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Shen YC, Hsia NY, Wu WH, Lin CL, Shen TC, Huang WC. Age-related macular degeneration and premorbid allergic diseases: a population-based case-control study. Sci Rep 2021; 11:16537. [PMID: 34400678 PMCID: PMC8368185 DOI: 10.1038/s41598-021-95937-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 07/29/2021] [Indexed: 11/09/2022] Open
Abstract
Evidence indicates that age-related macular degeneration (AMD) is associated with the prior presence of allergic diseases; however, large-scale studies in the literature are limited. A case-control study was conducted to describe the relationship between premorbid allergic diseases and AMD using Taiwan's National Health Insurance database. Eligibility criteria for inclusion of new adult AMD cases from 2000 to 2013 were set up. We defined the year of diagnosis as the index year. Age-, gender-, index year- matched controls who were drawn from the same database. The case control ratio was 1:4. For all participants, all premorbid conditions staring 1996 to index year were documented. Binary logistic regression was used to describe factors related to AMD occurrence. The AMD group consisted of 10,911 patients, and the comparison group consisted of 43,644 individuals. Patients with AMD showed significant associations with premorbid allergic diseases (aOR 1.54, 95% CI 1.47-1.61), specifically with allergic conjunctivitis (aOR 2.07, 95% CI 1.94-2.20), allergic rhinitis (aOR 1.32, 95% CI 1.25-1.39), asthma (aOR 0.99, 95% CI 0.93-1.06), and atopic dermatitis (aOR 1.04, 95% CI 0.94-1.17). Further analyses indicated that patients with more concurrent allergic diseases have higher associations with AMD than those with fewer concurrent diseases. Patients with more annual medical visits for their allergic diseases also showed higher associations with AMD than those with fewer visits. AMD is significantly associated with premorbid allergic diseases. The underlying mechanisms must be further investigated.
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Affiliation(s)
- Yi-Chen Shen
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, No. 91, Hsueh-Shih Road, Taichung, 404, Taiwan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, No. 2, Yude Road, Taichung, 404, Taiwan
| | - Ning-Yi Hsia
- Department of Ophthalmology, China Medical University Hospital, No. 2, Yude Road, Taichung, 404, Taiwan
| | - Wan-Hua Wu
- Department of Public Health, College of Public Health, China Medical University, No. 100, Jingmao 1st Road, Taichung, 404, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, No. 2, Yude Road, Taichung, 404, Taiwan
| | - Te-Chun Shen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, No. 2, Yude Road, Taichung, 404, Taiwan.
- School of Medicine, College of Medicine, China Medical University, No. 91, Hsueh-Shih Road, Taichung, 404, Taiwan.
- Department of Internal Medicine, Chu Shang Show Chwan Hospital, No. 75, Section 2, Jishan Road, Nantou, 557, Taiwan.
| | - Wei-Chien Huang
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, No. 91, Hsueh-Shih Road, Taichung, 404, Taiwan
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Wang YC, Chen YC, Ko CY, Guo YLL, Sung FC. Pre-existing comorbidity modify emergency room visit for out-of-hospital cardiac arrest in association with ambient environments. PLoS One 2018; 13:e0204593. [PMID: 30256842 PMCID: PMC6157874 DOI: 10.1371/journal.pone.0204593] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 09/11/2018] [Indexed: 11/19/2022] Open
Abstract
Background This study evaluated risks of emergency room visit (ERV) for out-of-hospital cardiac arrest (OHCA) in 2005–2011, among patients with cardiologic and metabolic syndromes (CMS), in association with ambient environments. Methods Pooled and area-specific weather related cumulative six-day (lags 0 to 5) relative risks (RRs) and confidence intervals (CIs) of ERV for OHCA were evaluated for CMS cases, using distributed lag nonlinear models and multivariate meta-analytical second-stage model in association with the daily average temperatures and daily concentrations of air pollutants. Results ERV risk increased as average temperature dropped to <27°C. At the mean temperature of 14°C, the cumulative six-day RRs of ERV were 1.73 (95% CI: 1.22, 2.46) for all OHCA patients, 1.74 (95% CI: 1.06, 2.84) for OHCA patients younger than 65 years old, and 1.99 (95% CI: 1.03, 3.81) for subjects with pre-existing hypertension. High temperature was also associated with elevated ERV of OHCA. Increased ERV risks in cases with pre-existing hypertension and diabetes mellitus were also associated with concentrations of air pollutants in northern Taiwan. Conclusions Our data provided evidences to clinicians, emerging medical services and public health that the ERV risk for OHCA patients is greater at low temperature than at high temperature. Patients with cardio and metabolic disorders need to pay greater attention to low temperature and avoid heat wave.
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Affiliation(s)
- Yu-Chun Wang
- Department of Environmental Engineering, College of Engineering, Zhongli, Taiwan
- Research Center for Environmental Risk Management, Chung Yuan Christian University, Zhongli, Taiwan
| | - Yi-Chun Chen
- Department of Health Management, I-Shou University, Kaohsiung, Taiwan
| | - Chun-Yu Ko
- Department of Environmental Engineering, College of Engineering, Zhongli, Taiwan
| | - Yue-Liang Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Fung-Chang Sung
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- * E-mail: ,
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Tsai CW, Chang WS, Shen TC, Su CH, Wang HC, Liu LC, Bau DT. Contribution of excision repair cross-complementing group 1 genotypes to triple negative breast cancer risk. PLoS One 2018; 13:e0202112. [PMID: 30096175 PMCID: PMC6086438 DOI: 10.1371/journal.pone.0202112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 07/27/2018] [Indexed: 12/31/2022] Open
Abstract
Compared with other subgroups of breast cancer, triple negative breast cancer (TNBC) is considered to be the one with the greatest invasiveness and metastatic mobility, and the highest recurrence rate. Considering the lack of predictive markers for TNBC, we aimed to examine the contribution of excision repair cross complementing-group 1 (ERCC1) genotypes to TNBC. The rs11615 and rs3212986 of ERCC1 were investigated and evaluated for their associations with susceptibility to breast cancer, especially TNBC, in Taiwan. In this study, 1,232 breast cancer patients (104 were TNBC) and 1,232 healthy controls were recruited and their genotypes at ERCC1 rs11615 and rs3212986 were revealed by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) analysis. Our results indicated that genotypes of ERCC1 rs11615 (Ptrend = 2.2*10E-9), but not rs3212986 (Ptrend = 0.6181), were associated with breast cancer risk. In the allelic frequency distribution analysis, breast cancer patients carried the T allele of ERCC1 rs11615 a higher rate than the control subjects, further supporting the idea that ERCC1 rs11615 TT genotype is positively associated with breast cancer susceptibility. More importantly, the frequency of the ERCC1 rs11615 TT genotype was even higher among TNBC patients than among other subtypes of breast cancer patients (P = 0.0001, odds ratio = 1.73, 95% confidence interval = 1.15-2.63). The genotypes of ERCC1 rs11615 were not associated with Ki67 status. Our findings firstly show that the T allele of ERCC1 rs11615 can serve as a predictive biomarker for breast cancer and TNBC. We believe that ERCC1 could serve as a target for personalized treatment of breast cancer, especially for TNBC.
