scholarly journals Cardiovascular disease risk burden in primary Sjögren's syndrome: results of a population-based multicentre cohort study

2015 ◽  
Vol 278 (2) ◽  
pp. 185-192 ◽  
Author(s):  
E. Bartoloni ◽  
C. Baldini ◽  
G. Schillaci ◽  
L. Quartuccio ◽  
R. Priori ◽  
...  
2021 ◽  
Vol 12 ◽  
Author(s):  
Seo Young Sohn ◽  
Gi Hyeon Seo ◽  
Jae Hoon Chung

BackgroundAlthough hypothyroidism is associated with various comorbidities, its relationship with increased all-cause mortality remains controversial. The aim of this nationwide retrospective cohort study was to investigate whether hypothyroid patients treated with levothyroxine had increased mortality compared to controls.MethodsHypothyroid subjects were identified through the Korean National Health Insurance Service Claims database between 2008 and 2017. Hypothyroidism in this study was defined as overt hypothyroidism treated with long-term prescription of levothyroxine (>6 months). After 1:3 age-, sex- and index year-matching, 501,882 patients with newly diagnosed hypothyroidism and 1,505,646 controls without hypothyroidism were included.ResultsDuring a mean follow-up of 6 years, 25,954 (5.2%) hypothyroid patients and 59,105 (3.9%) controls died. Hypothyroidism was significantly associated with increased all-cause mortality (adjusted hazard ratio [HR], 1.14; 95% confidence interval [CI] 1.12–1.16) even with levothyroxine treatment. When stratified by age, sex, and cardiovascular disease risk, independent associations between hypothyroidism and mortality remained significant in all subgroups. The risk of mortality was higher in the < 65 age group (HR: 1.25, 95% CI: 1.22–1.29), men (HR: 1.28, 95% CI: 1.25–1.31), and the high cardiovascular disease risk group (HR: 1.31, 95% CI: 1.29–1.34). The mortality rate of hypothyroid patients was highest within 1 year of treatment and decreased with time.ConclusionThis nationwide, population-based cohort study showed that all-cause mortality was significantly higher in levothyroxine-treated hypothyroid patients than in non-hypothyroid controls. This association remained significant regardless of age, sex, and cardiovascular disease risk.


BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026913 ◽  
Author(s):  
Yon Ho Jee ◽  
Hyoungyoon Chang ◽  
Keum Ji Jung ◽  
Sun Ha Jee

ObjectivesDepression has been reported to be a risk factor of cardiovascular disease in the western world, but the association has not yet been studied among Asian populations. The aim of this study was to investigate whether depression increases the risk of developing atherosclerotic cardiovascular disease (ASCVD) in a large Korean cohort study.DesignPopulation based cohort study.SettingDatabase of National Health Insurance System, Republic of Korea.Participants481 355 Koreans (260 695 men and 220 660 women) aged 40–80 years who had a biennial health check-up between 2002 and 2005.Main outcome measureThe main outcome in this study was the first ASCVD event (hospital admission or death).ResultsDepression increased the risk of developing ASCVD by 41% for men and 48% for women. In men, 3–4 outpatient visits for depression increased the risk of angina pectoris by 2.12 times (95% CI 1.55 to 2.90) and acute myocardial infarction by 2.29 times (95% CI 1.33 to 3.95). Depression was also associated with stroke in men (HR 1.29, 95% CI 1.19 to 1.39) and in women (HR 1.37, 95% CI 1.29 to 1.46). However, no increased risk of ASCVD was found for men who received 10 or more depressive treatments, compared with those without any outpatient visit for depression.ConclusionsIn this cohort, depressed people were at increased risk of ASCVD incidence. Therefore, individuals with depression may need routine monitoring of heart health that may prevent their future CVD risk.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 145.3-145
Author(s):  
K. S. K. MA ◽  
L. T. Wang

