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Yuan X, Chen H, Zeng K, Xiao J, Liu J, Lin G, Zhang J, Lu T, Cai J, Yao J, Zhang Y, Sui X, Liang J, Zheng J. Causal associations between changes in lipid profiles and risk of gallstone disease: a two-sample Mendelian randomization study. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:818. [PMID: 36035003 PMCID: PMC9403919 DOI: 10.21037/atm-21-4007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 02/27/2022] [Indexed: 11/28/2022]
Abstract
Background Nonalcoholic fatty liver disease (NAFLD) has been linked to gallstone disease (GSD) in observational studies; however, the relationships between certain lipid profiles and GSD remain unclear. Methods We adopted a two-sample Mendelian randomization (MR) framework by applying different statistical methods to assess causalities between lipid profiles and GSD. We identified single-nucleotide polymorphisms (SNPs) for blood lipids and NAFLD from separate previous genome-wide association studies (GWASs). Results We retrieved GSD SNPs attributed to 10,520 cases and 361,194 controls and validated our estimates using GWAS summary data from UK Biobank. We also performed sex-stratified analyses. Based on the summary estimates of 41, 59, 35, and 2 SNPs for low-density lipoprotein cholesterol (LDLC), high-density lipoprotein cholesterol (HDLC), triglycerides (TGs), and NAFLD, respectively, we found no evidence of a causal relationship between genetically-predicted lipid profiles and GSD. The odds ratios were 0.995 for LDLC [95% confidence interval (CI): 0.994-0.998] per 0.98 mmol/L, 0.999 for HDLC (95% CI: 0.996-1.003) per 0.41 mmol/L, 0.997 for TGs (95% CI: 0.994-1.001) per 1 mmol/L, and 0.993 for NAFLD (95% CI: 0.984-1.003). No evidence of associations between lipid profile s and GSD in validation MR analyses or the sex-stratification analyses was noted. Conclusions Genetically predicted hyperlipidemia or NAFLD is not causally associated with GSD.
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Affiliation(s)
- Xiaofeng Yuan
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of General Intensive Care Unit, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Haitian Chen
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Key Laboratory of Liver Disease Research, Guangdong Province Engineering Laboratory for Transplantation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Kaining Zeng
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Key Laboratory of Liver Disease Research, Guangdong Province Engineering Laboratory for Transplantation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jiaqi Xiao
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Key Laboratory of Liver Disease Research, Guangdong Province Engineering Laboratory for Transplantation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jiaqing Liu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Guowang Lin
- Microbiome Medicine Center, Division of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jiebin Zhang
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Key Laboratory of Liver Disease Research, Guangdong Province Engineering Laboratory for Transplantation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Tongyu Lu
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Key Laboratory of Liver Disease Research, Guangdong Province Engineering Laboratory for Transplantation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jianye Cai
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Key Laboratory of Liver Disease Research, Guangdong Province Engineering Laboratory for Transplantation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jia Yao
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Key Laboratory of Liver Disease Research, Guangdong Province Engineering Laboratory for Transplantation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yingcai Zhang
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Key Laboratory of Liver Disease Research, Guangdong Province Engineering Laboratory for Transplantation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xin Sui
- Department of Surgical Intensive Care Unit, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jinliang Liang
- Guangdong Key Laboratory of Liver Disease Research, Guangdong Province Engineering Laboratory for Transplantation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jun Zheng
- Department of Hepatic Surgery and Liver Transplantation Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Guangdong Key Laboratory of Liver Disease Research, Guangdong Province Engineering Laboratory for Transplantation Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Wang H, So H, Ko SW, Jung SW, Bang SJ, Park EJ. Gallstone Is Associated with Metabolic Factors and Exercise in Korea. Healthcare (Basel) 2022; 10:healthcare10081372. [PMID: 35893194 PMCID: PMC9329956 DOI: 10.3390/healthcare10081372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/18/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
Gallstone is a common health problem. Cholesterol stone accounts for 90% of stones in the United States and Europe, but East Asia has a high proportion of pigment stone. The aim of this study was to determine the relationship between modifiable metabolic factors and gallstone in a region with a high prevalence of pigment stone. Among 3159 participants who underwent health screening at Ulsan University Hospital from March 2014 to June 2019, 178 patients were diagnosed with gallstone using abdominal ultrasonography; 2860 participants were selected as a control group. Demographic and laboratory data, and a medical questionnaire were obtained. Hypertension and diabetes mellitus were more prevalent in the gallstone group. Age, waist circumference, systolic blood pressure (SBP) ≥ 140 mmHg, fasting blood glucose, HbA1c ≥ 6.5%, visceral fat index, normal-attenuated muscle area index, and engaging in vigorous exercise for ≥2 days per week were associated with gallstone by univariate analysis. Through multivariate logistic regression analysis, HbA1c ≥ 6.5% (odds ratio (OR) 1.98, 95% confidence interval (CI) 1.31–2.98), and 2 or more days of vigorous exercise per week (OR 0.66, 95% CI 0.45–0.95) remained significant. The association persisted after adjusted analysis for age and sex. HbA1c ≥ 6.5% were positively associated with the gallstone. Vigorous exercise for at least 2 days weekly may be related to a lower risk of gallstone formation.
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Affiliation(s)
- Hoyoung Wang
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea;
| | - Hoonsub So
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea; (S.W.J.); (S.-J.B.)
- Correspondence: (H.S.); (S.W.K.); Tel.: +82-2-3010-3194 (H.S.); +82-2-2030-4595 (S.W.K.); Fax: +82-2-2030-4641 (S.W.K.)
| | - Sung Woo Ko
- Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, Catholic University of Korea, Seoul 03312, Korea
- Correspondence: (H.S.); (S.W.K.); Tel.: +82-2-3010-3194 (H.S.); +82-2-2030-4595 (S.W.K.); Fax: +82-2-2030-4641 (S.W.K.)
| | - Seok Won Jung
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea; (S.W.J.); (S.-J.B.)
| | - Sung-Jo Bang
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea; (S.W.J.); (S.-J.B.)
| | - Eun Ji Park
- BigData Center, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea;
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Liang KW, Huang HH, Wang L, Lu WY, Chou YH, Tantoh DM, Nfor ON, Chiu NY, Tyan YS, Liaw YP. Risk of gallstones based on ABCG8 rs11887534 single nucleotide polymorphism among Taiwanese men and women. BMC Gastroenterol 2021; 21:468. [PMID: 34906072 PMCID: PMC8672562 DOI: 10.1186/s12876-021-02060-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 12/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gallstones are abnormal masses caused by impaired metabolism of cholesterol, bilirubin, or bile salts in the gallbladder or biliary tract. ATP-binding cassette subfamily G member 8 (ABCG8) is a protein that regulates cholesterol efflux from the liver. Genome-wide association studies (GWAS) and meta-analyses of GWAS revealed the ABCG8 rs11887534 variant as the most common genetic determinant of gallstones in humans. These findings have not been extensively replicated in Taiwanese. Therefore, we appraised the relationship between gallstones and rs11887534 in a relatively large Taiwanese sample. METHODS We retrieved data collected through questionnaires, physical and biochemical tests from the Taiwan Biobank Bank (TWB). The study participants comprised 7388 men and 13,880 women who voluntarily enrolled in the Taiwan Biobank project between 2008 and 2019. Gallstones were self-reported. RESULTS The overall sample size was 21,268 comprising 938 gallstone patients and 20,330 non-gallstone individuals. Among the participants, 20,640 had the GG and 628 had the GC + CC genotype. At p-value < 0.05, the baseline genotypes and gallstone status between men and women were not significantly different. The risk of gallstones was higher in participants having the GC + CC compared to the GG genotype: odds ratio (OR); 95% confidence interval (CI) = 1.698; 1.240-2.325), but was lower in men compared to women (OR = 0.763; 95% CI = 0.638-0.913). Compared to men with the rs11887534 GG genotype, women with the GG and GC + CC genotypes had a higher risk of gallstone (OR; 95% CI = 1.304; 1.087-1.565 for GG and 2.291; 1.514-3.467 for GC + CC). The positive association between GC + CC and gallstones was retained after we restricted the analysis to the female participants (OR; 95% CI = 1.789 = 1.208-2.648). Hormone use was associated with an elevated risk of gallstones (OR; 95% CI = 1.359; 1.107-1.668). Relative to GG and no hormone use, we found a significantly high risk among hormone users with the GC + CC genotype (OR; 95% CI = 3.596; 1.495-8.650). CONCLUSIONS The rs11887534 GC + CC genotype was independently associated with a higher risk of gallstones. This risk was much higher among women, especially those who used hormones for various gynecological purposes.
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Grants
- CSH-2021-C-032 Chung Shan Medical University Hospital
- CSH-2021-C-032 Chung Shan Medical University Hospital
- CSH-2021-C-032 Chung Shan Medical University Hospital
- CSH-2021-C-032 Chung Shan Medical University Hospital
- CSH-2021-C-032 Chung Shan Medical University Hospital
- CSH-2021-C-032 Chung Shan Medical University Hospital
- CSH-2021-C-032 Chung Shan Medical University Hospital
- CSH-2021-C-032 Chung Shan Medical University Hospital
- CSH-2021-C-032 Chung Shan Medical University Hospital
- CSH-2021-C-032 Chung Shan Medical University Hospital
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
- MOST 109-2121-M-040-002; MOST 110-2121-M-040-002; MOST 109-2811-M-040-500; MOST 110-2811-M-040-001 Ministry of Science and Technology, Taiwan
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Affiliation(s)
- Keng-Wei Liang
- Institute of Medicine, Chung Shan Medical University, Taichung City, 40201, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, 40201, Taiwan
| | - Hsin-Hui Huang
- School of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, 40201, Taiwan
| | - Lee Wang
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Wen-Yu Lu
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Ying-Hsiang Chou
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, 40201, Taiwan
- Department of Radiation Oncology, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Disline Manli Tantoh
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, 40201, Taiwan
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan
| | - Oswald Ndi Nfor
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan.
| | - Neng-Yu Chiu
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, 40201, Taiwan
| | - Yeu-Sheng Tyan
- School of Medicine, Chung Shan Medical University, Taichung, 40201, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, 40201, Taiwan
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, 40201, Taiwan
| | - Yung-Po Liaw
- Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung City, 40201, Taiwan.
- Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, 40201, Taiwan.
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Ashraf Butt AU, Sajjad A, Malik AR, Farooq A, Ali Q, Rizvi ZA, Khan MS, Anwar M. Changes in Hematological Parameters and Liver Enzymes During Laparoscopic Cholecystectomy. Cureus 2021; 13:e13098. [PMID: 33728120 PMCID: PMC7934604 DOI: 10.7759/cureus.13098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2021] [Indexed: 12/04/2022] Open
Abstract
Background Changes in hematological parameters, such as neutrophils, leukocytes, neutrophil-lymphocyte ratio, platelet lymphocyte ratio, and mean platelet volume, have been observed during laparoscopic surgeries. Objectives The objectives of this research were to assess the changes in hematological parameters and liver enzymes during laparoscopic cholecystectomy (LC). Methods This prospective observational study included patients undergoing laparoscopic cholecystectomy for symptomatic cholelithiasis. Patients with comorbidities, including hepatitis, diabetes, and where laparoscopic cholecystectomy was converted to open cholecystectomy, were excluded. Preoperative and postoperative baseline hematological parameters and liver function tests (LFTs) were recorded. Characteristics like age, gender, body mass index (BMI), indication for surgery, duration of surgery, the pressure of pneumoperitoneum, and the duration of hospital stay were noted. A paired sample t-test was applied to assess the difference between the mean pre and postoperative values of different hematological parameters. Results It was observed that hemoglobin (Hb), hematocrit (Hct), platelets, and alkaline phosphatase (ALP) decreased postoperatively. However, mean corpuscular volume (MCV), mean platelet volume (MPV), leukocytes, and alanine transaminase (ALT) increased postoperatively. The difference in mean Hb, MCV, Hct, leukocytes, MPV, and ALT was statistically significant (p<0.05). Conclusion There were significant changes in the levels of hematological parameters and liver enzymes during LC.