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Affiliation(s)
- Chia-Wen Tsai
- Terry Fox Cancer Research Laboratory, Translational Medicine Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Shin Chang
- Terry Fox Cancer Research Laboratory, Translational Medicine Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Te-Chun Shen
- Terry Fox Cancer Research Laboratory, Translational Medicine Research Center, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | - Chen-Hsien Su
- Terry Fox Cancer Research Laboratory, Translational Medicine Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Hwei-Chung Wang
- Terry Fox Cancer Research Laboratory, Translational Medicine Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Liang-Chih Liu
- Terry Fox Cancer Research Laboratory, Translational Medicine Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Da-Tian Bau
- Terry Fox Cancer Research Laboratory, Translational Medicine Research Center, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
- * E-mail:
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Huang ZH, Chen HC, Chou YC, Lin CL, Kao CH, Lo HY, Yang TY, Liu FC. Does nephrotic syndrome without chronic kidney disease increase the risk of Parkinson's disease and secondary parkinsonism? A nationwide population-based study in Taiwan. BMJ Open 2018; 8:e020821. [PMID: 29982207 PMCID: PMC6045768 DOI: 10.1136/bmjopen-2017-020821] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 04/27/2018] [Accepted: 06/08/2018] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES Previous research has shown that patients with nephrotic syndrome (NS) have a higher risk of cognitive impairment, dementia or neurodegenerative disorder. The present study aimed to examine a relationship, if any exists between NS and Parkinson's disease (PD), a neurodegenerative disorder and secondary parkinsonism (sPS). METHODS A nationwide retrospective observational study conducted using data from the 2000-2010 Taiwan National Health Insurance Research Database. This study included 3663 patients with NS and 14 652 randomly selected, age-matched and sex-matched patients without NS. A Cox multivariable proportional hazards model was used to evaluate the risk of PD and sPS (PDsPS) in the NS cohort. RESULTS This study identified a positive association between NS and the risk of PDsPS in both men and women and in all age groups (adjusted HR 1.51; 95% CI 1.37 to 1.66). Compared with patients without NS and comorbidities, those with NS with two or more comorbidities exhibited an 8.23-fold higher risk of PDsPS (95% CI 6.22 to 10.9) and patients with NS and one comorbidity exhibited a 2.93-fold higher risk of PDsPS (95% CI 2.37 to 3.63). CONCLUSIONS Patients with NS have an increased risk of PDsPS. This increased risk may be related to brain vascular damage or blood-brain barrier impairment. Further research is necessary to explore the underlying relationship between NS and PDsPS.
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Affiliation(s)
- Zheng-Hao Huang
- Division of Rheumatology, Immunology and Allergy, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Division of Rheumatology, Immunology and Allergy, Department of Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | - Hsiang-Cheng Chen
- Division of Rheumatology, Immunology and Allergy, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Ching Chou
- Department of Health Promotion and Health Education, National Defense Medical Center, Taipei, Taiwan
| | - Cheng-Li Lin
- School of Medicine, China Medical University, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Hung Kao
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Hsin-Yi Lo
- Graduate Institute of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Tse-Yen Yang
- Molecular and Genomic Epidemiology Center, China Medical University Hospital, Taichung, Taiwan
| | - Feng-Cheng Liu
- Division of Rheumatology, Immunology and Allergy, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Hu WS, Lin CL. Role of CHA 2DS 2-VASc score in predicting new-onset atrial fibrillation in patients with type 2 diabetes mellitus with and without hyperosmolar hyperglycaemic state: real-world data from a nationwide cohort. BMJ Open 2018; 8:e020065. [PMID: 29567851 PMCID: PMC5875622 DOI: 10.1136/bmjopen-2017-020065] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
PURPOSE The objective of the current study was to explore the role of CHA2DS2-VASc score in predicting incidence of atrial fibrillation (AF) in patients with type 2 diabetes mellitus (DM). Furthermore, the use of the CHA2DS2-VASc score for stratifying new-onset AF risk in patients with DM and with/without hyperosmolar hyperglycaemic state (HHS) was also compared. METHODS The study subjects were identified from Longitudinal Health Insurance Database provided by the National Health Research Institutes. The patients with DM were divided into two groups based on a history of HHS or not. The predictive ability of CHA2DS2-VASc score for stratifying new-onset AF risk in the two groups was calculated using the area under the curve of receiver-operating characteristic (AUROC). RESULTS The present study involved a total of 69 530 patients with type 2 DM. Among them, 1558 patients had a history of HHS, whereas 67 972 patients did not. The AUROC of the CHA2DS2-VASc score as a predictor of incident AF in patients with DM and with/without HHS was 0.67 (95% CI 0.59 to 0.75) and 0.71 (95% CI 0.70 to 0.72), respectively. CONCLUSIONS To conclude, we reported for the first time on the assessment of CHA2DS2-VASc score for incident AF risk discrimination in patients with type 2 DM. We further found that the predictive ability of the CHA2DS2-VASc score was attenuated in patients with type 2 DM and with HHS in comparison with those without HHS.
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Affiliation(s)
- Wei-Syun Hu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Division of Cardiovascular Medicine, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
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Abstract
OBJECTIVES Population studies on hearing loss (HL) associated with rheumatoid arthritis (RA) are lacking. This study investigated the risk of developing HL in patients with RA using a nationwide population cohort. SETTING The population-based insurance claims data in the Taiwan National Health Insurance Research Database. DESIGN Retrospective cohort study followed up RA cohort and control cohort without RA frequency matched by sex, age and diagnosis year. STUDY POPULATION 18 267 patients with RA newly diagnosed in 2000-2006 and 73 068 controls without RA. MAIN OUTCOMES Incidences of HL by the end of 2011 and the RA cohort to non-RA cohort HRs after adjusting for sex, age and comorbidities. RESULTS The HL incidence was higher in the RA cohort than in the non-RA cohort (3.08 vs 1.62 per 1000 person-years), with an adjusted HR (aHR) of 1.91 (95% CI 1.70 to 2.14) for the RA cohort relative to the non-RA cohort after controlling for age, sex and comorbidities. Men and the elderly are at a higher risk. Cardiovascular comorbidities were associated with a further increased HL risk for patients with RA. Medications were associated with reduced HL incidence; patients with RA who used non-steroidal anti-inflammatory drugs (NSAIDs) had an aHR of 0.12 (95% CI 0.07 to 0.20), compared with non-users. CONCLUSIONS This study demonstrates that patients with RA are at an increased risk of developing HL. Findings highlight the need of disease-modifying treatment and scheduled auditory examinations for HL prevention and early detection for patients with RA.
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Affiliation(s)
- Chung-Ming Huang
- Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Hsuan-Ju Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- No department. Belong to College of Medicine., College of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Po-Hao Huang
- Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Gregory J Tsay
- Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Joung-Liang Lan
- Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- Department of Health Services Administration, China Medical University Hospital, Taichung, Taiwan
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Lo C, Sung FC, Mou CH, Lin TC, Tseng CH, Tzeng YL. Population study evaluating fracture risk among patients with chronic osteomyelitis. PLoS One 2017; 12:e0189743. [PMID: 29267371 PMCID: PMC5739410 DOI: 10.1371/journal.pone.0189743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 11/30/2017] [Indexed: 11/18/2022] Open
Abstract
Background Studies investigating the fracture risk in patients with chronic osteomyelitis (COM) limited to case reports. This study evaluated the association between COM and subsequent fracture risk using population-based data. Methods A subset claims data of the Taiwan National Health Insurance was used to identify 7,147 patients with COM newly diagnosed in 1999–2005 without fracture history and 28,588 general population controls, frequency matched by sex, age and diagnosis date. The incident fractures was measured by the end of 2013. Results The incidence density of fracture was 1.94-fold greater in the COM cohort than in controls (21.5 vs. 11.1 per 1000 person-years), with the adjusted hazard ratio (HR) of 1.81 (95% CI: 1.67–1.95) for COM patients compared to controls after controlling for sex, age, and comorbidities of diabetes, osteoporosis, depression and end-stage renal disease in Cox proportional hazards regression. The fracture risk increased with age and women were at greater risk than men. The fracture incidence increased substantially in those with osteoporosis, 40.2 per 1000 person-years in COM patients. Site specific analysis showed a higher portion of incident fractures for lower limbs, 52.7% in COM cohort and 46.3% in controls. Conclusion Findings in this 15-year follow-up observation support our hypothesis that patients with COM are at an elevated risk of subsequent fracture. COM patients and the elderly deserve adequate consultation and awareness for fracture prevention.
