scholarly journals Prevalence of autoimmune diseases in in-patients with schizophrenia: nationwide population-based study

2012 ◽  
Vol 200 (5) ◽  
pp. 374-380 ◽  
Author(s):  
Shaw-Ji Chen ◽  
Yu-Lin Chao ◽  
Chuan-Yu Chen ◽  
Chia-Ming Chang ◽  
Erin Chia-Hsuan Wu ◽  
...  

BackgroundThe association between autoimmune diseases and schizophrenia has rarely been systematically investigated.AimsTo investigate the association between schizophrenia and a variety of autoimmune diseases and to explore possible gender variation in any such association.MethodTaiwan's National Health Insurance Research Database was used to identify 10 811 hospital in-patients with schizophrenia and 108 110 age-matched controls. Univariate and multiple logistic regression analyses were performed, separately, to evaluate the association between autoimmune diseases and schizophrenia. We applied the false discovery rate to correct for multiple testing.ResultsWhen compared with the control group, the in-patients with schizophrenia had an increased risk of Graves' disease (odds ratio (OR) = 1.32, 95% CI 1.04–1.67), psoriasis (OR = 1.48, 95% CI 1.07–2.04), pernicious anaemia (OR = 1.71, 95% CI 1.04–2.80), celiac disease (OR = 2.43, 95% CI 1.12–5.27) and hypersensitivity vasculitis (OR = 5.00, 95% CI 1.64–15.26), whereas a reverse association with rheumatoid arthritis (OR = 0.52, 95% CI 0.35–0.76) was also observed. Gender-specific variation was found for Sjögren syndrome, hereditary haemolytic anaemia, myasthenia gravis, polymyalgia rheumatica and dermatomyositis.ConclusionsSchizophrenia was associated with a greater variety of autoimmune diseases than was anticipated. Further investigation is needed to gain a better understanding of the aetiology of schizophrenia and autoimmune diseases.

2018 ◽  
Vol 66 (7) ◽  
pp. 1070-1082 ◽  
Author(s):  
Shan-Yueh Chang ◽  
Wu-Chien Chien ◽  
Chi-Hsiang Chung ◽  
Hsin-An Chang ◽  
Yu-Chen Kao ◽  
...  

This study aimed to investigate the association between charcoal-burning suicide attempts and the risk of developing dementia. A nationwide, matched cohort, population-based study enrolled a total of 4103 patients with newly diagnosed charcoal-burning suicide attempts, between 2000 and 2010, which were selected from the National Health Insurance Research Database of Taiwan, along with 12,309 controls matched for sex and age. After adjusting for confounding factors, Fine and Gray’s competing risk analysis was used to compare the risk of developing dementia during the 10-year follow-up period. Of the enrolled patients (n=16,412), dementia developed in 303 (1.85%), including 2.56% in the study group (105 in 4103) and 1.61% (198 in 12,309) in the control group. The Fine and Gray’s survival analysis revealed that the patients with charcoal-burning suicide attempts were likely to develop dementia, with a crude HR of 5.170 (95% CI 4.022 to 6.644, p<0.001). After adjusting for age, sex, comorbidity, geographic area and urbanization level of residence, and monthly insured premium, the adjusted HR was 4.220 (95% CI 3.188 to 5.586, p<0.001). Suicide attempts were associated with an increased risk of degenerative dementia in this study. Patients with charcoal-burning suicide attempts had a fourfold risk of dementia than the control group.


Cephalalgia ◽  
2012 ◽  
Vol 33 (2) ◽  
pp. 80-86 ◽  
Author(s):  
Chia-Huei Chu ◽  
Chia-Jen Liu ◽  
Jong-Ling Fuh ◽  
An-Suey Shiao ◽  
Tzeng-Ji Chen ◽  
...  