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Affiliation(s)
| | - Ahsan Sajjad
- Medicine, Rawalpindi Medical University, Rawalpindi, PAK
| | | | - Ahmad Farooq
- Medicine, Government Rural Dispensary, Rawalpindi, PAK
| | - Qasim Ali
- General Surgery, Holy Family Hospital, Rawalpindi, PAK
- Surgery, Holy Family Hospital, Rawalpindi, PAK
| | - Zuhair Ali Rizvi
- Intensive Care Unit, Shifa International Hospital, Islamabad, PAK
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Wang J, Shen S, Wang B, Ni X, Liu H, Ni X, Yu R, Suo T, Liu H. Serum lipid levels are the risk factors of gallbladder stones: a population-based study in China. Lipids Health Dis 2020; 19:50. [PMID: 32192520 PMCID: PMC7083041 DOI: 10.1186/s12944-019-1184-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 12/30/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Gallstones are the cause of a majority of biliary tract discomfort. Although many community-based studies have addressed the risk factors for gallstone disease (GSD), little is known about GSD prevalence and risk factors in Chinese populations. METHODS From January 2014 to January 2015, participants (N = 2,068,523) were recruited by Meinian Onehealth Healthcare Co., Ltd. They received a physical examination, and GSD was determined by ultrasound. RESULTS The prevalence of GSD was 8.1%. Risks of GSD were similar between males and females in all age groups. Risk factors for gallstones include body mass index, waist circumference, waist-to-hip ratio, and physical activity, as well as biological factors such as age, sex, and elevated blood lipid levels. Serum lipid levels of GSD were statistically different from controls in total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (H-DL), low-density lipoprotein cholesterol (LDL), and apolipoprotein B (APOB). Furthermore, TC > 5.00 mmol/L, TG > 1.39 mmol/L, HDL < 1.19 mmol/L, LDL > 3.04 mmol/L, and APOB > 0.97 mmol/L were risk factors for gallstones. CONCLUSIONS Serum lipid levels are associated with GSD. TC, TG, LDL, and APOB are risk factors, while HDL is a protective factor.
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Affiliation(s)
- Jiwen Wang
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China.,Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China
| | - Sheng Shen
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China.,Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China
| | - Bo Wang
- Biliary Tract Disease Institute, Fudan University, Shanghai, 200032, China
| | - Xiaojian Ni
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China.,Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China
| | - Han Liu
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China.,Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China
| | - Xiaoling Ni
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China.,Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China
| | - Rong Yu
- Biliary Tract Disease Institute, Fudan University, Shanghai, 200032, China
| | - Tao Suo
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China. .,Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China.
| | - Houbao Liu
- Department of General Surgery, Zhongshan Hospital, General Surgery Institute, Fudan University, No. 180 Fenglin Rd, Shanghai, 200032, China. .,Meinian Onehealth Healthcare Holding Co., Ltd, Shanghai, 200030, China.
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Kiani Q, Farooqui F, Khan MS, Khan AZ, Nauman Tariq M, Akhtar A. Association of Body Mass Index and Diet with Symptomatic Gall Stone Disease: A Case-Control Study. Cureus 2020; 12:e7188. [PMID: 32269869 PMCID: PMC7135725 DOI: 10.7759/cureus.7188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 03/05/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Gall stone disease (GSD) is one of the commonest gastrointestinal disorders. Causative factors can be non-modifiable as genetics and modifiable like dietary habits. High-fat diet and high BMI are well known contributing factors world-over. Local and regional data is deficient about these factors. Moreover, Indo-Pakistani dietary patterns are very different from the western population. This study was conducted to see the association of high BMI and diet with GSD in our population. MATERIALS AND METHODS This case-control study was conducted in Shifa International Hospital, Islamabad, from 2012 to 2017. We included all female patients above 25 years of age with symptomatic gall stones on ultrasonography as cases and all females above 25 years of age with no gall stones on ultrasonography (done for any reason) as controls. The patients with gall stones having some other clear predisposing cause for gallstone formation, e.g., stoma, sudden weight loss, etc. were excluded. BMI, demographic details, dietary habits, and clinical profile of cases and controls were recorded. Data were analyzed by SPSS v 21. p-values were calculated. RESULTS A total of 396 patients were included in this study, with 103 cases and 293 controls. The mean BMI of GSD cases was 27.576±5.753, while controls had a mean BMI of 25.638±7.008 (p=0.08). About 26.4% of cases had an average fat consumption greater than 100g/day as compared to 11.9% controls (p=0.035). The average red meat intake per week was 222g among cases while 210g among controls (p=0.001). The average intake of fried food per week was 270g among controls and 250g among cases (p=0.012). The average intake of bakery items per week was 240g among cases and 210g among controls (p=0.038). CONCLUSION Gall stone disease is significantly related to high BMI and high dietary fat and meat intake in our population.
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Affiliation(s)
- Qamar Kiani
- General and Colorectal Surgery, Shifa Tameer-E-Millat University, Islamabad, PAK
| | | | | | - Aoun Z Khan
- Surgery, Rawalpindi Medical University, Islambad, PAK
| | | | - Aisha Akhtar
- Surgery, Texas Tech University Health Sciences Center, Lubbock, USA
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Dhamnetiya D, Goel MK, Dhiman B, Pathania OP. Gallstone disease and its correlates among patients attending teaching hospital of North India. J Family Med Prim Care 2019; 8:189-193. [PMID: 30911504 PMCID: PMC6396618 DOI: 10.4103/jfmpc.jfmpc_358_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Gallstone disease (GSD) represents a significant burden for healthcare systems worldwide and is one of the most common disorders among patients presenting to emergency rooms with abdominal discomfort. Aim and Objective This study was aimed to find correlates (demographic, dietary, and behavioral) of GSD in patients attending teaching hospital in North India. Methodology A case-control study was conducted from January 2013 to December 2013 among subjects attending outpatient department of general surgery in a teaching hospital. Data collection for both cases and controls was done on a self-designed pretested "interview schedule" which assessed the sociodemographic profile, personal history, medical history, comorbidities, physical examination including anthropometry, and dietary intakes. To measure the strength of association, odds ratio (OR) was calculated. Binary logistic regression was used for multivariate analysis. Results A total of 120 cases and the same number of age- and sex-matched controls were included in final analysis. In binary logistic regression, maximum association was seen with physical inactivity [OR 3.93, confidence interval (CI): 1.98-7.78] followed by current consumption of smokeless tobacco (OR 3.65, CI: 1.65-8.09), current smoking (OR 2.69, CI: 1.13-6.37), nonvegetarian diet (OR 3.10, CI: 1.65-5.83), and fat intake (OR 2.14, CI: 1.14-4.02). Current alcohol consumption (OR 0.90, CI: 0.41-1.98), high waist-hip ratio (OR 1.54, CI: 0.67-3.56), and intake of fruits and green leafy vegetables (OR 1.86, CI: 0.61-5.61) were not significantly associated with GSD. Conclusion Physical inactivity, smokeless tobacco, nonvegetarian diet, current smoking, high fat intake, and family history were found to be risk factors for the development of GSD.
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Affiliation(s)
- Deepak Dhamnetiya
- Department of Community Medicine, LHMC and Associated Hospitals, New Delhi, India
| | - Manish K Goel
- Department of Community Medicine, LHMC and Associated Hospitals, New Delhi, India
| | - BalRaj Dhiman
- Department of Community Medicine, LHMC and Associated Hospitals, New Delhi, India
| | - Om Prakash Pathania
- Department of General Surgery, LHMC and Associated Hospitals, New Delhi, India
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Dhamnetiya D, Goel MK, Dhiman B, Pathania OP. Gallstone disease and quantitative analysis of independent biochemical parameters: Study in a tertiary care hospital of India. J Lab Physicians 2018; 10:448-452. [PMID: 30498320 PMCID: PMC6210845 DOI: 10.4103/jlp.jlp_75_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION: Gallstone disease (GSD) represents a significant burden for health-care systems worldwide and is one of the most common disorders among patients presenting to emergency rooms with abdominal discomfort. This study was aimed to know the association of biochemical parameters and development of GSD. MATERIALS AND METHODS: We conducted a case–control study from January 2013 to December 2013 among patients attending outpatient department of general surgery at a tertiary care hospital of Delhi, North India; we recruited 120 cases and the same number of controls in the study. Data collection for both cases and controls was done on a self-designed pretested interview schedule and all the patients were investigated for relevant biochemical parameters. Logistic regression was used for univariate and multivariate analyses to find out different correlates and analyze the independent effects of these correlates on GSD. RESULTS: We have included 120 cases and the same number of age- and sex-matched controls in the study and final analysis. Almost 70% of the cases were females and 30% were males. In multivariate logistic regression, we have found maximum significant association with serum total cholesterol (odds ratio [OR]: 1.013, confidence interval [CI]: 1.003–1.024, P = 0.041) followed by low-density lipoprotein (LDL) cholesterol (OR: 1.017, CI: 1.001–1.034, P = 0.04) and triglycerides (OR: 1.009, CI: 1.001–1.018, P = 0.049). Fasting blood sugar (P = 0.18), high-density lipoprotein cholesterol (P = 0.07), aspartate transaminase (P = 0.21), alanine transaminase (P = 0.29), and total bilirubin (P = 0.13) were not found to be independently associated with GSD. CONCLUSION: Biochemical parameters such as plasma total cholesterol, triglycerides, and LDL cholesterol level were independently associated with GSD.
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Affiliation(s)
- Deepak Dhamnetiya
- Department of Community Medicine and General Surgery, LHMC and Associated Hospitals, New Delhi, India
| | - Manish Kumar Goel
- Department of Community Medicine and General Surgery, LHMC and Associated Hospitals, New Delhi, India
| | - BalRaj Dhiman
- Department of Community Medicine and General Surgery, LHMC and Associated Hospitals, New Delhi, India
| | - Om Prakash Pathania
- Department of Community Medicine and General Surgery, LHMC and Associated Hospitals, New Delhi, India
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9
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Wijarnpreecha K, Thongprayoon C, Panjawatanan P, Lekuthai N, Ungprasert P. Hepatitis C virus infection and risk of gallstones: A meta-analysis. J Evid Based Med 2017; 10:263-270. [PMID: 29193901 DOI: 10.1111/jebm.12277] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 11/06/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND/OBJECTIVES Gallstones and its complications are one of the most common hepatobiliary tract diseases. Several epidemiologic studies have suggested that patients with hepatitis C virus (HCV) infection might be at an increased risk of gallstones. However, the data on this relationship remain inconclusive. This meta-analysis was conducted with the aims to summarize all available evidence. METHODS A literature search was performed using MEDLINE and EMBASE databases from inception to May 2016. Studies that reported relative risks, odd ratios, or hazard ratios comparing the risk of gallstones among HCV-infected patients versus subjects without HCV infection were included. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. RESULTS Eleven studies met our eligibility criteria and were included in the analysis. The pooled OR of gallstones in HCV-infected patients versus subjects without HCV infection was 1.83 (95% CI, 1.35 to 2.48, I2 = 89%). Subgroup analysis showed that significant risk was increased for both male (pooled OR of 2.07, 95% CI, 1.14 to 3.76) and female (pooled OR of 3.00, 95% CI, 2.16 to 4.17). CONCLUSIONS Our study demonstrated a significantly increased risk of gallstones among HCV-infected patients. Further studies are required to clarify how this risk should be addressed in the clinical picture.