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Affiliation(s)
- Chyi Lo
- School of Nursing, College of Health Care, China Medical University, Taichung, Taiwan
- Department of Nursing, China Medical University Hospital, Taichung, Taiwan
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Chih-Hsin Mou
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Tzu-Chieh Lin
- Division of Traumatology, Emergency Department, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Chun-Huang Tseng
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Ya-Ling Tzeng
- School of Nursing, College of Health Care, China Medical University, Taichung, Taiwan
- Department of Nursing, China Medical University Hospital, Taichung, Taiwan
- * E-mail:
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Liou LS, Chang CY, Chen HJ, Tseng CH, Chen CY, Sung FC. Increased risk of peripheral arterial occlusive disease in patients with Bell's palsy using population data. PLoS One 2017; 12:e0188982. [PMID: 29216223 PMCID: PMC5720702 DOI: 10.1371/journal.pone.0188982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 11/16/2017] [Indexed: 11/19/2022] Open
Abstract
Objective This population-based cohort study investigated the risk of developing peripheral arterial occlusive disease (PAOD) in patients with Bell’s palsy. Methods We used longitudinal claims data of health insurance of Taiwan to identify 5,152 patients with Bell’s palsy newly diagnosed in 2000–2010 and a control cohort of 20,608 patients without Bell’s palsy matched by propensity score. Incidence and hazard ratio (HR) of PAOD were assessed by the end of 2013. Results The incidence of PAOD was approximately 1.5 times greater in the Bell’s palsy group than in the non-Bell’s palsy controls (7.75 vs. 4.99 per 1000 person-years). The Cox proportional hazards regression analysis measured adjusted HR was 1.54 (95% confidence interval (CI) = 1.35–1.76) for the Bell’s palsy group compared to the non-Bell’s palsy group, after adjusting for sex, age, occupation, income and comorbidities. Men were at higher risk of PAOD than women in the Bell’s palsy group, but not in the controls. The incidence of PAOD increased with age in both groups, but the Bell’s palsy group to control group HR of PAOD decreased as age increased. The systemic steroid treatment reduced 13% of PAOD hazard for Bell’s palsy patients, compared to those without the treatment, but not significant. Conclusions Bell’s palsy appears to be associated with an increased risk of developing PAOD. Further pathophysiologic, histopathology and immunologic research is required to explore the underlying biologic mechanism.
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Affiliation(s)
- Li-Syue Liou
- Department of Family Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien City, Hualien County, Taiwan, ROC
- Department of Family Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Xindian Dist., New Taipei City, Taiwan(R.O.C)
- Department of Family and Community Medicine, Tri-Service General Hospital, Neihu District, Taipei City, Taiwan(R.O.C.)
- School of Medicine, National Defense Medical Center, Neihu Dist., Taipei City, aiwan (R.O.C.)
| | - Chih-Ya Chang
- School of Medicine, National Defense Medical Center, Neihu Dist., Taipei City, aiwan (R.O.C.)
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, Neihu District, Taipei City, Taiwan(R.O.C.)
| | - Hsuan-Ju Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan, Taichung, Taichung, Taiwan (R.O.C.)
| | - Chun-Hung Tseng
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan, North District, Taichung, Taiwan (R.O.C.)
- School of Medicine, China Medical University, Taichung, Taiwan, Taichung, Taichung, Taiwan (R.O.C.)
| | - Cheng-Yu Chen
- Department of Family Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Xindian Dist., New Taipei City, Taiwan(R.O.C)
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan, Taichung, Taichung, Taiwan (R.O.C.)
- Graduate Institute of Clinical Medicine Science, College of Medicine, China Medical University, Taichung, Taiwan; Taichung, Taichung, Taiwan (R.O.C.)
- Department of Health Services Administration, China Medical University, Taichung, Taiwan; Taichung, Taichung, Taiwan (R.O.C.)
- * E-mail:
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Tsai SY, Chen HJ, Lio CF, Ho HP, Kuo CF, Jia X, Chen C, Chen YT, Chou YT, Yang TY, Sun FJ, Shi L. Increased risk of herpes zoster in patients with psoriasis: A population-based retrospective cohort study. PLoS One 2017; 12:e0179447. [PMID: 28829784 PMCID: PMC5567491 DOI: 10.1371/journal.pone.0179447] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 05/29/2017] [Indexed: 12/22/2022] Open
Abstract
Objectives The risk of herpes zoster (HZ) between patients with psoriasis receiving and not receiving systemic therapy has received increasing attention. This study investigated the association of psoriasis with the risk of HZ. Methods We conducted a population-based retrospective cohort study by using the Taiwan National Health Insurance Research Database. The psoriasis cohort consisted of 4077 patients with newly diagnosed psoriasis between 2000 and 2006. Each patient with psoriasis was frequency-matched with four people without psoriasis, by sex, age and index year. (nonpsoriasis cohort; 16308 subjects). Patients who received systemic therapy were classified as having severe psoriasis, whereas those who did not receive systemic therapy were classified as having mild psoriasis. The Cox proportional hazards regression analysis was conducted to estimate the association between psoriasis and HZ risk. Results The overall incidence density rate of HZ in the psoriasis cohort than in the nonpsoriasis cohort (4.50 vs. 3.44 per 1,000 person-years), with a multivariable Cox proportional hazards model measured adjusted HR of 1.29 [95% confidence interval (CI) = 1.07–1.56]. In additional, compared with the nonpsoriasis cohort, the risk of HZ was higher in the severe psoriasis cohort than in the nonpsoriasis cohort (adjusted hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.15–2.27). The comparison between psoriasis and nonpsoriasis cohorts revealed a greatest magnitude risk of HZ in women (adjusted HR, 1.36; 95% CI, 1.04–1.79), study participants in the age group of 20–39 years (adjusted HR, 1.77; 95% CI, 1.17–2.66), and study participants without any comorbidities (adjusted HR, 1.37; 95% CI, 1.02–1.84). Conclusions Our results suggest that psoriasis is associated with an increased risk of HZ, which involves differences in sex and age. Although systemic therapy may have a major role in the risk of HZ, the intrinsic factors of psoriasis cannot be excluded.