Background:Recent studies suggest that air pollution may play a role in autoimmune diseases. However, few of them report the correlation between air pollution and primary Sjögren’s syndrome (pSS).Objectives:We sought to determine whether people exposed to environmental fine particulate of air pollution have a higher risk of developing pSS.Methods:We performed a retrospective population-based cohort study from the National Health Insurance Research Database (NHIRD) of Taiwan’s population, using the international Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) to categorize each disease diagnosis. Air pollution data on Nitric oxide (NO), methane (CH4), and carbon monoxide (CO) were obtained from the Taiwan Air Quality-Monitoring Database (TAQMD), where daily air pollution data from community-based monitoring sites (78 sites since 1993) was available on a real-time basis. We followed up from January 1st, 1998 to the endpoint of SS diagnosis or to December 31, 2011.The daily average air pollutant concentrations were divided into 4 quartile-based groups (Q1-Q4). The incidence rate, hazard ratios (HRs), as well as 95% confidence intervals for pSS, were stratified by the quartiles of air pollutant concentration, and calculated with a Cox proportional regression model. Finally, Ingenuity Systems Pathway Analysis (IPA) was conducted to identify activated pathways among air way epithelial cells exposed to airborne coarse, fine, and ultrafine particles, and parotid gland tissues from pSS patients using Z-score visualization.Results:A total of 200 patients were diagnosed with SS. The mean age of patients with pSS was 53.1 years. The incidence of pSS was 0.11%. With the increase in exposure concentrations of nitrogen dioxide, methane, and carbon monoxide (from Q1 to Q4), the incidence rate for pSS of per 1000 person-years increased from 0.7 to 1.19, from 0.93 to 2.14, and from 0.57 to 1.06, respectively. Moreover, compared with Q1, the adjusted HR in Q4 after adjusting for age, gender, monthly income and urbanization levels increased to 1.86, 2.21 and 2.04, respectively. IPA analyses suggested that the underlying cellular mechanisms involved up-regulation of chronic inflammatory pathways including fibrosis signaling pathway.Conclusion:Exposure to air pollutants, specifically NO, CH4, and CO, was associated with SS development, mostly driven by fibrotic signaling cascades occurred during chronic inflammation.Disclosure of Interests:None declared


BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e014807 ◽  
Author(s):  
Chi-Ching Chang ◽  
Yu-Sheng Chang ◽  
Shu-Hung Wang ◽  
Shyr-Yi Lin ◽  
Yi-Hsuan Chen ◽  
...  

ObjectiveStudies on the risk of acute pancreatitis in patients with primary Sjogren’s syndrome (pSS) are limited. We evaluated the effects of pSS on the risk of acute pancreatitis in a nationwide, population-based cohort in Taiwan.Study designPopulation-based retrospective cohort study.SettingWe studied the claims data of the >97% Taiwan population from 2002 to 2012.ParticipantsWe identified 9468 patients with pSS by using the catastrophic illness registry of the National Health Insurance Database in Taiwan. We also selected 37 872 controls that were randomly frequency matched by age (in 5 year bands), sex and index year from the general population.Primary outcome measureWe analysed the risk of acute pancreatitis by using Cox proportional hazards regression models including sex, age and comorbidities.ResultsFrom 23.74 million people in the cohort, 9468 patients with pSS (87% women, mean age=55.6 years) and 37 872 controls were followed-up for 4.64 and 4.74 years, respectively. A total of 44 cases of acute pancreatitis were identified in the pSS cohort versus 105 cases in the non-pSS cohort. Multivariate Cox regression analysis indicated that the incidence rate of acute pancreatitis was significantly higher in the pSS cohort than in the non-pSS cohort (adjusted HR (aHR) 1.48, 95% CI 1.03 to 2.12). Cyclophosphamide use increased the risk of acute pancreatitis (aHR 5.27, 95% CI 1.16 to 23.86). By contrast, hydroxychloroquine reduced the risk of acute pancreatitis (aHR 0.23, 95% CI 0.09 to 0.55).ConclusionThis nationwide, retrospective cohort study demonstrated that the risk of acute pancreatitis was significantly higher in patients with pSS than in the general population.


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