Background The pathophysiology of idiopathic sudden sensorineural hearing loss (SSNHL) is poorly understood. Few case reports have proposed a possible link between migraine and SSNHL. Objectives This study aimed to explore the risk of idiopathic SSNHL in patients with migraine in a nationwide, population-based cohort study. Methods We identified patients with migraine from the Taiwan National Health Insurance Research Database (NHIRD) between 2000 and 2009. Each migraine patient was matched with four randomly selected subjects without migraine for age, sex, and comorbidities. Both cohorts were followed up until the end of 2009. We compared the incidence rates of SSNHL in the two cohorts and identified the risk factors. Results A total of 10,280 migraine patients and 41,120 matched controls were enrolled with a median follow-up of five years. The migraine cohort had a greater risk of developing SSNHL than the matched cohort (81.6 vs. 45.7 per 100,000 person-years, incidence rate ratio (IRR) = 1.8; 95% confidence interval (CI) 1.22–2.61, p = 0.002). The Cox proportional hazards analysis revealed that among migraine subjects, comorbidity with hypertension was associated with a trend of developing SSNHL (hazard ratio (HR) = 1.92, 95% CI 0.97–3.79, p = 0.06). Conclusions This population-based study demonstrates that migraine is associated with an increased risk of idiopathic SSNHL, which, however, is a rare condition.


2021 ◽  
Vol 9 ◽  
Author(s):  
Hsiao-Wen Chu ◽  
Chien-Heng Lin ◽  
Ming-Chih Lin ◽  
Ya-Chi Hsu

Introduction: Genetic susceptibility and immune dysregulation play important roles in the pathogenesis of Kawasaki disease (KD). However, it is still unclear whether KD causes immune disorder later in life or whether inherited susceptibility to immune disorders causes KD. The aim of this study was to elucidate whether inherited immune disease properties from mothers increase the risk of KD from a population-based perspective.Method: Taiwan's National Health Insurance Research Database was the main data source in this study. Parents and children were linked using the Taiwan Maternal and Child Health Database. Patients diagnosed with KD and younger than 18 years from 2004 to 2015 were enrolled as the study population. The control group was randomly selected from individuals without the diagnosis of KD matched by age, index year, sex, and urbanization level at a ratio of 1 to 10. The prevalence of maternal autoimmune and allergic diseases was compared between groups.Results: In total, 7,178 children were found to have been diagnosed with Kawasaki disease. Then 71,780 children matched by index year, gender, and urbanization were randomly selected to serve as the control group. Children born from mothers with asthma and allergic rhinitis had a higher risk of developing KD. Children of mothers with an autoimmune disorder had a significantly increased tendency to develop KD. Maternal numbers of autoimmune disorders showed a dose-dependent relationship with KD incidence.Conclusion: This is the first population-based study to investigate maternal immune diseases and the risk of KD in their children. Children of mothers with immune disorders tend to have a higher risk of KD.


Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1599-1599
Author(s):  
Yi-Chang Liu ◽  
Yi-Hsin Yang ◽  
Hui-Hua Hsiao ◽  
Ming-Yu Yang ◽  
Wen-Chi Yang ◽  
...  

Abstract Abstract 1599 Infectious agents have been shown to contribute to the development of certain lymphoid malignancies. The different distribution of lymphoid malignancies in Asian and Western populations suggests possibly different etiologies in lymphomagenesis in Asian populations. Herpes zoster infection, commonly seen in immunocompromised persons, has been reported to be associated with lymphoid malignancies, but the results are controversial and large-scale studies from Asian populations are lacking. In this study we performed a population-based matched-controlled prospective study on Taiwanese patients using the National Health Insurance Research Database which provided 1,000,000 random subjects from 1996 to 2007. We defined herpes zoster by compatible ICD-9-CM (International Classification of Disease, 9th Revision, Clinical Modification) codes of herpes zoster (053.0–053.9) on at least one service claim for inpatient or outpatient care. The cases were identified by compatible ICD-9-CM codes including Hodgkin's disease (code 201.0–201.9), non-Hodgkin's lymphoma (code 200.0–200.8, 202.0–202.9), multiple myeloma (code 203.0–203.1), and lymphoid leukemia (code 204.0–204.9). Patients who had been diagnosed with any lymphoid malignancies or any cancers (code 140.0–199.1) before herpes zoster, and who had been diagnosed with other viral infections (code 045.0–052.9, 054.0–066.9, 071–079.9) and HIV infection (code 042) before the diagnosis of lymphoid malignancies were excluded. We randomly selected 169,983 control subjects (4 for every herpes zoster patient), matched with the study group in terms of age, sex and the year and month of index visit. Of 42,498 patients with herpes zoster prior to the diagnosis of any malignancies, the mean age was 48.92 years (± 20.67 years), with a mild female predominance (52.4%). Patients with herpes zoster infection had a lower monthly income (p < 0.001), and tended to live in urban areas (p < 0.001). Among the patients with herpes zoster, 2.42% subsequently developed cancer, and 0.11% lymphoid malignancy. Among the controls, 2.26% of the patients subsequently developed cancer, and 0.06% lymphoid malignancy. Patients with herpes zoster had a significantly increased risk of developing any cancers (excluding lymphoid malignancies, crude HR: 1.07, 95% CI: 1.01–1.15), and lymphoid malignancies (crude HR: 1.82, 95% CI: 1.29–2.55) compared with the control group. After adjusting for Charlson disease index, income category, and residence using Cox proportional hazard regressions, patients with herpes zoster had an increased risk of developing lymphoid malignancies (adjusted HR: 1.72, 95% CI: 1.22–2.42, p = 0.0019), but did not have an increased risk of developing non-lymphoid malignancies (adjusted HR: 1.00, 95% CI: 0.93–1.07, p = 0.895). These data suggest that preceding herpes zoster infection is an independent risk factor for the subsequent development of lymphoid malignancies in Taiwanese subjects. Further studies are warranted to explore the role of herpes zoster in the pathogenesis. Disclosures: No relevant conflicts of interest to declare.