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Affiliation(s)
- Shin-Yi Tsai
- Department of Laboratory Medicine, Mackay Memorial Hospital, Taipei City, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
- * E-mail: (SYT); (LS)
| | - Hsuan-Ju Chen
- Management Office for Health Data, China Medical University Hospital, Taichung City, Taiwan
- College of Medicine, China Medical University, Taichung City, Taiwan
| | - Chon-Fu Lio
- Department of Laboratory Medicine, Mackay Memorial Hospital, Taipei City, Taiwan
- Centro Hospitalar Conde de São Januário, Macao
| | - Hui-Ping Ho
- Department of Laboratory Medicine, Mackay Memorial Hospital, Taipei City, Taiwan
| | - Chien-Feng Kuo
- Department of Infectious Disease, Mackay Memorial Hospital, Taipei City, Taiwan
| | - Xiaofeng Jia
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, Maryland, United States
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland, United States
| | - Chi Chen
- Department of Laboratory Medicine, Mackay Memorial Hospital, Taipei City, Taiwan
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Yu-Tien Chen
- Department of Laboratory Medicine, Mackay Memorial Hospital, Taipei City, Taiwan
| | - Yi-Ting Chou
- Department of Laboratory Medicine, Mackay Memorial Hospital, Taipei City, Taiwan
| | - Tse-Yen Yang
- Molecular and Genomic Epidemiology Center, China Medical University Hospital, Taichung City, Taiwan
- Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua County, Lugang Town, Taiwan
| | - Fang-Ju Sun
- Department of Medical Research, Mackay Memorial Hospital, Taipei City, Taiwan
- Mackay Junior College of Medicine, Nursing and Management, Taipei City, Taiwan
| | - Leiyu Shi
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
- * E-mail: (SYT); (LS)
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Peng YH, Huang CW, Liao WC, Chen HJ, Yin MC, Huang YM, Wu TN, Ho WC. Association between chronic obstructive pulmonary disease and increased risk of benign prostatic hyperplasia: a retrospective nationwide cohort study. BMJ Open 2017; 7:e015581. [PMID: 28645971 PMCID: PMC5734354 DOI: 10.1136/bmjopen-2016-015581] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Chronic obstructive pulmonary disease (COPD) and benign prostatic hyperplasia (BPH) are common disorders in ageing male populations. Nevertheless, the relationship between the two diseases has rarely been explored. The objective of this study was to examine whether patients with COPD are at an increased risk of BPH. DESIGN Retrospective nationwide cohort study. SETTING Data retrieved from the Taiwan National Health Insurance Research Database. PARTICIPANTS Overall, 19 959 male patients aged 40 years and over with newly diagnosed COPD between 2000 and 2006 were included as the COPD group, and 19 959 sex-matched and age-matched enrollees without COPD were included as the non-COPD group. Both groups were followed-up until the end of 2011. OUTCOME MEASURES A Cox proportional hazards regression model was used to compute the risk of BPH in patients with COPD compared with enrollees without COPD. RESULTS The overall incidence rate of BPH was 1.53 times higher in the COPD group than that in the non-COPD group (44.7 vs 25.7 per 1000 person-years, 95% CI 1.46 to 1.60) after adjusting for covariates. An additional stratified analysis revealed that this increased risk of BPH in patients with COPD remained significantly higher than that in enrollees without COPD in all men aged 40 years and over. CONCLUSION After adjustment for covariates, male patients with COPD were found to be at a higher risk of BPH. We suggest that clinicians should be cautious about the increased risk of BPH in male patients with COPD.
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Affiliation(s)
- Yi-Hao Peng
- Department of Public Health, China Medical University, Taichung, Taiwan
- Division of Respiratory Therapy, Asia University Hospital, Asia University, Taichung, Taiwan
- Department of Respiratory Therapy, China Medical University, Taichung, Taiwan
| | - Chien-Wen Huang
- Division of Chest Medicine, Department of Internal Medicine, Asia University Hospital, Taichung, Taiwan
- Department of Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Institute of Molecular Biology, College of Life Sciences, National Chung Hsing University, Taichung, Taiwan
| | - Wei-Chih Liao
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Hsuan-Ju Chen
- College of Medicine, China Medical University, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Ming-Chien Yin
- Department of Public Health, China Medical University, Taichung, Taiwan
- Department of Respiratory Therapy, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Yu-Ming Huang
- Division of Respiratory Therapy, Asia University Hospital, Asia University, Taichung, Taiwan
| | - Trong-Neng Wu
- Department of Health Care Administration, Asia University, Taichung, Taiwan
| | - Wen-Chao Ho
- Department of Public Health, China Medical University, Taichung, Taiwan
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11
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Abstract
OBJECTIVE In accordance with the dichotomy between T helper type 1(Th1) and T helper type 2 (Th2) responses, the occurrence of allergic conjunctivitis (AC) and type 1 diabetes mellitus (T1DM) is, in theory, inversely related in the individual. However, recent studies investigating the association between the two diseases are controversial. DESIGN Population-based cohort study. SETTING We used claims data of the National Health Insurance Research Database of Taiwan. PARTICIPANTS We identified 4160 patients aged 1-30 years with newly diagnosed T1DM and no history of AC at baseline. For each patient with T1DM, four non-T1DM controls (n=16,640) were matched by sex. The mean follow-up time was 6 years. PRIMARY AND SECONDARY OUTCOME MEASURES Multivariate Cox proportional hazards regression analysis was used to evaluate the risk of AC. We additionally evaluated the association between risk of AC and T1DM progression by examining Diabetes Complications Severity Index (aDCSI) changes from the date of diagnosis until the end of follow-up. RESULTS The overall incidence of allergic conjunctivitis (AC) was higher in the type 1 diabetes mellitus (T1DM) cohort than in the control cohort (23.0 vs 13.5 per 1000 person-years, adjusted incidence rate ratio (aIRR): 1.59, 95% CI 1.47 to 1.71). Relative to that in patients with mildly progressive T1DM, the risk of AC increased as the adapted Diabetes Complications Severity Index (aDCSI) increased (aIRR: 1.68, 3.78 and 18.8, with yearly changes in aDCSI score: 0.51 to 1.00, 1.01 to 2.00, and >2.00 vs <0.51, respectively; for trend <0.001). CONCLUSION Patients with T1DM are at an elevated risk of developing AC; this risk increases with T1DM progression. The T helper type 1/T helper type 2 hypothesis is an overly simplistic explanation for this association.
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Affiliation(s)
- Yin-Huei Chen
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Da-Tian Bau
- Terry Fox Cancer Research Laboratory, China Medical University Hospital, Taichung, Taiwan
| | - Yi-Chih Hung
- Division of Endocrinology and Metabolism, Department of Medicine, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
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12
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Wen SY, Tamilselvi S, Shen CY, Day CH, Chun LC, Cheng LY, Ou HC, Chen RJ, Viswanadha VP, Kuo WW, Huang CY. Protective effect of HDL on NADPH oxidase-derived super oxide anion mediates hypoxia-induced cardiomyocyte apoptosis. PLoS One 2017; 12:e0179492. [PMID: 28617849 PMCID: PMC5472312 DOI: 10.1371/journal.pone.0179492] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/31/2017] [Indexed: 11/20/2022] Open
Abstract
Cardiovascular diseases are the leading cause of death of death in Taiwan. Atherosclerosis can lead to serious problems, including heart attack, stroke, or even death. Coronary heart disease (CHD) occurs when plaque builds up in the coronary arteries to cause the ischemic heart disease which will enhance myocardial remodeling and also induce myocardial hypoxia. High density lipoprotein (HDL) has been proposed to have cardio-protective effects. Under hypoxic conditions (1%O2 for 24hr), in H9c2 cells, reactive oxygen species (ROS) is induced which leads to cardiomyocyte apoptosis and cardiac dysfunction. Therefore, the present study described the protective effect of HDL on hypoxia-induced cardiomyocyte damage. We investigated the NADPH oxidase-produced ROS-related signaling pathways and apoptosis in cardiomyocytes under hypoxia conditions. Results showed that the ROS mediated cardiac damage might occur via AT1 and PKC activation. Furthermore, hypoxia downregulated the survival protein (p-AKTser473) and anti-apoptotic protein (BCL2), whereas pro-apoptotic protein, Bax and caspase 3 were upregulated. These detrimental effects by ROS and apoptosis were prevented by HDL pretreatment. Our findings revealed the underlying molecular mechanism by which HDL suppresses the hypoxia-induced cardiomyocyte dysfunction. Further, we elucidated the role of HDL on preventing hypoxia induced cardiomyocyte apoptosis is mediated through the inhibition of NADPH oxidase-derived ROS.
