patients with type 2 diabetes mellitus in Taiwan. This study aimed to investigate the association between DPP-4 inhibitors use and the first episode of ischemic cerebrovascular disease. Methods: We designed a case-control study using the database of the Taiwan National Health Insurance Program. There were 1999 type 2 diabetic subjects aged 20-84 years with the first episode of ischemic cerebrovascular disease from 2000 to 2013 as the cases, and 7996 sex- and age-matched, randomly selected type 2 diabetic subjects aged 20-84 years without any type of cerebrovascular diseases as the matched controls. We estimated the odds ratio (OR) and 95% confidence interval (CI) of ischemic cerebrovascular disease associated with cumulative duration of DPP-4 inhibitors use by the multivariable logistic regression model. Results: After adjustment for confounding variables, the adjusted OR of ischemic cerebrovascular disease was 0.96 (95% CI 0.95, 0.97) in subjects with ever use of DPP-4 inhibitors as increase in use duration for every 1 month, compared with never use. The sub-analysis disclosed that the adjusted ORs of ischemic cerebrovascular disease were 1.57 (95% CI 1.36, 1.80) for subjects with cumulative duration of DPP-4 inhibitors use <1 year, and 0.70 (95% CI 0.57, 0.87) for subjects with cumulative duration of DPP-4 inhibitors use ≥1 year, compared with never use. Conclusion: Our findings suggest that DPP-4 inhibitors use correlates with relative risk reduction of the first episode of ischemic cerebrovascular disease in type 2 diabetic patients in a duration-dependent response. The beneficial effect will be marked when DPP-4 inhibitors use is ≥1 year.
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Affiliation(s)
- Shih-Wei Lai
- Department of Medicine, China Medical University, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Fu Liao
- Department of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- Department of Medicine, China Medical University, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Hsien-Feng Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- Department of Chinese Medicine, China Medical University, Taichung, Taiwan
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21
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Liao KF, Chuang HY, Lai SW. Metformin Use Correlates with Reduced Risk of Gallstones in Diabetic Patients: A 12-Year Follow-up Study. Front Pharmacol 2017; 8:765. [PMID: 29114226 PMCID: PMC5660725 DOI: 10.3389/fphar.2017.00765] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 10/11/2017] [Indexed: 12/17/2022] Open
Abstract
Objective: Few studies are available on the association between gallstones and metformin use. The objective of the study was to determine whether metformin use is associated with gallstones. Methods: A population-based retrospective cohort study was conducted using the database of the Taiwan National Health Insurance Program. Subjects of newly diagnosed diabetes mellitus were included from 2002 to 2013. The metformin-exposure group was defined as ≥29 cumulative defined daily dose (DDD) of metformin use. The un-exposure group was defined as <29 cumulative DDD of metformin use. The major endpoint was a new diagnosis of gallstones during the follow-up period. A multivariable Cox proportional hazards regression model was used to evaluate the hazard ratio (HR) and 95% confidence interval (CI) of gallstones associated with metformin use. Results: After controlling for potential confounders, the adjusted HRs of gallstones were 1.11 (95%CI: 0.84–1.46) for subjects with metformin dosage of 29–180 cumulative DDD, and 0.57 (95%CI: 0.42–0.78) for subjects with metformin dosage >180 cumulative DDD, compared with the un-exposure group. Conclusion: Long-term use of metformin is associated with reduced risk of gallstones.