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Affiliation(s)
- Karn Wijarnpreecha
- Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USA
| | - Charat Thongprayoon
- Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY, USA
| | | | - Natasorn Lekuthai
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Patompong Ungprasert
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
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10
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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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11
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Qiao QH, Zhu WH, Yu YX, Huang FF, Chen LY. Nonalcoholic fatty liver was associated with asymptomatic gallstones in a Chinese population. Medicine (Baltimore) 2017; 96:e7853. [PMID: 28930823 PMCID: PMC5617690 DOI: 10.1097/md.0000000000007853] [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: 12/23/2022] Open
Abstract
The aim of this study was to determine the association between nonalcoholic fatty liver disease (NAFLD) and asymptomatic gallstones in a Chinese population.The study had a cross-sectional design and enrolled 7583 subjects who visited the physical check-up center at Sir Run Run Shaw Hospital between 2009 and 2011. Colorimetric methods were used to measure the levels of cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), whereas fasting plasma glucose (FPG) level was measured using a dextrose-oxidizing enzyme method. Subjects who completed a questionnaire and underwent a medical and ultrasound examinations were included in the study.The prevalence of NAFLD was significantly higher in patients with asymptomatic gallstones than in those without asymptomatic gallstones (58.98% vs 46.58%, respectively; P < .0001). The age-adjusted odds ratio (OR) for NAFLD being accompanied by asymptomatic gallstones was 1.35 [95% confidence interval (CI), 1.13-1.61; P = .0009] in male and 1.92 (95% CI, 1.45-2.54; P < .0001) in female subjects. Asymptomatic gallstones were associated with NAFLD in subjects aged < 50 years (OR = 1.74, 95% CI, 1.44-2.12; P < .0001), but not in subjects aged > 50 years (OR = 1.17, 95% CI, 0.92-1.48; P = .2040). The OR of NAFLD for asymptomatic gallstones was 1.28 after multivariate logistic regression analysis (95% CI, 1.07-1.52; P = .006).Our results indicated that asymptomatic gallstones are strongly associated with NAFLD in the Chinese study population.
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Affiliation(s)
- Qiao-Hua Qiao
- Department of Family Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine
| | - Wen-Hua Zhu
- Department of Family Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine
| | - Yun-Xian Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Fei-Fei Huang
- Department of Family Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine
| | - Li-Ying Chen
- Department of Family Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine
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12
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Liao KF, Huang PT, Lin CC, Lin CL, Lai SW. Fluvastatin use and risk of acute pancreatitis: a population-based case-control study in Taiwan. Biomedicine (Taipei) 2017; 7:17. [PMID: 28840831 PMCID: PMC5571662 DOI: 10.1051/bmdcn/2017070317] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 10/20/2016] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES This study aimed to examine the association between fluvastatin use and acute pancreatitis in Taiwan. METHODS Using the database from the Taiwan National Health Insurance (NHI) Program, we designed a case-control study which consisted of 3501 individuals aged 20-84 with new at-the-time diagnoses acute pancreatitis as the case group and 8373 randomly selected individuals without acute pancreatitis as the control group during the period of 1998-2011. Both groups were matched for sex, age, and index year of being diagnosed with acute pancreatitis. "Current use" of fluvastatin was defined as individuals whose last remaining tablet of fluvastatin was noted ≤ 7 days before the date of their being diagnosed with acute pancreatitis. "Late use" of fluvastatin was defined as individuals whose last remaining tablet of fluvastatin was noted within 8-30 days before the date of their being diagnosed with acute pancreatitis. "No use" of fluvastatin was defined as individuals who had never had a fluvastatin prescription. The odds ratio (OR) and 95% confidence interval (CI) for acute pancreatitis associated with fluvastatin use was examined using a multivariable unconditional logistic regression analysis. RESULTS After adjustment for potential confounders, the multivariable analysis showed that the adjusted ORs of acute pancreatitis were 1.17 for individuals with "current use" of fluvastatin (95% CI 0.69, 1.97) and 1.82 for individuals with "late use" of fluvastatin (95% CI 0.41, 8.19), but there was no statistical significance when compared with individuals with "no use" of fluvastatin. CONCLUSIONS In this this study, no association was detected between fluvastatin use and acute pancreatitis.
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Affiliation(s)
- 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
| | - Po-Tsung Huang
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Department of Family Medicine, China Medical University Hospital Taichung
404 Taiwan
| | - Ching-Chun Lin
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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
| | - 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
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13
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Liang TJ, Liu SI, Chen YC, Chang PM, Huang WC, Chang HT, Chen IS. Analysis of gallstone disease after gastric cancer surgery. Gastric Cancer 2017; 20:895-903. [PMID: 28154944 DOI: 10.1007/s10120-017-0698-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Accepted: 01/23/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND The incidence rate of newly developed gallstone disease after gastrectomy for gastric cancer is thought to be higher than that in the general population. However, the presentation and management of these gallstones remain under debate, and the role of prophylactic cholecystectomy remains questionable. METHODS Data on adult patients who were diagnosed with gastric cancer and received gastrectomy between 2000 and 2011 were extracted from the Taiwan National Health Insurance Research Database. A patient was excluded if he or she had gallstone disease or received cholecystectomy before the index date. The incidence of newly developed gallstone disease and its subsequent management were recorded. Data were analyzed to evaluate the factors associated with gallstone development and treatment options. RESULTS A total of 17,325 gastric cancer patients who underwent gastrectomy were eligible for analysis. During the follow-up period (mean 4.1 years; median, 2.9 years), 1280 (7.4%) patients developed gallstone disease and 560 (3.2%) patients subsequently underwent cholecystectomy. The in-hospital mortality for cholecystectomy was 1.8% (10/560). Development of gallstone disease was associated with older age, total gastrectomy, duodenal exclusion, diabetes, cirrhosis, and more comorbidities. Factors associated with the use of cholecystectomy to treat gallstone disease included younger age, fewer comorbidities, medical center admission, and presentation as cholecystitis. CONCLUSIONS Although few patients required further gallbladder removal after gastrectomy for gastric malignancy, the increased mortality rate for subsequent cholecystectomy was worth noting. The decision to undergo prophylactic cholecystectomy might be individualized based upon patient characteristics and the surgeon's discretion.
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Affiliation(s)
- Tsung-Jung Liang
- Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd, Zuoying District, Kaohsiung, 81362, Taiwan
| | - Shiuh-Inn Liu
- Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd, Zuoying District, Kaohsiung, 81362, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Chia Chen
- Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd, Zuoying District, Kaohsiung, 81362, Taiwan
| | - Po-Min Chang
- Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd, Zuoying District, Kaohsiung, 81362, Taiwan
| | - Wei-Chun Huang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Critical Care Center and Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Hong-Tai Chang
- Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd, Zuoying District, Kaohsiung, 81362, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - I-Shu Chen
- Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd, Zuoying District, Kaohsiung, 81362, Taiwan.
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14
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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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15
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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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16
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Correlation between proton pump inhibitors and risk of pyogenic liver abscess. Eur J Clin Pharmacol 2017; 73:1019-1025. [PMID: 28434021 DOI: 10.1007/s00228-017-2256-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 04/18/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVE Little is known about the relationship between proton pump inhibitors use and pyogenic liver abscess. The objective of this study was to evaluate the correlation between proton pump inhibitors use and pyogenic liver abscess in Taiwan. METHODS This was a population-based case-control study using the database of the Taiwan National Health Insurance Program since 2000 to 2011. Subjects aged 20 to 84 who experienced their first episode of pyogenic liver abscess were enrolled as the case group (n = 1372). Randomly selected subjects aged 20 to 84 without pyogenic liver abscess were enrolled as the control group (n = 1372). Current use, early use, and late use of proton pump inhibitors was defined as subjects whose last one tablet for proton pump inhibitors was noted ≤30 days, between 31 to 90 days and ≥91 days before the date of admission for pyogenic liver abscess. Subjects who never received a prescription for proton pump inhibitors were defined as nonusers of proton pump inhibitors. A multivariable unconditional logistic regression model was used to measure the odds ratio and 95% confidence interval to evaluate the correlation between proton pump inhibitors use and pyogenic liver abscess. RESULTS After adjusting for confounders, the adjusted odds ratio of pyogenic liver abscess was 7.59 for subjects with current use of proton pump inhibitors (95% confidence interval 5.05, 11.4), when compared with nonusers. CONCLUSIONS Current use of proton pump inhibitors is associated with a greater risk of pyogenic liver abscess.
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17
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Liao KF, Cheng KC, Lin CL, Lai SW. Statin Use Correlates with Reduced Risk of Pyogenic Liver Abscess: A Population-Based Case-Control Study. Basic Clin Pharmacol Toxicol 2017; 121:144-149. [PMID: 28273396 DOI: 10.1111/bcpt.12777] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 03/01/2017] [Indexed: 01/17/2023]
Abstract
Little research is available on the relationship between statin use and pyogenic liver abscess. The objective of the study was to determine whether prior use of statins is associated with pyogenic liver abscess. This case-control study was conducted to analyse the claim data of the Taiwan National Health Insurance Program. There were 1828 participants aged 20-84 years with first episode of pyogenic liver abscess from 2000 to 2013 as the cases and 1828 randomly selected participants without pyogenic liver abscess matched with sex, age and index year as the controls. Statin use was defined as 'current', 'recent' or 'past' if the statin prescription was filled ≤3 months, 3-6 months or >6 months before the date of pyogenic liver abscess diagnosis, respectively. Relative risk of pyogenic liver abscess associated with statin use was estimated by the odds ratio (OR) with 95% confidence interval (CI) using the multivariable logistic regression model. After controlling for potential confounders, the adjusted ORs of pyogenic liver abscess were 0.65 for participants with current use of statins (95% CI 0.50, 0.84), 0.74 for participants with recent use of statins (95% CI 0.49, 1.11), and 1.10 for participants with past use of statins (95% CI 0.90, 1.34), compared with participants with never use of statins. In the further analysis, the adjusted ORs of pyogenic liver abscess were 0.65 for participants with cumulative duration of statin use ≥12 months (95% CI 0.48, 0.88) and 0.68 for participants with cumulative duration of statin use <12 months (95% CI 0.43, 1.07), compared with participants with never use of statins. Our findings provide strong evidence that patients with current use of statins are associated with a 35% reduced odds of pyogenic liver abscess. The protective effect is stronger for longer duration of statin use.
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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.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Kao-Chi Cheng
- 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
| | - 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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18
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Lin CM, Liao KF, Lin CL, Lai SW. Use of Simvastatin and Risk of Acute Pancreatitis: A Nationwide Case-Control Study in Taiwan. J Clin Pharmacol 2017; 57:918-923. [PMID: 28301063 DOI: 10.1002/jcph.881] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 01/19/2017] [Indexed: 12/24/2022]
Abstract
The correlation between simvastatin use and acute pancreatitis is explored. A case-control study was conducted to analyze claim data from the Taiwan National Health Insurance Program. The case group comprising a total of 3882 subjects aged 20 to 84 years with their first acute pancreatitis episode occurring between 1998 and 2011 formed the case group, against 3790 randomly selected controls matched for sex, age, comorbidities, and index year of acute pancreatitis diagnosis. Recent use of simvastatin was defined as subjects whose last remaining simvastatin tablet was noted ≤7 days before the date of acute pancreatitis diagnosis. Remote use of simvastatin was defined as subjects whose last remaining 1 tablet for simvastatin was noted >7 days before the date of acute pancreatitis diagnosis. Never use of simvastatin was defined as subjects who had never been prescribed simvastatin. A multivariable unconditional logistic regression model was used to estimate the odds ratio and 95%CI to explore the correlation between simvastatin use and acute pancreatitis. After adjustment for confounders, multivariable logistic regression analysis revealed that the adjusted odds ratio of acute pancreatitis was 1.3 for subjects with recent use of simvastatin (95%CI 1.02, 1.73), when compared with those with never use of simvastatin. The crude odds ratio decreased to 1.1 for those with remote use of simvastatin (95%CI 0.93, 1.34) but without statistical significance. Recent use of simvastatin is associated with acute pancreatitis. Clinicians should consider the possibility of simvastatin-associated acute pancreatitis for patients presenting for acute pancreatitis without known cause.