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Affiliation(s)
- Su-Ying Wen
- Department of Dermatology, Taipei City Hospital, Renai Branch, Taipei, Taiwan
- Center for General Education, Mackay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Shanmugam Tamilselvi
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
| | - Chia-Yao Shen
- Department of Nursing, MeiHo University, Pingtung, Taiwan
| | | | - Li-Chin Chun
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy & Science, Tainan County, Taiwan
| | - Li-Yi Cheng
- Department of Biological Science and Technology, Asia University, Taichung, Taiwan
| | - Hsiu-Chung Ou
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
| | - Ray-Jade Chen
- Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | | | - Wei-Wen Kuo
- Department of Biological Science and Technology, China Medical University, Taichung, Taiwan
| | - Chih-Yang Huang
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
- Department of Biological Science and Technology, Asia University, Taichung, Taiwan
- Graduate Institute of Chinese Medical Science, China Medical University, Taichung, Taiwan
- * E-mail:
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13
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Lee FY, Chen WK, Chiu CH, Lin CL, Kao CH, Chen CH, Yang TY, Lai CY. Increased risk of deep vein thrombosis and pulmonary thromboembolism in patients with aortic aneurysms: A nationwide cohort study. PLoS One 2017; 12:e0178587. [PMID: 28591152 PMCID: PMC5462404 DOI: 10.1371/journal.pone.0178587] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 05/06/2017] [Indexed: 02/07/2023] Open
Abstract
Studies on the association between aortic aneurysm (AA) and the subsequent risk of venous thromboembolism (VTE) are limited to a few case reports and investigations which only focused on surgical effects. Therefore, we used the National Health Insurance Research Database to clarify whether patients with AAs have a heightened risk of subsequent VTEs, including deep vein thrombosis (DVT) and pulmonary embolism (PE). Our retrospective cohort study comprised patients aged ≥ 18 years who received a diagnosis of an AA and were hospitalized at any point during 2000–2010 (n = 16,630). Each AA patient was frequency-matched to 4 non-AA hospitalized patients based on age, sex, and index year (n = 66,453). The Cox proportional hazard regressions model was used to estimate the adjusted effect of AAs on VTE risk. The overall incidence of DVT and PE was higher in the patients with AA than in the non-AA group patients (23.5 versus 13.2 and 13.5 versus 7.98/1,000 person-years). After adjustment for age, sex, duration of hospitalization in the study period, and comorbidities, patients with AAs were associated with a 1.88-fold higher risk of DVT and 1.90-fold higher risk of PE compared to the non-AA cohort. Patients with abdominal AAs were more likely to develop DVT, whereas thoracic AA patients were more likely to develop PE. A diagnosis of a ruptured AA was associated with a substantially increased risk of DVT. Surgical treatment of AAs was associated with a heightened risk of VTE within 6-months post-operation. Our study demonstrates that AAs are associated with an increased risk of subsequent VTE. Future investigations are encouraged to delineate the mechanisms underlying this association and to evaluate the cost-effectiveness of screening for VTEs in patients with AAs.
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Affiliation(s)
- Feng-You Lee
- Department of Emergency Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Wei-Kung Chen
- Department of Emergency Medicine, Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Hsiang Chiu
- Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Chao-Hsien Chen
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan
| | - Tse-Yen Yang
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
- * E-mail:
| | - Ching-Yuan Lai
- Department of Emergency Medicine, Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan
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14
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Chiu HT, Li TC, Li CI, Liu CS, Lin WY, Lin CC. Visit-to-visit glycemic variability is a strong predictor of chronic obstructive pulmonary disease in patients with type 2 diabetes mellitus: Competing risk analysis using a national cohort from the Taiwan diabetes study. PLoS One 2017; 12:e0177184. [PMID: 28489885 PMCID: PMC5425194 DOI: 10.1371/journal.pone.0177184] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 04/23/2017] [Indexed: 01/08/2023] Open
Abstract
Background This study aims to examine the association between visit-to-visit glucose variability, which was measured by coefficient of variation (CV) of fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c), and risk of chronic obstructive pulmonary disease (COPD) in a large number of patients with type 2 diabetes with an average follow-up of 7.58 years. Methods We conducted a retrospective cohort study on 27,257 patients with type 2 diabetes who participated in the National Diabetes Case Management Program in Taiwan. Visit-to-visit variability in HbA1c and FPG at baseline and the incidence of COPD were analyzed using a modified Cox proportional hazards model considering competing risks. Results A total of 2,346 incident cases of COPD. Patients were grouped into tertiles of FPG-CV and HbA1c-CV. The incidence rates in the first, second, and third tertiles were 9.87, 11.06, and 13.19, respectively, for FPG-CV and 10.2, 11.81, and 12.07, for HbA1c-CV per 1000 person-years. After adjusting for age, gender, diabetes duration, treatment type, smoking, hypertension, hyperlipidemia, baseline FPG and HbA1c levels, and complications, both FPG-CV and HbA1c-CV were independently associated with COPD. The hazard ratios of COPD for the third terile compared with the first tertile of FPG-CV were 1.26 (95% confidence interval [CI]: 1.13–1.40). Moreover, the hazard ratios of COPD for the third and second tertiles compared with the first tertile of HbA1c-CV were 1.13 (1.02–1.25) and 1.13 (1.02–1.26), respectively. Conclusions Patients with FPG-CV higher than 34.6% or HbA1c-CV higher than 8.4% exhibited an increased risk of COPD. This finding confirmed the linear relationship of FPG-CV and HbA1c-CV to COPD. Visit-to-visit variability in FPG and HbA1c levels are strong predictors of COPD in patients with type 2 diabetes. Future studies should focus on lung dysfunction in diabetes, and adequate glucose control strategy in regular clinical practices must be established for COPD prevention.