Author(s):  
Chien-Yu Lin ◽  
Kuo-Sen Tseng ◽  
Jui-Ming Liu ◽  
Heng-Chang Chuang ◽  
Chi-Hone Lien ◽  
...  

Both periodontal disease (PD) and inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are important diseases of the alimentary tract. Microbiome and immune-mediated inflammatory processes play important roles in these diseases. An association between PD and IBD may exist. This study investigated the risk of IBD in patients with PD. This study used data from the National Health Insurance Research Database of Taiwan from 1996 to 2013. A total of 27,041 patients with PD were enrolled as a study group, and 108,149 patients without PD were selected as the control group after matching by gender, age, insured region, urbanization, and income with a 1:4 ratio. Cox proportional hazards regression was used to calculate the risk of IBD. Of the 135,190 participants enrolled in this study, 5392 (4%) with newly diagnosed IBD were identified. The overall incidence of subsequent IBD was similar in both groups (3.8% vs. 4%, adjusted hazard ratio (aHR) = 1.01, 95% confidence interval (CI): 0.94–1.08). However, an increased risk of UC in the PD group was found after adjusting confounding factors (aHR: 1.56, 95% CI: 1.13–2.15; p < 0.05). This study demonstrated that patients with PD had approximately one-half higher risk of subsequent UC. Further studies are warranted to elucidate the relationship between PD and UC.


2021 ◽  
Vol 8 ◽  
Author(s):  
Hsin-Hua Chen ◽  
Ching-Heng Lin ◽  
Wen-Cheng Chao

Objective: To investigate the association between anti-phospholipid syndrome (APS) and the risk of newly diagnosed systemic lupus erythematosus (SLE).Methods: We used 2003–2013 data derived from Taiwan's National Health Insurance Research Database to conduct this nationwide, population-based. We identified AS patients newly diagnosed between 2005 to 2013 as the study group and applied age-sex matched (1:20) and propensity score-matched (PSM) (1:2) non-SLE individuals as controls. The association between APS and risk of incident SLE was determined by calculating hazard ratios (HRs) with 95% confidence intervals (CIs) using Cox proportional hazard regression analysis.Results: We identified 1,245 patients with APS as well as 24,900 age- and sex-matched non-APS controls and 727 APS patients as well as 1,454 PSM non-APS controls. We found that the risk for incident SLE in the APS group was 80.70 times higher than the non-APS group, and the association remained robust after PSM (HR, 28.55; 95% CI, 11.49–70.91). The increased risk for SLE in patients with APS mainly existed within 5 years after the diagnosis of APS. The sensitivity analyses found that the risk for SLE in patients with APS was consistent excluding patients with ITP/AIHA and using distinct definitions of SLE.Conclusion: The present population-based study revealed a robust association between SLE risk and recent APS and highlights the need for vigilance of SLE-associated symptoms in patients who had been diagnosed with APS.


QJM ◽  
2021 ◽  
Author(s):  
Wei-Hsin Hung ◽  
Jie Sung ◽  
Wen-Yee Chen ◽  
Lu-Ting Chiu ◽  
Hei-Tung Yip ◽  
...  