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Affiliation(s)
- Chih-Ming Lin
- Department of Internal Medicine, Taichung Tzu Chi General 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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19
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Lai SW, Lin HF, Lin CL, Liao KF. Immune thrombocytopenic purpura might be an early hematologic manifestation of undiagnosed human immunodeficiency virus infection. Intern Emerg Med 2017; 12:157-162. [PMID: 27562379 DOI: 10.1007/s11739-016-1520-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 08/04/2016] [Indexed: 01/20/2023]
Abstract
Little research focuses on the association between immune thrombocytopenic purpura and human immunodeficiency virus infection in Taiwan. This study investigated whether immune thrombocytopenic purpura might be an early hematologic manifestation of undiagnosed human immunodeficiency virus infection in Taiwan. We conducted a retrospective population-based cohort study using data of individuals enrolled in Taiwan National Health Insurance Program. There were 5472 subjects aged 1-84 years with a new diagnosis of immune thrombocytopenic purpura as the purpura group since 1998-2010 and 21,887 sex-matched and age-matched, randomly selected subjects without immune thrombocytopenic purpura as the non-purpura group. The incidence of human immunodeficiency virus infection at the end of 2011 was measured in both groups. We used the multivariable Cox proportional hazards regression model to measure the hazard ratio and 95 % confidence interval (CI) for the association between immune thrombocytopenic purpura and human immunodeficiency virus infection. The overall incidence of human immunodeficiency virus infection was 6.47-fold higher in the purpura group than that in the non-purpura group (3.78 vs. 0.58 per 10,000 person-years, 95 % CI 5.83-7.18). After controlling for potential confounding factors, the adjusted HR of human immunodeficiency virus infection was 6.3 (95 % CI 2.58-15.4) for the purpura group, as compared with the non-purpura group. We conclude that individuals with immune thrombocytopenic purpura are 6.47-fold more likely to have human immunodeficiency virus infection than those without immune thrombocytopenic purpura. We suggest not all patients, but only those who have risk factors for human immunodeficiency virus infection should receive testing for undiagnosed human immunodeficiency virus infection when they develop immune thrombocytopenic purpura.
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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
| | - Hsien-Feng Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Chinese 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
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien, Taiwan.
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
- Department of Internal Medicine, Taichung Tzu Chi General Hospital, No. 66, Sec. 1, Fongsing Road, Tanzi District, Taichung, 427, Taiwan.
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Liao KF, Cheng KC, Lin CL, Lai SW. Etodolac and the risk of acute pancreatitis. Biomedicine (Taipei) 2017; 7:4. [PMID: 28474580 PMCID: PMC5439338 DOI: 10.1051/bmdcn/2017070104] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 09/19/2016] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The aim of this study was to explore the association between etodolac use and acute in Taiwan. DESIGN We designed a case-control study using the database of Taiwan's National Health Insurance. SUBJECTS In all, 7577 subjects aged 20 years or older with newly diagnosed acute pancreatitis were defined as cases, and 27032 sex-matched and age-matched subjects without acute pancreatitis were defined as controls. The period considered for this study was from 1998 to 2011. For the study, never having used etodolac is defined as a subject never receiving a prescription for etodolac. Active use of etodolac is defined as a subject receiving at least 1 prescription for etodolac within 7 days of the date of their being diagnosed with acute pancreatitis. Non-active use of etodolac is defined as a subject not receiving a prescription for etodolac within 7 days but receiving at least 1 prescription for etodolac ≥ 8 days before the date of their being diagnosed with acute pancreatitis. MAIN OUTCOME MEASURE The association between etodolac use and acute pancreatitis was estimated by using the multivariable unconditional logistic regression model. RESULTS After correcting for covariates, the adjusted odds ratio of acute pancreatitis was 3.78 for subjects with active use of etodolac (95% confidence interval 1.11, 12.9), compared with subjects who never used etodolac. The adjusted odds ratio decreased to 1.18 for subjects with non-active use of etodolac (95% confidence interval 0.38, 3.67), but that was without statistical significance. CONCLUSION There could be an association between active use of etodolac and acute pancreatitis. Clinicians should take into account the possibility of etodolac-associated acute pancreatitis when patients currently using etodolac present with acute pancreatitis with an unknown cause.
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Affiliation(s)
- 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
| | - Kao-Chi Cheng
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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
| | - 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
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21
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Wijarnpreecha K, Thongprayoon C, Panjawatanan P, Manatsathit W, Ungprasert P. Hepatitis B virus infection and risk of gallstones: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol 2016; 28:1437-1442. [PMID: 27648485 DOI: 10.1097/meg.0000000000000754] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND/OBJECTIVES Gallstone disease and its complications are common, particularly in Western populations. Recent studies have reported a significantly increased risk of gallstones among hepatitis C virus-infected patients. However, the data on patients with hepatitis B virus (HBV) infection are still limited. This meta-analysis was carried out with the aim of summarizing all available evidence. PATIENTS AND METHODS A literature search was performed using MEDLINE and the EMBASE database from inception to May 2016. Studies that reported relative risks, odd ratios, or hazard ratios comparing the risk of gallstones among HBV-infected patients versus patients without HBV infection were included. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse-variance method. RESULTS Nine studies fulfilled our eligibility criteria and were included in the analysis. We found no significant association between HBV infection and the risk of gallstones, with a pooled OR of 1.10 (95% CI, 0.91-1.33). The statistical heterogeneity was moderate, with an I of 69%. Subgroup analysis was carried out. The pooled OR of cross-sectional studies was 1.01 (95% CI, 0.91-1.12; I 0%), whereas the pooled OR of case-control studies was 1.53 (95% CI, 0.85-2.74; I 80%). CONCLUSION A significant association between HBV infection and the risk of gallstones was not observed in this study.
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Affiliation(s)
- Karn Wijarnpreecha
- aDepartment of Internal Medicine, Bassett Medical Center, Cooperstown, New York bDepartment of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska cDivision of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA dDepartment of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai eDivision of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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22
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Christiani Y, Tavener M, Byles JE. Contextualizing urban living as a determinant of women's health in Jakarta, Indonesia. Women Health 2016; 57:1204-1220. [PMID: 27880091 DOI: 10.1080/03630242.2016.1263271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Big cities can offer great opportunities for women to have a better life. At the same time, however, the physical and social environment in cities can negatively affect their health. We conducted focus groups with 24 women (aged 18-72 years) living in Jakarta, Indonesia from October to November 2014. Our aim was to elicit women's experiences of living in Jakarta, including their health and accessing health care. The most frequent health problems reported by women in this study were hypertension and arthritis. Women often gave priority to their family, particularly their children, over themselves and their own health. Discussants also thought that the city's physical and social conditions could affect their health, and that women were more prone to feel stress than men. The results of this study highlight the importance of addressing social determinants of health across the life course, including gender, to improve women's health status. Moreover, multi-sectoral collaboration at the municipal and national level is needed for urban planning to create better living conditions for women in the cities.
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Affiliation(s)
- Yodi Christiani
- a Priority Research Centre for Gender, Health and Ageing, Hunter Medical Research Institute , University of Newcastle , New Lambton Heights , New South Wales , Australia
| | - Meredith Tavener
- a Priority Research Centre for Gender, Health and Ageing, Hunter Medical Research Institute , University of Newcastle , New Lambton Heights , New South Wales , Australia
| | - Julie E Byles
- a Priority Research Centre for Gender, Health and Ageing, Hunter Medical Research Institute , University of Newcastle , New Lambton Heights , New South Wales , Australia
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Mei-Ling S, Kuan-Fu L, Sung-Mao T, Cheng-Li LM, Shih-Wei L. Herpes zoster correlates with pyogenic liver abscesses in Taiwan. Biomedicine (Taipei) 2016; 6:22. [PMID: 27854050 PMCID: PMC5112182 DOI: 10.7603/s40681-016-0022-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 08/05/2016] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE The purpose of the paper was to explore the relationship between herpes zoster and pyogenic liver abscesses in Taiwan. METHODS This was a nationwide cohort study. Using the database of the Taiwan National Health Insurance Program, there were 33049 subjects aged 20-84 years who were newly diagnosed with herpes zoster from 1998 to 2010 that were selected for our study, and they were our herpes zoster group. 131707 randomly selected subjects without herpes zoster were our non-herpes zoster group. Both groups were matched by sex, age, other comorbidities, and the index year of their herpes zoster diagnosis. The incidence of pyogenic liver abscesses at the end of 2011 was then estimated. The multivariable Cox proportional hazard regression model was used to estimate the hazard ratio and 95% confidence interval for pyogenic liver abscesses associated with herpes zoster and other comorbidities. RESULTS The overall incidence rate was 1.38-fold higher in the herpes zoster group than in the non-herpes zoster group (4.47 vs. 3.25 per 10000 person-years, 95% confidence interval 1.32, 1.44). After controlling for potential confounding factors, the adjusted hazard ratio of pyogenic liver abscesses was 1.34 in the herpes zoster group (95% confidence interval 1.05, 1.72) when compared with the non-herpes zoster group. Sex (in this case male), age, presence of biliary stones, chronic kidney diseases, chronic liver diseases, cancers, and diabetes mellitus were also significantly associated with pyogenic liver abscesses. CONCLUSIONS Patients with herpes zoster are associated with an increased hazard of developing pyogenic liver abscesses.
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Affiliation(s)
- Shen Mei-Ling
- Department of Anesthesiology, Taichung Tzu Chi General Hospital, Taichung, 427, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, 404, Taiwan
| | - Liao Kuan-Fu
- College of Medicine, Tzu Chi University, Hualien, 970, Taiwan.,Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, 427, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, 404, Taiwan
| | - Tsai Sung-Mao
- Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, 427, Taiwan
| | - Lin Ms Cheng-Li
- College of Medicine, China Medical University, Taichung, 404, Taiwan.,Management Office for Health Data, China Medical University Hospital, Taichung, 404, Taiwan
| | - Lai Shih-Wei
- College of Medicine, China Medical University, Taichung, 404, Taiwan. .,Department of Family Medicine, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung, 404, Taiwan.
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24
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Lai SW, Lin HF, Lin CL, Liao KF. Splenectomy and risk of renal and perinephric abscesses: A population-based cohort study in Taiwan. Medicine (Baltimore) 2016; 95:e4438. [PMID: 27495069 PMCID: PMC4979823 DOI: 10.1097/md.0000000000004438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Little epidemiological research is available on the relationship between splenectomy and renal and perinephric abscesses. The purpose of the study was to examine this issue in Taiwan.We conducted a population-based retrospective cohort study using the hospitalization dataset of the Taiwan National Health Insurance Program. A total of 16,426 participants aged 20 and older who were newly diagnosed with splenectomy from 1998 to 2010 were assigned to the splenectomy group, whereas 65,653 sex-matched, age-matched, and comorbidity-matched, randomly selected participants without splenectomy were assigned to the nonsplenectomy group. The incidence of renal and perinephric abscesses at the end of 2011 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 risk of renal and perinephric abscesses associated with splenectomy and other comorbidities including cystic kidney disease, diabetes mellitus, urinary tract infection, and urolithiasis.The overall incidence rate of renal and perinephric abscesses was 2.14-fold greater in the splenectomy group than that in the nonsplenectomy group (2.24 per 10,000 person-years vs 1.05 per 10,000 person-years, 95% CI 2.02, 2.28). After controlling for sex, age, cystic kidney disease, diabetes mellitus, urinary tract infection, and urolithiasis, the multivariable regression analysis demonstrated that the adjusted HR of renal and perinephric abscesses was 2.24 for the splenectomy group (95 % CI 1.30, 3.88), when compared with the nonsplenectomy group. In further analysis, the adjusted HR markedly increased to 7.69 for those comorbid with splenectomy and diabetes mellitus (95% CI 3.31, 17.9).Splenectomy is associated with renal and perinephric abscesses, particularly comorbid with diabetes mellitus. In view of its potential morbidity and mortality, clinicians should consider the possibility of renal and perinephric abscesses when patients with splenectomy present with fever of unknown origin.