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Affiliation(s)
- Hsien-Tsai Chiu
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
- Clinical Research Outcome and Training Center, Big Data Center, China Medical University Hospital, Taichung, Taiwan
| | - Tsai-Chung Li
- Graduate Institute of Biostatistics, College of Public Health, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Chia-Ing Li
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Shong Liu
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Yuan Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Chieh Lin
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
- * E-mail:
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15
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Chen YW, Li CH, Yang CD, Liu CH, Chen CH, Sheu JJ, Lin SK, Chen AC, Chen PK, Chen PL, Yeh CH, Chen JR, Hsiao YJ, Lin CH, Hsu SP, Chen TS, Sung SF, Yu SC, Muo CH, Wen CP, Sung FC, Jeng JS, Hsu CY. Low cholesterol level associated with severity and outcome of spontaneous intracerebral hemorrhage: Results from Taiwan Stroke Registry. PLoS One 2017; 12:e0171379. [PMID: 28422955 PMCID: PMC5396870 DOI: 10.1371/journal.pone.0171379] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 01/18/2017] [Indexed: 01/14/2023] Open
Abstract
The relationship between cholesterol level and hemorrhagic stroke is inconclusive. We hypothesized that low cholesterol levels may have association with intracerebral hemorrhage (ICH) severity at admission and 3-month outcomes. This study used data obtained from a multi-center stroke registry program in Taiwan. We categorized acute spontaneous ICH patients, based on their baseline levels of total cholesterol (TC) measured at admission, into 3 groups with <160, 160–200 and >200 mg/dL of TC. We evaluated risk of having initial stroke severity, with National Institutes of Health Stroke Scale (NIHSS) >15 and unfavorable outcomes (modified Rankin Scale [mRS] score >2, 3-month mortality) after ICH by the TC group. A total of 2444 ICH patients (mean age 62.5±14.2 years; 64.2% men) were included in this study and 854 (34.9%) of them had baseline TC <160 mg/dL. Patients with TC <160 mg/dL presented more often severe neurological deficit (NIHSS >15), with an adjusted odds ratio [aOR] of 1.80; 95% confidence interval [CI], 1.41–2.30), and 3-month mRS >2 (aOR, 1.41; 95% CI, 1.11–1.78) using patients with TC >200 mg/dL as reference. Those with TC >160 mg/dL and body mass index (BMI) <22 kg/m2 had higher risk of 3-month mortality (aOR 3.94, 95% CI 1.76–8.80). Prior use of lipid-lowering drugs (2.8% of the ICH population) was not associated with initial severity and 3-month outcomes. A total cholesterol level lower than 160 mg/dL was common in patients with acute ICH and was associated with greater neurological severity on presentation and poor 3-month outcomes, especially with lower BMI.
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Affiliation(s)
- Yu-Wei Chen
- Department of Neurology, Taiwan Landseed Hospital, Taoyuan, Taiwan
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chen-Hua Li
- Department of Neurology, Taiwan Landseed Hospital, Taoyuan, Taiwan
- Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Dong Yang
- Department of Neurosurgery, Taiwan Landseed Hospital, Taoyuan, Taiwan
| | - Chung-Hsiang Liu
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Hung Chen
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jau-Jiuan Sheu
- Department of Neurology, Taipei Medical University Hospital, Taipei, Taiwan
| | - Shinn-Kuang Lin
- Department of Neurology, Taipei Tzu Chi Hospital, and School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - An-Chih Chen
- Department of Neurology, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ping-Kun Chen
- Department of Neurology, Lin Shin Hospital, Taichung, Taiwan
| | - Po-Lin Chen
- Department of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chung-Hsin Yeh
- Department of Neurology, Yuan Rung Hospital, Changhua, Taiwan
- Department of Sport and Health Management, Da-Yeh University, Changhua, Taiwan
- Department of Nursing, College of Medicine & Nursing, Hung-Kuang University, Taichung, Taiwan
| | - Jiunn-Rong Chen
- Department of Neurology, Yunlin Christian Hospital, Yunlin, Taiwan
| | - Yu-Jen Hsiao
- Department of Neurology, National Taiwan University Hospital—Yunlin Branch, Yunlin, Taiwan
| | - Ching-Huang Lin
- Department of Neurology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Shih-Pin Hsu
- Department of Neurology, E-Da Hospital, Kaohsiung, Taiwan
| | | | - Sheng-Feng Sung
- Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Shih-Chieh Yu
- Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan
| | - Chih-Hsin Muo
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chi Pang Wen
- National Health Research Institutes, Miaoli, Taiwan
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Fung-Chang Sung
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
- * E-mail: (JSJ); (FCS)
| | - Jiann-Shing Jeng
- Department of Neurology, Taiwan Landseed Hospital, Taoyuan, Taiwan
- Stroke Center, National Taiwan University Hospital, Taipei, Taiwan
- * E-mail: (JSJ); (FCS)
| | - Chung Y. Hsu
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
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16
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Lin WY, Andersson KE, Lin CL, Kao CH, Wu HC. Association of lower urinary tract syndrome with peripheral arterial occlusive disease. PLoS One 2017; 12:e0170288. [PMID: 28301517 PMCID: PMC5354249 DOI: 10.1371/journal.pone.0170288] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 01/03/2017] [Indexed: 01/03/2023] Open
Abstract
PURPOSE To describe atherosclerosis may lead to chronic bladder ischemia, eventually resulting in lower urinary tract syndrome (LUTS), and peripheral arterial occlusive disease (PAOD). We investigated the association of LUTS with PAOD. METHODS This nationwide population-based cohort study was based on data from the Taiwan National Health Insurance Database from 2000 to 2010; follow-up lasted until the end of 2011. We identified patients with newly diagnosed LUTS by using International Classification of Diseases, Ninth Revision, Clinical Modification codes. RESULTS In total, 36,042 and 36,042 patients were enrolled in LUTS and non-LUTS cohorts, respectively. After adjustment for age, sex, and comorbidities, the risk of subsequent PAOD was 1.36-fold higher [95% confidence interval (CI) = 1.26-1.46] in the LUTS cohort than in the non-LUTS cohort. The adjusted risk of PAOD was the highest in patients with LUTS without any comorbidity [adjusted hazard ratio (aHR) = 1.93, 95% CI = 1.54-2.41]. The age-specific relative risk of PAOD was significantly higher in all age groups, particularly in those aged <49 years (aHR = 1.80, 95% CI = 1.39-2.34], in the LUTS cohort than in the non-LUTS cohort. CONCLUSION LUTS is a risk factor for PAOD. Physicians should consider the possibility of underlying PAOD in patients with LUTS aged <49 years and without cardiovascular comorbidities. Additional studies developing strategies for decreasing the risk of PAOD are warranted.
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Affiliation(s)
- Wei-Yu Lin
- Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Chia-Yi, Taiwan
- Department of Medicine, Chang Gung University, Taoyuan, Taiwan
- Chang Gung University of Science and Technology, Chia-Yi, Taiwan
- Department of Medicine and Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taiwan
| | - Karl-Erik Andersson
- Wake Forest Institute for Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States of America
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Hsi-Chin Wu
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Urology, China Medical University Beigang Hospital, Taichung, Taiwan
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17
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Chiu TF, Chuang YW, Lin CL, Yu TM, Chung MC, Li CY, Chung CJ, Ho WC. Long-Term Outcomes of Systemic Lupus Erythematous Patients after Pregnancy: A Nationwide Population-Based Cohort Study. PLoS One 2016; 11:e0167946. [PMID: 27992461 PMCID: PMC5167320 DOI: 10.1371/journal.pone.0167946] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 11/24/2016] [Indexed: 12/12/2022] Open
Abstract
Background Data on long-term maternal outcomes in patients with systemic lupus erythematosus (SLE) are lacking. The study aimed to explore the relationships among SLE, pregnancy, outcomes of end-stage renal disease (ESRD), and overall mortality. Methods We established a retrospective cohort study consisting of four cohorts: pregnant (case cohort) and nonpregnant SLE patients, as well as pregnant and nonpregnant non-SLE patients. One case cohort and three comparison cohorts were matched by age at first pregnancy and index date of pregnancy by using the Taiwan National Health Insurance Research Dataset. All study subjects were selected based on the index date to the occurrence of ESRD or overall death. Cox proportional hazard regression models and Kaplan–Meier curves were used in the analysis. Results SLE pregnant patients exhibited significantly increased risk of ESRD after adjusting for other important confounders, including immunosuppressant and parity (HR = 3.19, 95% CI: 1.35–7.52 for pregnant non-SLE; and HR = 2.77, 95% CI: 1.24–6.15 for nonpregnant non-SLE patients). No significant differences in ESRD incidence were observed in pregnant and nonpregnant SLE patients. Pregnant SLE patients exhibited better clinical condition at the baseline and a significantly lower risk of overall mortality than nonpregnant SLE patients. Conclusions Our data support current recommendations for SLE patients to avoid pregnancy until disease activity is quiescent. Multicenter recruitment and clinical information can be used to further examine the association of SLE and ESRD (or mortality) after pregnancy.