Abstract Background and Purpose Stroke is a rare complication of snakebites, but may lead to serious sequelae. We aimed to explore the relationship between venomous snakebite and the risk for acute stroke, in a nationwide population-based cohort study. Methods This retrospective cohort study used claims data between January 1, 2000 and December 31, 2012, from the Taiwan National Health Insurance Research Database. The study included data of patients aged 18 years or older with venomous snakebite (N = 535), matched for propensity score with controls without venomous snakebite (N = 2140). The follow-up period was the duration from the initial diagnosis of venomous snakebite and administration of antivenom to the date of an acute stroke, or until December 31, 2013. The competing risk model was used to estimate the hazard ratio (HR) and 95% confidence intervals (CIs) of stroke, ischemic stroke, and hemorrhagic stroke, after adjusting for demographic and other possible stroke risk factors. Result The adjusted HR for the venomous snakebite group compared with the control group was 2.72 for hemorrhagic stroke (95% CI: 1.41, 5.26). Stratified analysis showed that the older age group (&gt;65 years old) had a higher risk of hemorrhagic stroke. A 2.68-fold significant increase in the risk for hemorrhagic stroke was observed following venomous snakebite with antivenom usage (95% CI = 1.46, 26.63). Conclusion Venomous snakebite is associated with an increased risk of hemorrhagic stroke after the use of an antivenom. Further study of the underlying mechanism is warranted.


2020 ◽  
Author(s):  
Peng-Yi Lee ◽  
KS Clifford Chao ◽  
Yu-Ting Wei ◽  
Chin-Nan Chu ◽  
Hao-Che Chuang ◽  
...  

Abstract BackgroundThere are emerging but inconsistent evidences about anti-epileptic drugs (AEDs) as radiosensitizers to improve survival in glioblastoma (GBM) patients. We conducted a population-based study to evaluate the impact of concurrent AED during post-operative chemo-radiotherapy (CCRT) on outcome.Methods1057 GBM patients were identified by National Health Insurance Research Database and Cancer Registry in 2008-2015. Eligible criteria included those receiving surgery, adjuvant RT and temozolomide (TMZ), and without other cancer diagnoses. Survival between patients taking concurrent AED for 14 days or more during CCRT (AED group) and those who did not (non-AED group) were compared, and subgroup analyses for valproic acid (VPA), levetiracetam (LEV), and phenytoin were performed. Multivariate analyses were used to adjust for confounding factors. ResultsThere were 642 patients in the AED group while 415 in the non-AED group. The demographic data was balanced except trend of more patients in the AED group had previous drug history of AEDs. (22.6% vs 18%, p=0.078). Overall, the AED group had significantly increased risk of mortality (HR=1.18, p=0.016). In subgroup analyses, the significant detrimental effect was demonstrated in VPA (HR=1.29, p=0.0002), but not in LEV (HR=1.18, p=0.079) and phenytoin (HR = 0.98, p=0.862). When stratified by sex and age, this detrimental effect was seen in male and patients less than 65 years old in the VPA group.Conclusion:Survival was not improved and even worse in patients with AEDs during CCRT in this nationwide population-based study. Our real-world data did not support prophylactic use of AEDs for GBM.


2014 ◽  
Vol 204 (3) ◽  
pp. 188-193 ◽  
Author(s):  
Pin-Liang Chen ◽  
Chih-Wen Yang ◽  
Yi-Kuan Tseng ◽  
Wei-Zen Sun ◽  
Jane-Ling Wang ◽  
...  

BackgroundThe potential relationship between anaesthesia, surgery and onset of dementia remains elusive.AimsTo determine whether the risk of dementia increases after surgery with anaesthesia, and to evaluate possible associations among age, mode of anaesthesia, type of surgery and risk of dementia.MethodThe study cohort comprised patients aged 50 years and older who were anaesthetised for the first time since 1995 between 1 January 2004 and 31 December 2007, and a control group of randomly selected patients matched for age and gender. Patients were followed until 31 December 2010 to identify the emergence of dementia.ResultsRelative to the control group, patients who underwent anaesthesia and surgery exhibited an increased risk of dementia (hazard ratio = 1.99) and a reduced mean interval to dementia diagnosis. The risk of dementia increased in patients who received intravenous or intramuscular anaesthesia, regional anaesthesia and general anaesthesia.ConclusionsThe results of our nationwide, population-based study suggest that patients who undergo anaesthesia and surgery may be at increased risk of dementia.


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