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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
- Graduate Institute of Integrated Medicine, China Medical University
- Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan
- Correspondence: Kuan-Fu Liao, Department of Internal Medicine, Taichung Tzu Chi General Hospital, No. 66, Sec. 1, Fongsing Road, Tanzi District, Taichung City 427, Taiwan (e-mail: )
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25
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Lai SW, Lin HF, Lin CL, Liao KF. Long-term effects of pioglitazone on first attack of ischemic cerebrovascular disease in older people with type 2 diabetes: A case-control study in Taiwan. Medicine (Baltimore) 2016; 95:e4455. [PMID: 27495077 PMCID: PMC4979831 DOI: 10.1097/md.0000000000004455] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Long-term studies demonstrating the effect of pioglitazone use on primary prevention of ischemic cerebrovascular disease in older people with type 2 diabetes mellitus are lacking. This study investigated the relationship between pioglitazone use and first attack of ischemic cerebrovascular disease in Taiwan.We conducted a case-control study using the database of the Taiwan National Health Insurance Program. There were 2359 type 2 diabetic subjects aged ≥65 years with newly diagnosed ischemic cerebrovascular disease from 2005 to 2011 as the case group and 4592 sex- and age-matched, randomly selected type 2 diabetic subjects aged ≥65 years without ischemic cerebrovascular disease as the control group. The odds ratio (OR) with 95% confidence interval (CI) of ischemic cerebrovascular disease associated with pioglitazone use was measured by the multivariable unconditional logistic regression model.After adjustment for confounding factors, the multivariable logistic regression analysis disclosed that the adjusted ORs of first attack of ischemic cerebrovascular disease associated with cumulative duration of using pioglitazone were 3.34 for <1 year (95% CI 2.59-4.31), 2.53 for 1 to 2 years (95% CI 1.56-4.10), 2.20 for 2 to 3 years (95% CI 1.05-4.64), and 1.09 for ≥3 years (95% CI 0.55-2.15), respectively.Our findings suggest that pioglitazone use does not have a protective effect on primary prevention for ischemic cerebrovascular disease among older people with type 2 diabetes mellitus during the first 3 years of use. Whether using pioglitazone for >3 years would have primary prevention for ischemic cerebrovascular disease needs a long-term research to prove.
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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
| | - Hsien-Feng Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Chinese 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
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
- Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan
- Correspondence: Kuan-Fu Liao, Department of Internal Medicine, Taichung Tzu Chi General Hospital, No. 66, Sec. 1, Fongsing Road, Tanzi District, Taichung City 427, Taiwan (e-mail: )
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Liao KF, Lai SW, Lin CL, Chien SH. Appendectomy correlates with increased risk of pyogenic liver abscess: A population-based cohort study in Taiwan. Medicine (Baltimore) 2016; 95:e4015. [PMID: 27368018 PMCID: PMC4937932 DOI: 10.1097/md.0000000000004015] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Little is known on the association between appendectomy and pyogenic liver abscess. The objective of this study was to investigate the association between appendectomy and the risk of pyogenic liver abscess in Taiwan.This population-based retrospective cohort study was conducted using the hospitalization dataset of the Taiwan National Health Insurance Program. There were 212,530 subjects age 20 to 84 years with newly diagnosed appendectomy as the appendectomy group since 1998 to 2010, and 850,099 randomly selected subjects without appendectomy as the nonappendectomy group. Both appendectomy and nonappendectomy groups were matched with sex, age, comorbidities, and index year of diagnosing appendectomy. The incidence of pyogenic liver abscess at the end of 2011 was estimated in both groups. The multivariable Cox proportional hazards regression model was applied to investigate the hazard ratio (HR) and 95% confidence interval (CI) for risk of pyogenic liver abscess associated with appendectomy and other comorbidities including alcoholism, biliary stone, chronic kidney disease, chronic liver diseases, and diabetes mellitus.The overall incidence of pyogenic liver abscess was 1.73-fold greater in the appendectomy group than that in the nonappendectomy group (3.85 vs 2.22 per 10,000 person-years, 95% CI 1.71, 1.76). The multivariable regression analysis disclosed that the adjusted HR of pyogenic liver abscess was 1.77 for the appendectomy group (95% CI 1.59, 1.97), when compared with the nonappendectomy group.Appendectomy is associated with increased hazard of pyogenic liver abscess. Further studies remain necessary to confirm our findings.
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Affiliation(s)
- Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien
- Department of Internal Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung
| | - 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
| | - Sou-Hsin Chien
- College of Medicine, Tzu Chi University, Hualien
- Department of Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
- Correspondence: Sou-Hsin Chien, Department of Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 66, Sec. 1, Fongsing Road, Tanzi, Taichung 427, Taiwan (e-mail: )
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Lai SW, Lin HF, Lin CL, Liao KF. No association between losartan use and acute pancreatitis in hypertensive patients. Eur J Hosp Pharm 2016; 24:120-123. [PMID: 31156917 DOI: 10.1136/ejhpharm-2015-000840] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 03/17/2016] [Accepted: 04/21/2016] [Indexed: 12/21/2022] Open
Abstract
Background and objective Clinical evidence is scarce about the relationship between losartan use and acute pancreatitis. We therefore conducted a population-based case-control study using the database from the Taiwan National Health Insurance Program to investigate this question. Methods The study consisted of 1449 hypertensive subjects aged 20-84 years with a first episode of acute pancreatitis during the period 2000-2011 as the case group and 2479 hypertensive subjects without acute pancreatitis as the control group. Both the case and control groups were matched for sex, age, comorbidities and index year of acute pancreatitis diagnosis. According to the history of losartan prescription before the date of diagnosis of acute pancreatitis, subjects who had never received a prescription for losartan were defined as 'never use of losartan', those whose last remaining losartan tablet was detected within 7 days before the date of diagnosis of acute pancreatitis were defined as 'current use of losartan' and those whose last remaining tablet of losartan was detected ≥8 days before the date of diagnosis of acute pancreatitis were defined as 'late use of losartan'. ORs and 95% CIs were measured to investigate the risk of acute pancreatitis associated with losartan use by the multivariable unconditional logistic regression model. Results After adjustment for potentially confounding factors, the adjusted OR of acute pancreatitis was 0.96 (95% CI 0.68 to 1.37) for subjects with current use of losartan compared with those with never use of losartan, but the difference was not statistically significant. For subjects with late use of losartan the adjusted OR of acute pancreatitis was 1.05 (95% CI 0.80 to 1.37), which also was not statistically significant. Conclusions No significant association can be detected between losartan use and acute pancreatitis in hypertensive patients. More research is required to determine the potential role of losartan in the risk of acute pancreatitis.
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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
| | - Hsien-Feng Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.,School of Chinese 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
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.,Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan
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Lai SW, Lin CL, Liao KF. Splenectomy Correlates With Increased Risk of Acute Pancreatitis: A Case-Control Study in Taiwan. J Epidemiol 2016; 26:488-92. [PMID: 27087607 PMCID: PMC5008969 DOI: 10.2188/jea.je20150214] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE The objective of the study was to investigate the association between splenectomy and acute pancreatitis. METHODS We conducted a case-control study using the database of the Taiwan National Health Insurance Program. We included 7666 subjects aged 20-84 years with first-time acute pancreatitis during the period of 1998-2011 as cases and 30 664 randomly selected subjects without acute pancreatitis as controls. Both cases and controls were matched for sex, age, and index year of acute pancreatitis diagnosis. The association of acute pancreatitis with splenectomy was examined using a multivariable unconditional logistic regression model and reported as an odds ratio and its 95% confidence interval (CI). RESULTS After adjustment for covariables, the adjusted odds ratio of acute pancreatitis was 2.90 for subjects with splenectomy (95% CI, 1.39-6.05) compared with subjects without splenectomy. CONCLUSIONS Splenectomy is associated with acute pancreatitis. Further studies are necessary to clarify the underlying mechanism.
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Wong TS, Liao KF, Lin CM, Lin CL, Chen WC, Lai SW. Chronic Pancreatitis Correlates With Increased Risk of Cerebrovascular Disease: A Retrospective Population-Based Cohort Study in Taiwan. Medicine (Baltimore) 2016; 95:e3266. [PMID: 27082563 PMCID: PMC4839807 DOI: 10.1097/md.0000000000003266] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The aim of this study is to explore whether there is a relationship between chronic pancreatitis and cerebrovascular disease in Taiwan. Using the claims data of the Taiwan National Health Insurance Program, we identified 16,672 subjects aged 20 to 84 years with a new diagnosis of chronic pancreatitis from 2000 to 2010 as the chronic pancreatitis group. We randomly selected 65,877 subjects aged 20 to 84 years without chronic pancreatitis as the nonchronic pancreatitis group. Both groups were matched by sex, age, comorbidities, and the index year of diagnosing chronic pancreatitis. The incidence of cerebrovascular disease at the end of 2011 was measured. The multivariable Cox proportional hazards regression model was used to measure the hazard ratio (HR) and 95% confidence interval (CI) for cerebrovascular disease risk associated with chronic pancreatitis and other comorbidities. The overall incidence of cerebrovascular disease was 1.24-fold greater in the chronic pancreatitis group than that in the nonchronic pancreatitis group (14.2 vs. 11.5 per 1000 person-years, 95% CI = 1.19-1.30). After controlling for confounding factors, the adjusted HR of cerebrovascular disease was 1.27 (95% CI = 1.19-1.36) for the chronic pancreatitis group as compared with the nonchronic pancreatitis group. Woman (adjusted HR = 1.41, 95% CI = 1.31-1.51), age (every 1 year, HR = 1.04, 95% CI = 1.04-1.05), atrial fibrillation (adjusted HR = 1.23, 95% CI = 1.02-1.48), chronic kidney disease (adjusted HR = 1.48, 95% CI = 1.31-1.67), chronic obstructive pulmonary disease (adjusted HR = 1.27, 95% CI = 1.16-1.40), diabetes mellitus (adjusted HR = 1.82, 95% CI = 1.72-1.92), hypertension (adjusted HR = 1.66, 95% CI = 1.56-1.76), and peripheral atherosclerosis (adjusted HR = 1.26, 95% CI = 1.06-1.51) were other factors significantly associated with cerebrovascular disease. Chronic pancreatitis is associated with increased hazard of subsequent cerebrovascular disease.
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Affiliation(s)
- Tuck-Siu Wong
- From the Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung (T-SW, K-FL, C-ML); College of Medicine, Tzu Chi University, Hualien (K-FL); Graduate Institute of Integrated Medicine (K-FL, W-CC); College of Medicine, China Medical University (C-LL, S-WL); Management Office for Health Data (C-LL); Department of Urology (W-CC); and Department of Family Medicine, China Medical University Hospital (S-WL), Taichung, Taiwan
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30
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Nabumetone use and risk of acute pancreatitis in a case-control study. Pancreatology 2016; 16:353-7. [PMID: 27029853 DOI: 10.1016/j.pan.2016.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 03/02/2016] [Accepted: 03/03/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND It remains unknown whether nabumetone increases or decreases acute pancreatitis risk. To investigate this, we conducted a population-based case-control study using the database from the Taiwan National Health Insurance Program. METHODS We analysed 5384 cases aged 20-84 years who had their first attack of acute pancreatitis during 1998-2011 and 21,536 controls without acute pancreatitis, and matched them according to sex, age and year in which acute pancreatitis was diagnosed. Never use of nabumetone was defined as subjects who had never received a nabumetone prescription; active use as subjects receiving a minimum of one prescription for nabumetone within 7 days before acute pancreatitis diagnosis and non-active use of nabumetone as subjects who did not receive a prescription for nabumetone within 7 days before but received at least one prescription for nabumetone ≥8 days before. The odds ratio and 95% confidence interval (CI) were estimated to investigate the risk of acute pancreatitis associated with nabumetone use, using the multivariable unconditional logistic regression model. RESULTS The adjusted odds ratio of acute pancreatitis was 3.69 (95%CI 1.69, 8.05) for subjects with active use of nabumetone compared with those with never use. The odds ratios decreased to 1.0 (95%CI 0.88, 1.12) for subjects with non-active use. CONCLUSIONS Active use of nabumetone may increase the risk of acute pancreatitis.