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Affiliation(s)
- Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan
| | - Hsun-Yang Chuang
- Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan
| | - Shih-Wei Lai
- College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
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22
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Lai SW, Lin CL, Liao KF. Predialysis chronic kidney disease correlates with increased risk of pyogenic liver abscess: a population-based cohort study. Eur J Clin Invest 2017; 47:694-701. [PMID: 28771692 DOI: 10.1111/eci.12793] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 07/31/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND/OBJECTIVE The incidence of pyogenic liver abscess in Taiwan appears to be much higher than that in western countries. However, little is known about the incidence of pyogenic liver abscess among patients with predialysis chronic kidney disease. The objective of this study was to assess the association between predialysis chronic kidney disease and the risk of pyogenic liver abscess in Taiwan. METHODS This population-based, retrospective, cohort study was conducted to analyse the database of the Taiwan National Health Insurance Program. There were 81118 subjects aged 20-84 years with newly diagnosed chronic kidney disease as the predialysis chronic kidney disease group since 2000-2010, and 81118 randomly selected subjects without chronic kidney disease as the nonchronic kidney disease group. The predialysis chronic kidney disease group and the nonchronic kidney disease group were matched with sex, age and comorbidities. The incidence of pyogenic liver abscess at the end of 2013 was calculated in both groups. Subjects who currently received dialysis therapy before the endpoint were excluded from the study. The multivariable Cox proportional hazards regression model was used to assess the hazard ratio (HR) and 95% confidence interval (CI) for the risk of pyogenic liver abscess associated with predialysis chronic kidney disease and other comorbidities including alcohol-related disease, biliary stone, chronic liver disease and diabetes mellitus. RESULTS The overall incidence of pyogenic liver abscess was 1·65-fold higher in the predialysis chronic kidney disease group than that in the nonchronic kidney disease group (1·38 vs. 0·83 per 1000 person-years, 95% CI 1·59, 1·71). After adjustment for covariables, the adjusted HR of pyogenic liver abscess was 1·51(95% CI 1·30, 1·76) for the predialysis chronic kidney disease group, comparing with the nonchronic kidney disease group. In addition, the adjusted HR would increase to 3·31 (95% CI 2·61, 4·19) for subjects with predialysis chronic kidney disease and with any comorbidity studied. CONCLUSION Predialysis chronic kidney disease is associated with 1·5-fold increased risk of pyogenic liver abscess. There seem to be a synergistic effect on the risk of pyogenic liver abscess between predialysis chronic kidney disease and comorbidities.
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Affiliation(s)
- Shih-Wei Lai
- College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung, Taiwan.,Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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23
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Lai SW, Lin CL, Liao KF. Head and neck cancer associated with increased rate of pulmonary tuberculosis in a population-based cohort study. Medicine (Baltimore) 2017; 96:e8366. [PMID: 29069025 PMCID: PMC5671858 DOI: 10.1097/md.0000000000008366] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The objective of this study was to examine the incidence and hazard ratio (HR) of pulmonary tuberculosis in patients with head and neck cancer in Taiwan.This population-based retrospective cohort study was conducted to analyze the database of the Taiwan National Health Insurance Program. There were 2522 subjects aged 20 to 84 years with newly diagnosed head and neck cancer as the head and neck cancer group between 2000 and 2012, and 10,064 randomly selected sex- and age-matched subjects without any cancer as the noncancer group. The incidence of pulmonary tuberculosis at the end of 2013 was estimated in both groups. A multivariable Cox proportional hazards regression model was used to estimate the HR and 95% confidence interval (CI) for pulmonary tuberculosis being associated with head and neck cancer.The overall incidence of pulmonary tuberculosis was 2.86-fold greater in the head and neck cancer group than that in the noncancer group (4.70 vs 1.64 per 1000 person-years, 95% CI, 2.53-3.24). After adjusting for confounding factors, the adjusted HR of pulmonary tuberculosis became 2.90 for the head and neck cancer group (95% CI, 2.11-3.99), compared with the noncancer group. In addition, male (adjusted HR 2.27, 95% CI, 1.29-4.00) and age (increase for 1 year, adjusted HR 1.06, 95% CI, 1.05-1.08) were associated with pulmonary tuberculosis.Head and neck cancer is significantly associated with 2.90-fold increased hazard of pulmonary tuberculosis in Taiwan, compared with the general population.