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Affiliation(s)
- Ting-Fang Chiu
- Department of Pediatrics, Taipei City Hospital, Zhongxiao Branch, Taipei, Taiwan
| | - Ya-Wen Chuang
- Division of Nephrology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- Department of Medicine, College of Medicine, China Medical University and Hospital, Taichung, Taiwan
| | - Tung-Min Yu
- Division of Nephrology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Mu-Chi Chung
- Division of Nephrology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chi-Yuan Li
- Department of Anesthesiology, China Medical University Hospital, Taichung, Taiwan
| | - Chi-Jung Chung
- Department of Health Risk Management, College of Public Health, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Wen-Chao Ho
- Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
- * E-mail:
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18
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Hsu TY, Shih HM, Wang YC, Lin LC, He GY, Chen CY, Kao CH, Chen CH, Chen WK, Yang TY. Effect of Alcoholic Intoxication on the Risk of Inflammatory Bowel Disease: A Nationwide Retrospective Cohort Study. PLoS One 2016; 11:e0165411. [PMID: 27802288 PMCID: PMC5089729 DOI: 10.1371/journal.pone.0165411] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 09/20/2016] [Indexed: 12/14/2022] Open
Abstract
PURPOSE This study investigated whether alcoholic intoxication (AI) increases the risk of inflammatory bowel disease (IBD) by using a population-based database in Taiwan. METHODS This retrospective matched-cohort study included 57 611 inpatients with new-onset AI (AI cohort) and 230 444 randomly selected controls (non-AI cohort). Each patient was monitored for 10 years to individually identify those who were subsequently diagnosed with Crohn disease (CD) and ulcerative colitis (UC) during the follow-up period. Cox proportional hazard regression analysis was conducted to determine the risk of IBD in patients with AI compared with controls without AI. RESULTS The incidence rate of IBD during the 10-year follow-up period was 2.69 per 1 000 person-years and 0.49 per 1 000 person-years in the AI and non-AI cohorts, respectively. After adjustment for age, sex, and comorbidity, the AI cohort exhibited a 3.17-fold increased risk of IBD compared with the non-AI cohort (hazard ratio [HR] = 3.17, 95% confidence interval [CI] = 2.19-4.58). Compared with the non-AI cohort, the HRs of CD and UC were 4.40 and 2.33 for the AI cohort, respectively. After stratification for the severity of AI according to the duration of hospital stay, the adjusted HRs exhibited a significant correlation with the severity; the HRs of IBD were 1.76, 6.83, and 19.9 for patients with mild, moderate, and severe AI, respectively (p for the trend < .0001). CONCLUSION The risk of IBD was higher in patients with AI and increased with the length of hospital stay.
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Affiliation(s)
- Tai-Yi Hsu
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Hong-Mo Shih
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Yu-Chiao Wang
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Leng-Chieh Lin
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
| | - Guan-Yi He
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Dermatology, National Taiwan University Hospital Yunlin Branch, Douliou, Taiwan
| | - Chih-Yu Chen
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Chao-Hsien Chen
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan
| | - Wei-Kung Chen
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Tse-Yen Yang
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
- * E-mail:
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Hung YC, Cheng YC, Muo CH, Chiu HE, Liu CT, Hu WL. Adjuvant Chinese Herbal Products for Preventing Ischemic Stroke in Patients with Atrial Fibrillation. PLoS One 2016; 11:e0159333. [PMID: 27428543 PMCID: PMC4948896 DOI: 10.1371/journal.pone.0159333] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 06/30/2016] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE Chinese herbal products (CHPs) are widely used for atrial fibrillation (AF) in Taiwan. We investigated the effect of adjuvant CHPs in preventing ischemic stroke in patients with AF. METHODS Taiwanese patients in the Health Insurance Database newly diagnosed with AF during 2000-2011 were enrolled. Medication treatment with/without CHPs was administered within 7 days after the AF diagnosis. The clinical endpoint was an ischemic stroke. The Chi-square test, Fisher's exact test, and Student t test were used to examine differences between the traditional Chinese medicine (TCM) and non-TCM cohorts. Cox proportional hazard regression was used to assess the risk for ischemic stroke between two cohorts. RESULTS Three hundred and eleven patients underwent TCM treatment and 1715 patients did not. Compared to non-TCM users, TCM users had a lower incidence of stroke (12.59% vs. 1.93%, respectively) and lower risk of stroke [CHA2DS2-VASc score = 0-2 (hazard ratio = 0.20; 95% confidence interval = 0.06-0.65)]. Compared to non-TCM users, the stroke risk was significantly lower in TCM users with AF who were female or younger than 65 years, but not in males, people more than 65 years old, or people with comorbidities. Compared to TCM users, non-TCM users who received conventional treatment had a higher ischemic stroke risk. The risk for AF-related hospitalization was significantly lower in TCM users (0.64%) than in non-TCM users (38.1%). CONCLUSIONS Users of TCM with AF have a lower risk of new-onset ischemic stroke. Therefore, adjuvant CHP therapy may have a protective effect and may be used in AF patients to prevent ischemic stroke.
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Affiliation(s)
- Yu-Chiang Hung
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- School of Chinese Medicine for Post Baccalaureate, I-Shou University, Kaohsiung, Taiwan
- * E-mail: (YCH); (WLH)
| | - Yu-Chen Cheng
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Hsin Muo
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Hsienhsueh Elley Chiu
- School of Chinese Medicine for Post Baccalaureate, I-Shou University, Kaohsiung, Taiwan
| | - Chun-Ting Liu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Long Hu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Kaohsiung Medical University College of Medicine, Kaohsiung, Taiwan
- Fooyin University College of Nursing, Kaohsiung, Taiwan
- * E-mail: (YCH); (WLH)
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Kuo HF, Liu PL, Chong IW, Liu YP, Chen YH, Ku PM, Li CY, Chen HH, Chiang HC, Wang CL, Chen HJ, Chen YC, Hsieh CC. Pigment Epithelium-Derived Factor Mediates Autophagy and Apoptosis in Myocardial Hypoxia/Reoxygenation Injury. PLoS One 2016; 11:e0156059. [PMID: 27219009 PMCID: PMC4878768 DOI: 10.1371/journal.pone.0156059] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 05/09/2016] [Indexed: 12/30/2022] Open
Abstract
Pigment epithelium-derived factor (PEDF) is a multifunctional protein that exhibits anti-angiogenic, antitumor, anti-inflammatory, antioxidative, anti-atherogenic, and cardioprotective properties. While it was recently shown that PEDF expression is inhibited under low oxygen conditions, the functional role of PEDF in response to hypoxia/reoxygenation (H/R) remains unclear. The goal of this study was to therefore investigate the influence of PEDF on myocardial H/R injury. For these analyses, PEDF-specific small interfering RNA-expressing and PEDF-expressing lentivirus (PEDF-LV) vectors were utilized to knockdown or stably overexpress PEDF, respectively, within human cardiomyocytes (HCM) in vitro. We noted that reactive oxygen species (ROS) play important roles in the induction of cell death pathways, including apoptosis and autophagy in ischemic hearts. Our findings demonstrate that overexpression of PEDF resulted in a significant reduction in ROS production and attenuation of mitochondrial membrane potential depletion under H/R conditions. Furthermore, PEDF inhibited the activation of a two-step apoptotic pathway in which caspase-dependent (caspase-9 and caspase-3) and caspase-independent (apoptosis inducing factor and endonuclease G), which in turn cleaves several crucial substrates including the DNA repair enzyme poly (ADP-ribose) polymerase. Meanwhile, overexpression of PEDF also promoted autophagy, a process that is typically activated in response to H/R. Therefore, these findings suggest that PEDF plays a critical role in preventing H/R injury by modulating anti-oxidant and anti-apoptotic factors and promoting autophagy.