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Lai SW, Lin CL, Liao KF. Atrial fibrillation associated with acute pancreatitis: a retrospective cohort study in Taiwan. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2016; 23:242-7. [PMID: 26842603 DOI: 10.1002/jhbp.331] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 01/02/2016] [Indexed: 01/04/2023]
Abstract
BACKGROUND There is little data on the relationship between atrial fibrillation and acute pancreatitis. The aim of this study was to evaluate whether atrial fibrillation is associated with acute pancreatitis. METHODS This retrospective cohort study analyzed the database of the Taiwan National Health Insurance Program from 2000 to 2010. There were 8,981 subjects aged 20-84 with newly diagnosed atrial fibrillation as the atrial fibrillation group and 26,643 sex- and age-matched, randomly selected subjects without atrial fibrillation as the non-atrial fibrillation group. We used the multivariable Cox proportional hazards regression model to measure the hazard ratio (HR) and 95% confidence interval (CI) for acute pancreatitis risk associated with atrial fibrillation and other comorbidities. RESULTS The crude incidence rates of acute pancreatitis were 3.07 per 1,000 person-years in the atrial fibrillation group and 2.03 per 1,000 person-years in the non-atrial fibrillation group (incidence rate ratio 1.51, 95% CI 1.40, 1.63). After controlling for potential confounding factors, the adjusted HR of acute pancreatitis was 1.46 for the atrial fibrillation group, as compared with the non-atrial fibrillation group (95% CI 1.18, 1.80). In further analysis, even in the absence of alcohol-related disease and biliary stone, the adjusted HR of acute pancreatitis was 1.62 for the atrial fibrillation group, as compared with the non-atrial fibrillation group (95% CI 1.24, 2.12). CONCLUSIONS Atrial fibrillation is associated with acute pancreatitis in the Taiwanese population, even in the absence of alcohol-related disease and biliary stone. Further research is necessary to explore the pathogenesis underlying the relationship between atrial fibrillation and acute pancreatitis.
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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. e-mail: .,Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan. e-mail: .,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan. e-mail:
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Abstract
Few data are present in the literature on the relationship between atorvastatin use and acute pancreatitis. The aim of this study was to explore this issue in Taiwan. Using representative claims data established from the Taiwan National Health Insurance Program, this case-control study consisted of 5810 cases aged 20 to 84 years with a first-time diagnosis of acute pancreatitis during the period 1998 to 2011and 5733 randomly selected controls without acute pancreatitis. Both cases and controls were matched by sex, age, comorbidities, and index year of diagnosing acute pancreatitis. Subjects who at least received 1 prescription for other statins or nonstatin lipid-lowering drugs were excluded from the study. If subjects never had 1 prescription for atorvastatin, they were defined as never use of atorvastatin. Current use of atorvastatin was defined as subjects whose last remaining 1 tablet of atorvastatin was noted ≤7 days before the date of diagnosing acute pancreatitis. Late use of atorvastatin was defined as subjects whose last remaining 1 tablet of atorvastatin was noted >7 days before the date of diagnosing acute pancreatitis. The odds ratio with 95% confidence interval of acute pancreatitis associated with atorvastatin use was calculated by using the logistic regression analysis. The logistic regression analysis revealed that the odds ratio of acute pancreatitis was 1.67 for subjects with current use of atorvastatin (95% confidence interval 1.18, 2.38), when compared with subjects with never use of atorvastatin. The odds ratio decreased to 1.15 for those with late use of atorvastatin (95% confidence interval 0.87, 1.52), but without statistical significance. Current use of atorvastatin is associated with the diagnosis of acute pancreatitis. Clinically, clinicians should consider the possibility of atorvastatin-associated acute pancreatitis when patients present with a diagnosis of acute pancreatitis without a definite etiology but are taking atorvastatin.
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Affiliation(s)
- Shih-Wei Lai
- From the College of Medicine (S-WL, C-LL); Department of Family Medicine (S-WL); Management Office for Health Data (C-LL), China Medical University Hospital, Taichung; College of Medicine (K-FL), Tzu Chi University, Hualien; Department of Internal Medicine (K-FL); Taichung Tzu Chi General Hospital, Taichung; and Graduate Institute of Integrated Medicine (K-FL), China Medical University, Taichung, Taiwan
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Lai SW, Lin CL, Chen WC, Liao KF. Correlation Between Use of Zopiclone and Risk of Hip Fracture in Elderly Adults: A Case-Control Study in Taiwan. J Am Geriatr Soc 2015; 63:2534-2537. [PMID: 26662510 DOI: 10.1111/jgs.13823] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate the correlation between zopiclone use and risk of hip fracture in elderly adults. DESIGN Case-control study. SETTING Claim data from the Taiwan National Health Insurance Program. PARTICIPANTS Individuals aged 65 and older who experienced their first episode of hip fracture between 1998 and 2011 were enrolled as the case group (n = 10,996). Randomly selected subjects aged 65 and older without hip fracture were enrolled as controls (n = 9,081). Case and control groups were matched according to sex, comorbidities, and index year of hip fracture diagnosis. MEASUREMENTS Current users of zopiclone were defined as those whose last remaining tablet of zopiclone was detected within 7 days or less before the date of hip fracture diagnosis. Late users of zopiclone were defined as those whose last remaining tablet of zopiclone was detected more than 7 days before the date of hip fracture diagnosis. Subjects who never received a prescription of zopiclone were defined as nonusers of zopiclone. A multivariable unconditional logistic regression model was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) to investigate the correlation between zopiclone use and risk of hip fracture. RESULTS After adjusting for confounders, multivariable logistic regression analysis demonstrated that current users of zopiclone were three and a half times as likely as nonusers to experience a hip fracture (adjusted OR = 3.56, 95% CI = 2.33-4.84), whereas late users were essentially equally as likely as nonusers to experience a hip fracture (OR = 1.05, 95% CI = 0.94-1.18). CONCLUSION Current use of zopiclone was associated with greater risk of hip fracture in the elderly adults studied. Clinicians should alert elderly people to the risk of hip fracture when prescribing zopiclone.
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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
| | - Wen-Chi Chen
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.,Department of Urology, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Fu Liao
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.,College of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan
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Hung SC, Hung SR, Lin CL, Lai SW, Hung HC. Use of celecoxib correlates with increased relative risk of acute pancreatitis: a case-control study in Taiwan. Am J Gastroenterol 2015; 110:1490-6. [PMID: 26323189 DOI: 10.1038/ajg.2015.259] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 07/05/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVES This study evaluated whether there is an association between the use of celecoxib and acute pancreatitis in Taiwan. METHODS We conducted a case-control study using the database of the Taiwan National Health Insurance Program. The participants comprised 5,095 subjects, aged 20-84 years, with a first admission episode of acute pancreatitis from 2000 to 2011 as the cases and 20,380 randomly selected sex-matched and age-matched subjects without acute pancreatitis as the controls. The absence of celecoxib prescription was defined as "never used." Current use of celecoxib was defined as subjects who had received at least one prescription for celecoxib within 3 days before diagnosis with acute pancreatitis. A multivariate unconditional logistic regression model was used to calculate the odds ratio (OR) and 95% confidence interval (CI) for acute pancreatitis associated with the use of celecoxib. RESULTS Compared with subjects who never used celecoxib, the adjusted OR of acute pancreatitis was 5.62 in subjects with current use of celecoxib (95% CI=3.33-9.46). CONCLUSIONS The current use of celecoxib is associated with an increased risk of acute pancreatitis.
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Affiliation(s)
- Shih-Chang Hung
- Department of Emergency Medicine, Nantou Hospital, Nantou, Taiwan
| | - Shih-Rong Hung
- Department of Pharmacy, Erlin Christian Hospital, Changhua, 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
| | - Hung-Chang Hung
- Division of Gastroenterology, Department of Internal Medicine, Nantou Hospital, Nantou, Taiwan
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Lai SW, Lin CL, Liao KF, Chen WC. Herpes zoster could be an early manifestation of undiagnosed human immunodeficiency virus infection. J Formos Med Assoc 2015; 115:372-6. [PMID: 26395527 DOI: 10.1016/j.jfma.2015.08.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 08/20/2015] [Accepted: 08/21/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND/PURPOSE No formal epidemiological research based on systematic analysis has focused on the relationship between herpes zoster and immunodeficiency virus (HIV) infection in Taiwan. Our aim was to explore whether herpes zoster is an early manifestation of undiagnosed human HIV infection in Taiwan. METHODS This was a retrospective cohort study using the database of the Taiwan National Health Insurance Program. A total of 35,892 individuals aged ≤ 84 years with newly diagnosed herpes zoster from 1998 to 2010 were assigned to the herpes zoster group, whereas 143,568 sex-matched and age-matched, randomly selected individuals without herpes zoster served as the non-herpes zoster group. The incidence of HIV diagnosis at the end of 2011 was estimated in both groups. The multivariable Cox proportional hazards regression model was used to estimate the hazard ratio and 95% confidence interval (CI) for risk of HIV diagnosis associated with herpes zoster and other comorbidities including drug dependence and venereal diseases. RESULTS The overall incidence of HIV diagnosis was 4.19-fold greater in the herpes zoster group than that in the non-herpes zoster group (3.33 per 10,000 person-years vs. 0.80 per 10,000 person-years, 95% CI 4.04-4.35). The multivariable Cox proportional hazards regression analysis revealed that the adjusted hazard ratio of HIV diagnosis was 4.37 (95% CI 3.10-6.15) for individuals with herpes zoster and without comorbidities, as compared with individuals without herpes zoster and without comorbidities. CONCLUSION Herpes zoster is associated with HIV diagnosis. Patients who have risk behaviors of HIV infection should receive regular surveillance for undiagnosed HIV infection when they present with herpes zoster.
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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.
| | - Wen-Chi Chen
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan; Department of Urology, China Medical University Hospital, Taichung, Taiwan
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Liao KF, Lin CL, Lai SW, Chen WC. Zolpidem Use Associated With Increased Risk of Pyogenic Liver Abscess: A Case-Control Study in Taiwan. Medicine (Baltimore) 2015; 94:e1302. [PMID: 26266369 PMCID: PMC4616684 DOI: 10.1097/md.0000000000001302] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to explore the association between zolpidem use and pyogenic liver abscess in Taiwan.This was a population-based case-control study using the database of the Taiwan National Health Insurance Program since 2000 to 2011. We identified 1325 patients aged 20 to 84 years with the first-attack of pyogenic liver abscess as the cases, and 5082 patients without pyogenic liver abscess matched with sex, age, comorbidities, and index year of hospitalization for pyogenic liver abscess as the controls. Patients whose last remaining 1 tablet for zolpidem was noted ≤7 days before the date of admission for pyogenic liver abscess were defined as current use of zolpidem. Patients whose last remaining 1 tablet for zolpidem was noted >7 days before the date of admission for pyogenic liver abscess were defined as late use of zolpidem. Patients who never received 1 prescription for zolpidem were defined as never use of zolpidem. A multivariable unconditional logistic regression model was used to measure the odds ratio (OR) and 95% confidence interval (CI) to explore the association between zolpidem use and pyogenic liver abscess.After adjustment for possible confounding variables, the adjusted OR of pyogenic liver abscess was 3.89 for patients with current use of zolpidem (95% CI 2.89, 5.23), when compared with those with never use of zolpidem. The adjusted OR decreased to 0.85 for those with late use of zolpidem (95% CI 0.70, 1.03), but without statistical significance.Current use of zolpidem is associated with the increased risk of pyogenic liver abscess. Physicians should take the risk of pyogenic liver abscess into account when prescribing zolpidem.
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Affiliation(s)
- Kuan-Fu Liao
- From the College of Medicine (K-FL), Tzu Chi University, Hualien; Department of Internal Medicine (K-FL), Taichung Tzu Chi General Hospital, Taichung; Graduate Institute of Integrated Medicine (K-FL, W-CC), China Medical University, Taichung; College of Medicine (C-LL, S-WL), China Medical University, Taichung; Management Office for Health Data (C-LL), China Medical University Hospital, Taichung; Department of Family Medicine (S-WL), China Medical University Hospital, Taichung; and Department of Urology (W-CC), China Medical University Hospital, Taichung, Taiwan
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Hung SC, Liao KF, Muo CH, Lai SW, Chang CW, Hung HC. Hearing Loss is Associated With Risk of Alzheimer's Disease: A Case-Control Study in Older People. J Epidemiol 2015; 25:517-21. [PMID: 25986155 PMCID: PMC4517989 DOI: 10.2188/jea.je20140147] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background It remains unknown whether hearing loss increases the risk of Alzheimer’s disease. This study aimed to examine the association between hearing loss and risk of Alzheimer’s disease in older people in Taiwan. Methods Analyzing the database from Taiwan’s National Health Insurance Program, this case-control study enrolled 488 subjects ≥65 years old with newly diagnosed Alzheimer’s disease as a case group and 1952 subjects without Alzheimer’s disease as a control group from 1998–2011. Patients with Alzheimer’s disease and other comorbidities were identified by analyzing ICD-9 coding in claims data. The association of hearing loss, other comorbidities, and risk of Alzheimer’s disease were compared between groups. Results After controlling for confounders, multivariable logistic regression showed an adjusted odds ratio of Alzheimer’s disease of 1.39 in people with hearing loss (95% CI, 1.05–1.84) versus those without. Parkinson’s disease (OR 4.44; 95% CI, 2.54–7.78), head injury (OR 2.31; 95% CI, 1.46–3.66), depression (OR 1.68; 95% CI, 1.19–2.39), hypertension (OR 1.40; 95% CI, 1.10–1.79), and age (each year, OR 1.03; 95% CI, 1.01–1.05) also showed strong links with Alzheimer’s. Conclusions Hearing loss is associated with increased risk of Alzheimer’s disease in older people in Taiwan.