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Affiliation(s)
- Shih-Wei Lai
- College of Medicine, China Medical University, Taichung
- Department of Family Medicine, China Medical University Hospital, Taichung
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung
- Management Office for Health Data, China Medical University Hospital, Taichung
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien
- Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan
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24
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Lin HF, Liao KF, Chang CM, Lin CL, Lai SW. Population-based cohort study examining the association between splenectomy and empyema in adults in Taiwan. BMJ Open 2017; 7:e015101. [PMID: 28947439 PMCID: PMC5623461 DOI: 10.1136/bmjopen-2016-015101] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 07/05/2017] [Accepted: 08/04/2017] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the association between splenectomy and empyema in Taiwan. METHODS A population-based cohort study was conducted using the hospitalisation dataset of the Taiwan National Health Insurance Program. A total of 13 193 subjects aged 20-84 years who were newly diagnosed with splenectomy from 2000 to 2010 were enrolled in the splenectomy group and 52 464 randomly selected subjects without splenectomy were enrolled in the non-splenectomy group. Both groups were matched by sex, age, comorbidities and the index year of undergoing splenectomy. The incidence of empyema at the end of 2011 was calculated. A multivariable Cox proportional hazards regression model was used to estimate the HR with 95% CI of empyema associated with splenectomy and other comorbidities. RESULTS The overall incidence rate of empyema was 2.56-fold higher in the splenectomy group than in the non-splenectomy group (8.85 vs 3.46 per 1000 person-years). The Kaplan-Meier analysis revealed a higher cumulative incidence of empyema in the splenectomy group than in the non-splenectomy group (6.99% vs 3.37% at the end of follow-up). After adjusting for confounding variables, the adjusted HR of empyema was 2.89 for the splenectomy group compared with that for the non-splenectomy group. Further analysis revealed that HR of empyema was 4.52 for subjects with splenectomy alone. CONCLUSION The incidence rate ratio between the splenectomy and non-splenectomy groups reduced from 2.87 in the first 5 years of follow-up to 1.73 in the period following the 5 years. Future studies are required to confirm whether a longer follow-up period would further reduce this average ratio. For the splenectomy group, the overall HR of developing empyema was 2.89 after adjusting for age, sex and comorbidities, which was identified from previous literature. The risk of empyema following splenectomy remains high despite the absence of these comorbidities.
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Affiliation(s)
- Hsien-Feng Lin
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Fu Liao
- Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan
- College of Medicine, Tzu Chi University, Hualien, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Ching-Mei Chang
- Department of Nursing, Tungs’Taichung Metro Habor Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Shih-Wei Lai
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
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25
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Liao KF, Lin CL, Lai SW. Nationwide Case-Control Study Examining the Association between Tamoxifen Use and Alzheimer's Disease in Aged Women with Breast Cancer in Taiwan. Front Pharmacol 2017; 8:612. [PMID: 28928665 PMCID: PMC5591818 DOI: 10.3389/fphar.2017.00612] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 08/23/2017] [Indexed: 12/23/2022] Open
Abstract
Background and Objectives: Little is known about the association between tamoxifen use and Alzheimer's disease in women with breast cancer. The study aimed to explore the association between tamoxifen use and Alzheimer's disease in aged women with breast cancer in Taiwan. Methods: We conducted a retrospective nationwide case-control study using the database of the Taiwan National Health Insurance Program. Totally, 173 female subjects with breast cancer aged ≥ 65 years with newly diagnosed Alzheimer's disease from 2000 to 2011 were identified as the cases. Additionally, 684 female subjects with breast cancer aged ≥ 65 years without any type of dementia were selected as the matched controls. The cases and the matched controls were matched with age and comorbidities. Ever use of tamoxifen was defined as subjects who had at least a prescription for tamoxifen before the index date. Never use of tamoxifen was defined as subjects who never had a prescription for tamoxifen before the index date. We used the logistic regression model to calculate the odds ratio (OR) and 95% confidence interval (CI) of Alzheimer's disease associated with tamoxifen use. Results: The OR of Alzheimer's disease was 3.09 for subjects with ever use of tamoxifen (95% CI 2.10, 4.55), compared with never use. The OR of Alzheimer's disease was 1.23 for subjects with increasing cumulative duration of tamoxifen use for every 1 year (95% CI 1.13, 1.34), compared with never use. Conclusion: The increased odds of Alzheimer's disease associated with tamoxifen use may be due to the survival effect, not the toxic effect. That is, the longer the tamoxifen use, the longer the patients survive, and the greater the likelihood that she may have a chance to develop Alzheimer's disease.