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Affiliation(s)
- Hsuan-Fu Kuo
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 801, Taiwan
| | - Po-Len Liu
- Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
| | - Inn-Wen Chong
- Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
| | - Yu-Peng Liu
- Department of Genome Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, 404, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, 413, Taiwan
| | - Po-Ming Ku
- Cardiovascular Center, Chi-Mei Hospital, Liouying, Tainan, 736, Taiwan
- Chia-Nan University of Pharmacy & Science, Tainan, 717, Taiwan
| | - Chia-Yang Li
- Department of Genome Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsiu-Hua Chen
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 801, Taiwan
| | - Hui-Ching Chiang
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 801, Taiwan
| | - Chiao-Lin Wang
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 801, Taiwan
| | - Huang-Jen Chen
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 801, Taiwan
| | - Yen-Chieh Chen
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 801, Taiwan
| | - Chong-Chao Hsieh
- Division of Cardiovascular Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, 807, Taiwan
- * E-mail:
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Huang LY, Wang YC, Wu CC, Chen YC, Huang YL. Risk of Flood-Related Diseases of Eyes, Skin and Gastrointestinal Tract in Taiwan: A Retrospective Cohort Study. PLoS One 2016; 11:e0155166. [PMID: 27171415 PMCID: PMC4865035 DOI: 10.1371/journal.pone.0155166] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 04/25/2016] [Indexed: 11/20/2022] Open
Abstract
Floods are known to cause serious environmental damage and health impacts. Studies on flood-related diseases have been primarily on individual events, and limited evidence could be drawn on potential health impacts from floods using large population data. This study used reimbursement records of one million people of the Taiwan National Health Insurance program to compare incident diseases of the eyes, skin and gastrointestinal (GI) tract associated with floods. Incidence rates for the selected diseases were calculated according to outpatient/emergency visit data. The incidence rates were evaluated by flood status: in 10 days before floods, during floods and within 10 days after the floods receded. Outpatient/emergency visit rates for the eye, skin and GI tract diseases were highest after floods and lowest during floods. Results from multivariate Poisson regression analyses showed that, when compared with the incidence in 10 days before floods, the incidence rate ratios (IRR) of diseases within 10 days after floods were 1.15 (95% confidence interval (CI) = 1.10–1.20) for eyes, 1.08 (95% C.I. = 1.05–1.10) for skin, and 1.11 (95% CI = 1.08–1.14) for GI tract, after controlling for covariates. All risks increased with ambient temperature. V-shaped trends were found between age and eye diseases, and between age and GI tract diseases. In contrast, the risk of skin diseases increased with age. In conclusion, more diseases of eyes, skin and GI tract could be diagnosed after the flood.
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Affiliation(s)
- Ling-Ya Huang
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Chun Wang
- Department of Bioenvironmental Engineering, Chung Yuan Christian University College of Engineering, Chung Li, Taiwan
| | - Chin-Ching Wu
- Department of Public Health, China Medical University College of Public Health, Taichung, Taiwan
| | - Yi-Chun Chen
- Department of Health Management, I-Shou University, Kaohsiung, Taiwan
- Bachelor’s Degree Program for Indigenous Peoples in Long-term Care, I-Shou University, Kaohsiung, Taiwan
- * E-mail: ; (YLH)
| | - Yu-Li Huang
- Department of Safety, Health and Environmental Engineering, National Kaohsiung First University of Science and Technology, Kaohsiung, Taiwan
- * E-mail: ; (YLH)
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Shen TC, Lin CL, Wei CC, Chen CH, Tu CY, Hsia TC, Shih CM, Hsu WH, Sung FC, Kao CH. Bidirectional Association between Asthma and Irritable Bowel Syndrome: Two Population-Based Retrospective Cohort Studies. PLoS One 2016; 11:e0153911. [PMID: 27093172 PMCID: PMC4836663 DOI: 10.1371/journal.pone.0153911] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 04/06/2016] [Indexed: 12/13/2022] Open
Abstract
Background There is a demonstrated association between asthma and irritable bowel syndrome (IBS). In this study, we examined the bidirectional association between asthma and IBS using a nationwide database. Methods We conducted two retrospective cohort studies using data obtained from the National Health Insurance of Taiwan. Study 1 included 29,648 asthma patients newly diagnosed between 2000 and 2010. Study 2 included 29,875 IBS patient newly diagnosed between 2000 and 2010. For each study, four subjects without asthma and IBS were selected, respectively, frequency-matched by sex, age, and the diagnosis date. All four cohorts were followed up until the end of 2011 to estimate incident IBS for Study 1 and incident asthma for study 2. Adjusted hazard ratios (aHRs) were estimated using the Cox proportional hazards model after controlling for sex, age and comorbidities. Results The incidence of IBS was 1.89 times higher in the asthma cohort than in the comparison cohort (8.26 vs. 4.36 per 1,000 person-years), with an aHR of 1.57 [95% confidence interval (CI) = 1.47–1.68]. The aHRs remained significant in all subgroups measured by sex, age and the presence of comorbidities. In contrast, the incidence of asthma was 1.76 times higher in the IBS cohort than the comparison cohort (7.09 vs. 4.03 per 1,000 person-years), with an aHR of 1.54 (95% CI = 1.44−1.64). Similarly, aHRs remained significant in all subgroups measured by sex, age and the presence of comorbidities. Conclusion The present study suggests a bidirectional association between asthma and IBS. Atopy could be a shared pathophysiology underlying this association, deserving a further investigation.
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Affiliation(s)
- Te-Chun Shen
- Graduate Institute of Clinical Medicine Science, College of Medicine, China Medical University, Taichung, Taiwan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chang-Ching Wei
- Children’s Hospital, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Chia-Hung Chen
- Graduate Institute of Clinical Medicine Science, College of Medicine, China Medical University, Taichung, Taiwan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Yen Tu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Te-Chun Hsia
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chuen-Ming Shih
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Wu-Huei Hsu
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
- Faculty of Public Health, Mahidol University, Bangkok, Thailand
- * E-mail: (CHK); (FCS)
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medicine Science, College of Medicine, China Medical University, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
- * E-mail: (CHK); (FCS)
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