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Lai SW, Lin CL, Liao KF, Chang-Ou KC. Increased risk of Parkinson's disease in cataract patients: A population-based cohort study. Parkinsonism Relat Disord 2015; 21:68-71. [DOI: 10.1016/j.parkreldis.2014.11.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 11/06/2014] [Accepted: 11/07/2014] [Indexed: 12/23/2022]
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Chen YC, Chiou C, Lin MN, Lin CL. The prevalence and risk factors for gallstone disease in taiwanese vegetarians. PLoS One 2014; 9:e115145. [PMID: 25521621 PMCID: PMC4270735 DOI: 10.1371/journal.pone.0115145] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 11/18/2014] [Indexed: 01/06/2023] Open
Abstract
Introduction Gallstone disease (GSD) and its complications are major public health issues globally. Although many community-based studies had addressed the risk factors for GSD, little is known about GSD prevalence and risk factors among Taiwanese vegetarians. Methods This study included 1721 vegetarians who completed a questionnaire detailing their demographics, medical history, and life-styles. GSD was ascertained by ultrasonography or surgical history of cholecystectomy for GSD. The predictive probability of GSD for male and female vegetarians was estimated from the fitted model. Results The prevalence of GSD was 8.2% for both male and female vegetarians. The risk of GSD is similar in men and women across all age groups, and increases steadily with increasing age. For male vegetarians, age (OR: 1.04; 95% CI: 1.00–1.08) and serum total bilirubin level (OR: 2.35; 95% CI: 1.31–4.22) predict risk for GSD. For female vegetarians, age (OR: 1.03; 95% CI: 1.01–1.05), BMI (OR: 1.07; 95% CI: 1.01–1.13), and alcohol consumption (OR: 7.85; 95% CI: 1.83–33.73) are associated with GSD. GSD is not associated with type of vegetarian diet, duration of vegetarianism, low education level, physical inactivity, diabetes, coronary artery disease, cerebral vascular accident, chronic renal failure, hepatitis C virus infection, and lipid abnormalities. GSD is also not associated with age at menarche, postmenopausal status, and multiparity in female vegetarians. Conclusions Risk factors useful for predicting GSD in vegetarians are (1) age and total bilirubin level in men, and (2) age, BMI, and alcohol consumption in women. Many previously identified risk factors for general population does not seem to apply to Taiwanese vegetarians.
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Affiliation(s)
- Yen-Chun Chen
- Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi County, Taiwan
| | - Chia Chiou
- Department of Family Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi County, Taiwan
| | - Ming-Nan Lin
- Department of Family Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi County, Taiwan
- Department of Family Medicine, College of Medicine, Tzu Chi University, Hualien, Taiwan
- * E-mail:
| | - Chin-Lon Lin
- Medical Mission, Tzu Chi Foundation, Hualien, Taiwan
- Department of Internal Medicine, Buddhist Hualien Tzu Chi Hospital, Hualien, Taiwan
- Department of Internal Medicine, College of Medicine, Tzu Chi University, Hualien, Taiwan
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Tsai MS, Lee PH, Lin CL, Peng CL, Kao CH. Type II diabetes mellitus is associated with a reduced risk of cholangiocarcinoma in patients with biliary tract diseases. Int J Cancer 2014; 136:2409-17. [PMID: 25348605 DOI: 10.1002/ijc.29292] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 10/20/2014] [Indexed: 12/15/2022]
Abstract
It has not yet been reported whether Type II diabetes mellitus (DM) is associated with an increased cholangiocarcinoma (CC) risk in patients with biliary tract diseases. We identified 123,050 patients concomitantly diagnosed with biliary tract diseases and DM between 1998 and 2010. The control cohort consisted of 122,721 individuals with biliary tract diseases but not DM. Both cohorts were followed-up until the end of 2010 to estimate the risk of CC. We also compared the risk of CC between DM and non-DM cohorts without biliary tract diseases. Overall, the incidence of CC was 21% lower among the DM patients than among the control patients (1.11 vs. 1.41 per 1,000 person-years). DM cohorts exhibited significantly reduced risks for both intrahepatic and extrahepatic CC. A multivariable Cox proportional hazards regression model was used, and the adjusted hazard ratio (HR) of CC was 0.74 (95% confidence interval [CI], 0.66-0.82) for the DM cohort in comparison with the control cohort. The age-specific data indicated that compared with the control patients, the adjusted HRs for the DM patients were significantly lower among patients 50-64 (adjusted HR = 0.67; 95% CI = 0.55-0.82) and 65-74 years old (adjusted HR = 0.70; 95% CI, 0.59-0.84). Furthermore, DM was associated with a lower risk of CC among patients with biliary diseases, regardless of the presence of comorbidities and the status of cholecystectomy. In the patients without biliary tract diseases, DM is associated with significantly increased risk of CC (adjusted HR = 1.58; 95% CI, 1.37-1.82).
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Affiliation(s)
- Ming-Shian Tsai
- Department of General Surgery, E-Da Hospital and I-Shou University, Kaohsiung, Taiwan
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Zhu L, Aili A, Zhang C, Saiding A, Abudureyimu K. Prevalence of and risk factors for gallstones in Uighur and Han Chinese. World J Gastroenterol 2014; 20:14942-14949. [PMID: 25356055 PMCID: PMC4209558 DOI: 10.3748/wjg.v20.i40.14942] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Revised: 07/05/2014] [Accepted: 08/28/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To perform a single-centre survey of the prevalence of and possible risk factors for gallstones in Uighur and Han Chinese.
METHODS: Complete medical data for 9455 patients were collected from the medical centre of our hospital, and the overall prevalence of gallstones as well as the prevalence in different ethnic groups was studied. The risk factors for gallstones in different ethnic groups were identified in a univariate analysis, and variables with statistical significance were analysed by unconditional multiple logistic regression, to primarily explore the similarities and differences in gallstone risk factors between different ethnic groups.
RESULTS: The prevalence of gallstones was significantly higher in the Uighur population than in the Han population (22.87% vs 11.64%, P < 0.05). Further analysis of risk factors for gallstones based on the different ethnic areas revealed that age was a risk factor for gallstones in both groups; triglycerides, body-mass index (BMI) and high-density lipoprotein were risk factors for gallstones in the Han population, while total cholesterol (TC), gender and fatty liver were risk factors in the Uighur population. The Uighur patients were older than the Han patients, and had higher BMI, TC, low-density lipoprotein, female rate and fatty liver rate, while the incidence of hypertension was lower than that in the Han patients.
CONCLUSION: The prevalence of and risk factors for gallstones differ between the Uighur and Han populations.
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Body mass index and biliary tract disease: a systematic review and meta-analysis of prospective studies. Prev Med 2014; 65:13-22. [PMID: 24721739 DOI: 10.1016/j.ypmed.2014.03.027] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Revised: 03/25/2014] [Accepted: 03/28/2014] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To evaluate the association between body mass index (BMI, kg/m(2)) and incidence of biliary tract disease. METHODS We performed a systematic review and a meta-analysis of prospective studies by searching the database of PubMed and EMBASE published up to December 31, 2013. Outcome of interest was disease of biliary tract system (gallbladder, extrahepatic bile duct and Ampullar of Vater). We used a random-effects model to combine the study-specific relative risks (RRs) and 95% confidence intervals (95% CIs) from 22 prospective studies. We examined whether BMI was associated with a higher risk of biliary tract disease in a combined analysis. RESULTS The positive association was stronger for non-cancer biliary tract disease than biliary tract cancer; combined RRs (95% CIs) comparing the top with bottom categories were 1.40 (1.15-1.65) for biliary tract cancer and 2.75 (2.35-3.15) for non-cancer biliary tract disease (P for difference<0.001). For non-cancer biliary tract disease, combined RRs (95% CIs) comparing the top with bottom categories were 3.21 (2.48-3.93) for women and 2.01 (1.66-2.37) for men (P for difference=0.04). CONCLUSION Obesity is associated with higher risks of biliary tract cancer and, to a greater extent, non-cancer biliary tract disease.
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Li CH, Sung FC, Wang YC, Lin D, Kao CH. Gallstones increase the risk of developing renal stones: a nationwide population-based retrospective cohort study. QJM 2014; 107:451-7. [PMID: 24453284 DOI: 10.1093/qjmed/hcu017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND This study identifies the effects of gall stone on the risks of developing renal stone in a nationwide cohort study. AIM Studies on the association between gall stone and renal stone are scarce. METHODS We identified patients with gallstones using the catastrophic illness registry of the Taiwan National Health Insurance Research Database (NHIRD). We selected a comparison cohort, random frequency-matched by age, sex and index year, from the general population. We analyzed the risk of renal stones by using Cox proportional hazards regression models for sex, age and comorbidities. RESULTS Of the 23.74 million people in the database, we followed 25 258 gallstone patients (54.5% female) and 101 029 control patients. The risk of developing renal stones was 1.68-fold greater in gallstone patients, compared with patients without gallstones after adjusting for age, sex and comorbidities. The substantially increased risk of renal stones was also significant in gallstone patients regardless of comorbidities. In the follow-up period <1 year, the adjusted hazard ratio was 2.51 (95% CI = 2.25-2.80) compared to non-gallstone group. The cumulative incidence of renal stone in the gallstone group was higher than in the non-gallstone group (P < 0.0001, in the log-rank test). CONCLUSION This nationwide cohort study demonstrates that the risk of renal stones is significantly higher in gallstone patients, compared with the general population. This study provides information to enable physicians to implement adequate prevention measures to decrease both stones formation.
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Affiliation(s)
- C-H Li
- From the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, China Medical University, Taichung, Management Office for Health Data, China Medical University Hospital, Taichung, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, TaiwanFrom the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, China Medical University, Taichung, Management Office for Health Data, China Medical University Hospital, Taichung, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
| | - F-C Sung
- From the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, China Medical University, Taichung, Management Office for Health Data, China Medical University Hospital, Taichung, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, TaiwanFrom the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, China Medical University, Taichung, Management Office for Health Data, China Medical University Hospital, Taichung, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
| | - Y-C Wang
- From the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, China Medical University, Taichung, Management Office for Health Data, China Medical University Hospital, Taichung, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
| | - D Lin
- From the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, China Medical University, Taichung, Management Office for Health Data, China Medical University Hospital, Taichung, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
| | - C-H Kao
- From the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, China Medical University, Taichung, Management Office for Health Data, China Medical University Hospital, Taichung, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, TaiwanFrom the Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, China Medical University, Taichung, Management Office for Health Data, China Medical University Hospital, Taichung, Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung and Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
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Chen YK, Yeh JH, Lin CL, Peng CL, Sung FC, Hwang IM, Kao CH. Cancer risk in patients with cholelithiasis and after cholecystectomy: a nationwide cohort study. J Gastroenterol 2014; 49:923-31. [PMID: 23807230 DOI: 10.1007/s00535-013-0846-6] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 06/03/2013] [Indexed: 02/04/2023]
Abstract
BACKGROUND This study examined the association of cholelithiasis post-cholecystectomy with subsequent cancers and evaluated the risk of cancer in patients with both cholelithiasis and cholecystectomy. METHODS The Taiwanese National Health Insurance Research Database was used to identify 15545 newly diagnosed cholelithiasis patients from 2000 to 2010, and 62180 frequency-matched non-cholelithiasis patients. A total of 5850 (37.6 %) with cholelithiasis patients received a cholecystectomy. The risk of developing cancer after cholecystectomy was measured using the Cox proportional-hazards model. RESULTS The incidence of developing cancer in the cholelithiasis cohort was 1.52-fold higher than that in the comparison cohort (p < 0.001). Compared with patients aged 20-34 years, patients in older age groups had a higher risk of developing cancer. The hazard ratio (HR) for developing gallbladder, extrahepatic bile duct, pancreatic, liver, stomach, and colorectal cancer was 59.3, 10.7, 3.12, 1.90, 1.71, and 1.36-fold higher for patients with cholelithiasis, respectively. After a cholecystectomy, the HR for developing stomach and colorectal cancer was 1.81-fold and 1.56-fold, respectively. The incidence rate ratio was higher for the first 5 years and over 5 years (5.05 and 4.46, respectively) (95 % confidence interval 4.73-5.39 and 4.11-4.84, respectively) in proximal colon and stomach cancer patients with cholecystectomies. CONCLUSIONS Cholelithiasis patients have a higher risk of gastrointestinal cancer, particularly of gallbladder and extrahepatic bile duct cancer. Post-cholecystectomy patients have a risk of colorectal and stomach cancer within the first 5 years and persisting after 5 years, respectively. This paper proposes strategies for preventing gastrointestinal cancer.