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Affiliation(s)
- Kuan-Fu Liao
- College of Medicine, Tzu Chi UniversityHualien, Taiwan.,Department of Internal Medicine, Taichung Tzu Chi General HospitalTaichung, Taiwan.,Graduate Institute of Integrated Medicine, China Medical UniversityTaichung, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical UniversityTaichung, Taiwan.,Management Office for Health Data, China Medical University HospitalTaichung, Taiwan
| | - Shih-Wei Lai
- College of Medicine, China Medical UniversityTaichung, Taiwan.,Department of Family Medicine, China Medical University HospitalTaichung, Taiwan
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26
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Lai SW, Lin CL, Liao KF. Population-based cohort study investigating the correlation of diabetes mellitus with pleural empyema in adults in Taiwan. Medicine (Baltimore) 2017; 96:e7763. [PMID: 28885331 PMCID: PMC6392655 DOI: 10.1097/md.0000000000007763] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 05/23/2017] [Accepted: 07/24/2017] [Indexed: 12/13/2022] Open
Abstract
We assessed the association between diabetes mellitus and the risk of pleural empyema in Taiwan.A population-based retrospective cohort study was conducted using the database of the Taiwan National Health Insurance Program. There were 28,802 subjects aged 20 to 84 years who were newly diagnosed with diabetes mellitus from 2000 to 2010 as the diabetes group and 114,916 randomly selected subjects without diabetes mellitus as the non-diabetes group. The diabetes group and the non-diabetes group were matched by sex, age, comorbidities, and the year of index date. The incidence of pleural empyema at the end of 2011 was estimated. A multivariable Cox proportional hazards regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (95% CI) for pleural empyema associated with diabetes mellitus.The overall incidence of pleural empyema was 1.65-fold higher in the diabetes group than that in the non-diabetes group (1.58 vs 0.96 per 10,000 person-years, 95% CI 1.57-1.72). After adjusting for confounders, a multivariable Cox proportional hazards regression model revealed that the adjusted HR of pleural empyema was 1.71 in subjects with diabetes mellitus (95% CI 1.16-2.51), compared with those without diabetes mellitus. In further analysis, even in the absence of any comorbidity, the adjusted HR was 1.99 for subjects with diabetes mellitus alone (95% CI 1.18-3.38).Diabetic patients confer a 1.71-fold increased hazard of developing pleural empyema. Even in the absence of any comorbidity, the risk remains existent.