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Affiliation(s)
- Yen-Kung Chen
- Department of Nuclear Medicine and PET Center, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
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45
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Vogtmann E, Shu XO, Li HL, Chow WH, Yang G, Ji BT, Cai H, Yu C, Gao YT, Zheng W, Xiang YB. Cholelithiasis and the risk of liver cancer: results from cohort studies of 134,546 Chinese men and women. J Epidemiol Community Health 2014; 68:565-70. [PMID: 24574318 DOI: 10.1136/jech-2013-203503] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Cholelithiasis and cholecystectomy have been proposed as risk factors for liver cancer, but findings have been inconsistent. We assessed this association using data from the Shanghai Women's and Men's Health Studies. METHODS History of cholelithiasis and cholecystectomy were reported at baseline and follow-up interviews, and liver cancer diagnoses were ascertained from the Shanghai Cancer Registry and Vital Statistics Unit. Adjusted hazard ratios (aHRs) and 95% CIs were calculated after adjustment for potential confounders. RESULTS A history of cholelithiasis and cholecystectomy was reported by 9.5% and 3.6% of participants at baseline, respectively. After a total of 859,882 person-years of follow-up for women and 391,093 for men, incident liver cancer was detected in 160 women and 252 men. A positive association was observed between a history of cholelithiasis or cholecystectomy and liver cancer in men (aHR 1.46; 95% CI 1.02 to 2.07) and women (aHR 1.55; 95% CI 1.06 to 2.26). Similar results were observed for cholelithiasis only, but cholecystectomy did not reach statistical significance. There was no strong evidence for detection bias of liver cancer due to cholelithiasis or cholecystectomy. CONCLUSIONS Our study suggests that cholelithiasis and possibly cholecystectomy may increase the risk of liver cancer.
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Affiliation(s)
- Emily Vogtmann
- State Key Laboratory of Oncogene and Related Genes and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, , Shanghai, P R China
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Kim JW, Oh HC, Do JH, Choi YS, Lee SE. Has the prevalence of cholesterol gallstones increased in Korea? A preliminary single-center experience. J Dig Dis 2013; 14:559-63. [PMID: 23750885 DOI: 10.1111/1751-2980.12080] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES We aimed to determine the prevalence of cholesterol gallstones, the compositional changes of gallstones and its predisposing factors in Korea with this single-center study. METHODS Data of 365 patients who underwent cholecystectomy for cholecystolithiasis from July 2008 to September 2011 were reviewed. Based on the compositional analysis of the gallstones, patients were assigned to either cholesterol gallstone group or pigment gallstone group. The characteristics of the patients and the gallstones were summarized and compared. RESULTS After eight patients with mixed gallstones were excluded, 357 patients were enrolled in the study, including cholesterol gallstones in 175 (49.0%) and pigment gallstones in 182 (51.0%). The number of patients with cholecystolithiasis increased but the prevalence of cholesterol gallstone decreased with age. Compared with the pigment gallstone group, the cholesterol gallstone group was associated with young age (<50 years), female gender, obesity (body mass index ≥ 25 kg/m²) and the absence of chronic liver diseases. CONCLUSION The relative prevalence of cholesterol gallstones in Korea has been stationary so far, but may change in the future since cholesterol gallstones are increasingly prevalent in the young generation.
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Affiliation(s)
- Ju Wan Kim
- Division of Gastroenterology, Chung-Ang University College of Medicine, Seoul, Korea
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Aslam HM, Saleem S, Edhi MM, Shaikh HA, Khan JD, Hafiz M, Saleem M. Assessment of gallstone predictor: comparative analysis of ultrasonographic and biochemical parameters. Int Arch Med 2013; 6:17. [PMID: 23618353 PMCID: PMC3653701 DOI: 10.1186/1755-7682-6-17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 04/20/2013] [Indexed: 12/14/2022] Open
Abstract
Background Gallstones represent a significant burden for health care systems worldwide and are one of the most common disorders presenting to emergency room. Ultrasonography, complete blood picture test and liver function tests are procedures of choice in suspected gallstones or biliary diseases. They are the most sensitive, specific, non-invasive and inexpensive tests for the detection of gallstones. Our main objective was to evaluate the relationship of ultrasonographic findings, hemolytic indices and liver function tests with gallstones. Methodology It was a prospective study carried out in Civil Hospital Karachi (DUHS) and Liaquat National Hospital, two largest tertiary care hospitals of Karachi, Pakistan. Duration of the study was from July 2011 to October 2012. The study was carried out on diagnosed, pre-operative and symptomatic patients of cholelithiases. Exclusion criteria were patients of gallbladder and pancreatic carcinoma, emergency operations, patients having age <12 years and non-cooperative patients, who refused to give written consent for participation in the study. Total two tests were performed on each patient after diagnosis by ultrasonography. These were complete blood count and liver function tests. All the demographic data, laboratory findings and ultrasonographic features were noted in a pre-structured Performa. Sample size was calculated by using open-epidemiological sample size calculator prevalence (p) = 35%, d = 5%, and confidence interval (CI) 95% = 350. All the data was entered and analyzed through SPSS 19. Result There were 454 diagnosed and pre-operative cases of gallstones present in the study. There were 120(26.4%) males and 334(73.6%) females, with a mean age of 42.80 ± 12.26 years. Most of the suspects had multiple stones 384 (84.5%) while few had single stones 70(15.4%). Fatty liver was found to be present in 144(31.7%) patients and 92(20.2%) had hepatomegaly. Splenomegaly was present in 16(3.5%) patients. Alkaline phosphatase was elevated in 186(41.0%) patients while SGPT was found to be raised in 160(35.2%). Blood urea nitrogen was found to be elevated in 186(41%) patients and serum creatinine was elevated in 46(10.1%) patients. Conclusion In the light of findings it is recommend that all patients should go through the process of ultrasonography and all the biochemical parameters should be analyzed before surgery.
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Affiliation(s)
- Hafiz Muhammad Aslam
- Dow Medical College, Dow University of Health sciences, Flat #14, 3rd floor, Rafiq Mansion, Cambell road, Off Arambagh, Karachi, Pakistan
| | - Shafaq Saleem
- Dow Medical College, Dow University of Health sciences, Flat #14, 3rd floor, Rafiq Mansion, Cambell road, Off Arambagh, Karachi, Pakistan
| | | | - Hiba Arshad Shaikh
- Dow Medical College, Dow University of Health sciences, Flat #14, 3rd floor, Rafiq Mansion, Cambell road, Off Arambagh, Karachi, Pakistan
| | | | - Mehak Hafiz
- Liaquat National Medical College, Karachi University, Karachi, Pakistan
| | - Maria Saleem
- Karachi Medical and Dental College, Karachi, Pakistan
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Lai SL, Yang JC, Wu JM, Lai IR, Chen CN, Lin MT, Lai HS. Combined cholecystectomy in gastric cancer surgery. Int J Surg 2013; 11:305-8. [PMID: 23434939 DOI: 10.1016/j.ijsu.2013.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 02/05/2013] [Accepted: 02/09/2013] [Indexed: 01/06/2023]
Abstract
BACKGROUND Many studies have described the risk factors of gallstone formation in gastric cancer patients after gastrectomy, but few studies focus on the management of asymptomatic gallstones. Our goal is to examine the rationale of simultaneous cholecystectomy during gastric cancer surgery, and influence of surgical mortality, morbidity and overall survival after combined cholecystectomy and gastrectomy. METHODS We retrospectively reviewed 445 gastric cancer patients and the gallbladders evaluated by abdominal ultrasound or computed tomography preoperatively and postoperatively. Clinicopathologic factors, including surgical morbidity, mortality and overall survival of combined surgery, were compared between patients receiving gastrectomy with simultaneous cholecystectomy and patients receiving gastrectomy only. We also evaluated the risk factors of gallstone formation after gastrectomy and the probability of subsequent cholecystectomy after gastrectomy in gastric cancer patients with or without asymptomatic gallstones. RESULTS Of 445 gastric cancer patients, 52 (11.7%) patients had asymptomatic gallstones upon diagnosis of gastric cancer. Among patients with healthy gallbladders, 15.2% developed gallstones after gastrectomy. Men and older patients (age over 60) had significantly higher risk of gallstone formation. Rate of subsequent cholecystectomy in patients with and without preoperative asymptomatic gallstones was 30.8% and 4.5%, respectively (p = 0.005). The rates of mortality and morbidity were not significantly different between combined surgery (3.4%, 24.2%) and gastrectomy only (3.1%, 22%). There was also no significant difference in 5-year survival between combined surgery (61%) and gastrectomy only (63%) groups. CONCLUSION Combined cholecystectomy for asymptomatic gallstone in gastric cancer surgery may be considered. It was not associated with increased surgical morbidity or mortality, and had no significant effect on overall survival.
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Affiliation(s)
- Shuo-Lun Lai
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7 Chung-Shan S Road, Taipei, Taiwan.
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Kao WY, Hwang CY, Su CW, Chang YT, Luo JC, Hou MC, Lin HC, Lee FY, Wu JC. Risk of hepato-biliary cancer after cholecystectomy: a nationwide cohort study. J Gastrointest Surg 2013. [PMID: 23188223 DOI: 10.1007/s11605-012-2090-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Epidemiologic studies have identified cholecystectomy as a possible risk factor for cancers in Western countries. The aim of this study was to estimate the risk of hepato-biliary cancer after cholecystectomy in Taiwan. METHODS Based on the Taiwan National Health Insurance Research Database, 2,590 cholecystectomized patients without prior cancers in the period 1996-2008 were identified from a cohort dataset of 1,000,000 randomly sampled individuals. The standard incidence ratio (SIR) of each cancer was calculated. RESULTS After a median follow-up of 4.82 years, 67 liver cancer and 17 biliary tract cancer patients were diagnosed. Patients who received cholecystectomy had higher risks of liver cancer (SIR, 3.29) and biliary tract cancer (SIR, 8.50). Cholecystectomized patients aged ≤60 years had higher risks of liver cancer (SIR, 11.14) and biliary tract cancer (SIR, 55.86) compared to those aged >60 years (SIR, 2.31 and 5.67). Female cholecystectomized patients had higher risks of liver cancer (SIR, 4.18) and biliary tract cancer (SIR, 10.56) than males (SIR, 2.96 and 7.26). Cholecystectomized patients with cirrhosis had higher SIR of liver cancer than patients without cirrhosis (SIR, 33.84 vs. 1.41). CONCLUSIONS Cholecystectomy may be associated with an increased risk of hepato-biliary cancer. Further and regular surveillance should be performed on such patients.
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Affiliation(s)
- Wei-Yu Kao
- Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei, 112, Taiwan
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Pezzilli R, Calculli L, Cariani G, Imbrogno A, Fabbri D. Acute recurrent pancreatitis and pancreas divisum: appearances can be deceiving. Dig Liver Dis 2012; 44:965-6. [PMID: 22748915 DOI: 10.1016/j.dld.2012.05.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 05/16/2012] [Accepted: 05/24/2012] [Indexed: 12/11/2022]
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