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Affiliation(s)
- Shih-Wei Lai
- College of Medicine
- Department of Family Medicine
| | - Cheng-Li Lin
- College of Medicine
- Management Office for Health Data, China Medical University Hospital, Taichung
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien
- Department of Internal Medicine, Taichung Tzu Chi General Hospital
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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27
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Lin HF, Liao KF, Chang CM, Lin CL, Lin CH, Lai SW. Use of thiazolidinediones and risk of hip fracture in old people in a case-control study in Taiwan. Medicine (Baltimore) 2017; 96:e7712. [PMID: 28885328 PMCID: PMC6392959 DOI: 10.1097/md.0000000000007712] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 07/13/2017] [Accepted: 07/14/2017] [Indexed: 12/29/2022] Open
Abstract
Little research is available on the association between use of thiazolidinediones and hip fracture in old people in Taiwan. We conducted a population-based case-control study to examine this issue.Using the database of the Taiwan National Health Insurance Program, we identified 603 type 2 diabetic subjects 65 years or older in age with newly diagnosed hip fracture in 2000 to 2013 as cases. We randomly selected 603 type 2 diabetic subjects 65 years or older without hip fracture as the controls. Both cases and controls were matched with sex, age, comorbidities, and index year of diagnosing hip fracture. Current use of thiazolidinediones was defined as subjects whose last remaining one tablet of thiazolidinediones was noted ≤30 days before the date of diagnosing hip fracture. Never use of thiazolidinediones was defined as subjects who never had a prescription of thiazolidinediones. The odds ratio (OR) and 95% confidence interval (CI) for hip fracture associated with thiazolidinediones use was estimated by the multivariable unconditional logistic regression analysis.After adjustment for covariables, the multivariable logistic regression analysis revealed that the adjusted OR of hip fracture was 1.64 for subjects with current use of thiazolidinediones (95% CI 1.01, 2.67), when compared with subjects with never use of thiazolidinediones.Our findings suggest that current use of thiazolidinediones is associated with a 64% higher risk of hip fracture in type 2 diabetic old people in Taiwan. Clinicians should consider the possibility of thiazolidinediones-associated hip fracture among type 2 diabetic old people currently using thiazolidinediones.
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Affiliation(s)
- Hsien-Feng Lin
- School of Chinese Medicine
- Department of Family Medicine, China Medical University Hospital, Taichung
| | - Kuan-Fu Liao
- Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung
- College of Medicine, Tzu Chi University, Hualien
- Graduate Institute of Integrated Medicine, China Medical University Hospital, Taichung
| | - Ching-Mei Chang
- Department of Nursing, Tungs Taichung Metro Harbor Hospital, Taichung
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Hsueh Lin
- Department of Family Medicine, China Medical University Hospital, Taichung
- College of Medicine, China Medical University, Taichung
| | - Shih-Wei Lai
- Department of Family Medicine, China Medical University Hospital, Taichung
- College of Medicine, China Medical University, Taichung
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28
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Liao KF, Lin CL, Lai SW. Population-Based Case-Control Study Assessing the Association between Statins Use and Pulmonary Tuberculosis in Taiwan. Front Pharmacol 2017; 8:597. [PMID: 28912719 PMCID: PMC5583193 DOI: 10.3389/fphar.2017.00597] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 08/18/2017] [Indexed: 02/04/2023] Open
Abstract
Background and Objectives: Little evidence is available about the relationship between statins use and pulmonary tuberculosis in Taiwan. The aim of the study was to explore this issue. Methods: Using the database of the Taiwan National Health Insurance Program, we conducted a population-based case-control study to identify 8,236 subjects aged 20 years and older with newly diagnosed pulmonary tuberculosis from 2000 to 2013 as the cases. We randomly selected 8,236 sex-matched and age-matched subjects without pulmonary tuberculosis as the controls. Subjects who had at least one prescription of statins before the index date were defined as “ever use.” Subjects who never had one prescription of statins before the index date were defined as “never use.” The odds ratio (OR) and 95% confidence interval (CI) for pulmonary tuberculosis associated with statins use was estimated by a multivariable logistic regression model. Results: After adjustment for co-variables, the adjusted OR of pulmonary tuberculosis was 0.67 for subjects with ever use of statins (95% CI 0.59, 0.75). In a sub-analysis, the adjusted ORs of pulmonary tuberculosis were 0.87 (95% CI 0.69, 1.10) for subjects with cumulative duration of statins use <3 months, 0.77 (95% CI 0.58, 1.03) for 3–6 months, and 0.59 (95% CI 0.51, 0.68) for ≥6 months, compared with subjects with never use of statins. Conclusions: Statins use correlates with a small but statistically significant risk reduction of pulmonary tuberculosis. The protective effect is stronger for longer duration of statins use. Due to a case-control design, a causal-relationship cannot be established in our study. A prospective cohort design is needed to confirm our findings.
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Affiliation(s)
- Kuan-Fu Liao
- College of Medicine, Tzu Chi UniversityHualien, Taiwan.,Department of Internal Medicine, Taichung Tzu Chi General HospitalTaichung, Taiwan.,Graduate Institute of Integrated Medicine, China Medical UniversityTaichung, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical UniversityTaichung, Taiwan.,Management Office for Health Data, China Medical University HospitalTaichung, Taiwan
| | - Shih-Wei Lai
- College of Medicine, China Medical UniversityTaichung, Taiwan.,Department of Family Medicine, China Medical University HospitalTaichung, Taiwan
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29
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Lin HF, Liao KF, Chang CM, Lin CL, Lai SW. Association of use of selective serotonin reuptake inhibitors with risk of acute pancreatitis: a case-control study in Taiwan. Eur J Clin Pharmacol 2017; 73:1615-1621. [PMID: 28856398 DOI: 10.1007/s00228-017-2328-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 08/22/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND OBJECTIVES Few studies have reported the association of the use of selective serotonin reuptake inhibitors (SSRIs) with acute pancreatitis. We conducted a population-based case-control study to explore this relationship. METHODS In this study, 4631 cases with first attack of acute pancreatitis and 4631 controls without acute pancreatitis were selected using a randomly sampled cohort of one million health insurance enrollees from 2000 to 2013. Both cases and controls were aged 20-84 years and were matched with sex, age, comorbidities, and index year of diagnosis of acute pancreatitis. Patients with current use of SSRIs were defined as those whose last tablet of SSRIs was noted ≤ 7 days before the date of diagnosis of acute pancreatitis; patients with late use of SSRIs were defined as those whose last tablet of SSRIs was noted ≥ 8 days before the date of diagnosis; and patients with no use of SSRIs were defined as those who were never prescribed SSRIs. The odds ratio (OR) and 95% confidence interval (CI) for acute pancreatitis associated with the use of SSRIs were assessed using multivariate unconditional logistic regression analysis. RESULTS After adjusting for covariables, multivariate logistic regression analysis revealed that compared with patients with no use of SSRIs, the adjusted OR of acute pancreatitis for those with current use of SSRIs was 1.7 (95% CI, 1.1-2.5), whereas that for patients with late use of SSRIs was 1.0 (95% CI, 0.9-1.2) without statistical significance. CONCLUSIONS Current use of SSRIs is associated with the diagnosis of acute pancreatitis. Therefore, clinicians should consider the possibility of SSRI-associated acute pancreatitis among patients currently taking SSRIs and those presenting with the diagnosis of acute pancreatitis without a definite cause.
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Affiliation(s)
- Hsien-Feng Lin
- School of Chinese Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, No 2, Yuh-Der Road, Taichung City, 404, Taiwan
| | - Kuan-Fu Liao
- Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan.,College of Medicine, Tzu Chi University, Hualien, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Ching-Mei Chang
- Department of Nursing, Tungs' Taichung Metro Habor Hospital, Taichung, 435, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung, Taiwan.,Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Shih-Wei Lai
- Department of Family Medicine, China Medical University Hospital, No 2, Yuh-Der Road, Taichung City, 404, Taiwan. .,College of Medicine, China Medical University, Taichung, Taiwan.
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30
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Cheng KC, Liao KF, Lin CL, Lai SW. Correlation of Proton Pump Inhibitors with Pulmonary Tuberculosis: A Case-Control Study in Taiwan. Front Pharmacol 2017; 8:481. [PMID: 28769810 PMCID: PMC5515903 DOI: 10.3389/fphar.2017.00481] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 07/04/2017] [Indexed: 12/15/2022] Open
Abstract
Background and Objectives: Although the relationship between the use of proton pump inhibitors (PPIs) and pulmonary tuberculosis (TB) in Taiwan published in 2014. Due to just only one article and not enough comprehensively, we explore this issue. Methods: We conducted a population-based case-control study to identify 9,422 subjects aged 20 years or older with newly diagnosed pulmonary TB in 2000–2013 as test cases. We then randomly selected 9,422 subjects aged 20 years or older without pulmonary TB as controls. Both cases and controls were matched in terms of sex, age, and comorbidities. Use of PPIs were defined as subjects who had had at least one prescription for these medications before the index date. No use was defined as subjects who had never had a prescription for PPIs before the index date. The odds ratio (OR) and 95% confidence interval (CI) for pulmonary TB associated with PPI use was estimated using the logistic regression model. Results: The OR of pulmonary TB was 1.31 for subjects who had used PPIs (95% CI 1.22, 1.41) compared with those with no use of the medications. Sub-analysis revealed the OR of pulmonary TB in subjects using PPI per increasing microgram was 1.25 (95% CI 1.19, 1.30). Conclusions: PPI use is associated with a 1.3-fold increase in odds of developing pulmonary TB in Taiwan. There is a dose-related response between PPI use and pulmonary TB.
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Affiliation(s)
- Kao-Chi Cheng
- College of Medicine, China Medical UniversityTaichung, Taiwan.,Department of Family Medicine, China Medical University HospitalTaichung, Taiwan
| | - Kuan-Fu Liao
- Department of Internal Medicine, Taichung Tzu Chi General HospitalTaichung, Taiwan.,College of Medicine, Tzu Chi UniversityHualien, Taiwan.,Graduate Institute of Integrated Medicine, China Medical UniversityTaichung, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical UniversityTaichung, Taiwan.,Management Office for Health Data, China Medical University HospitalTaichung, Taiwan
| | - Shih-Wei Lai
- College of Medicine, China Medical UniversityTaichung, Taiwan.,Department of Family Medicine, China Medical University HospitalTaichung, Taiwan
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Cheng KC, Liao KF, Lin CL, Lai SW. Increased Risk of Pulmonary Tuberculosis in Patients with Depression: A Cohort Study in Taiwan. Front Psychiatry 2017; 8:235. [PMID: 29180971 PMCID: PMC5694036 DOI: 10.3389/fpsyt.2017.00235] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Accepted: 10/31/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND/OBJECTIVE Tuberculosis (TB) and depression were major public health issues worldwide and the mutual causative relationships between them were not exhaustive. This study was performed to explore the association between depression, comorbidities, and the risk of pulmonary TB in Taiwan. METHODS The cohort study used the database of the Taiwan National Health Insurance Program. The depression group included 34,765 subjects aged 20-84 years with newly diagnosed depression from 2000 to 2012, and the non-depression group included 138,187 randomly selected subjects without depression. Both depression and non-depression groups were matched with respect to sex, age, and comorbidities. We explored the incidence of pulmonary TB at the end of 2013 in both the groups and used multivariable Cox proportional hazards regression model to explore the hazard ratio (HR) and 95% confidence interval (CI) for the risk of pulmonary TB associated with depression. RESULTS The overall incidence of pulmonary TB was 1.16-fold greater in the depression group than that in the non-depression group (1.52 vs. 1.31 per 1,000 person-years, 95% CI 1.12, 1.21). The multivariable Cox proportional hazards regression analysis revealed that the adjusted HR of pulmonary TB was 1.15 for the depression group (95% CI 1.03, 1.28), compared with the non-depression group. CONCLUSION Depression is associated with 1.15-fold increased hazard of pulmonary TB in Taiwan.
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Affiliation(s)
- Kao-Chi Cheng
- College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Fu Liao
- Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan.,College of Medicine, Tzu Chi University, Hualien, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung, Taiwan.,Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Shih-Wei Lai
- College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
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