Being Underweight Increases the Risk of Non-Cystic Fibrosis Bronchiectasis in the Young Population: A Nationwide Population-Based Study

Although body mass index (BMI) is a potential risk factor for bronchiectasis in young adults, the association between BMI and incident bronchiectasis has not been well elucidated. This study included 6,329,838 individuals aged 20–40 years from the Korean National Health Insurance Service database 2009–2012 who were followed up until the date of the diagnosis of bronchiectasis, death, or 31 December 2018. We evaluated the incidence and risk of bronchiectasis according to the BMI category. The incidence rate of bronchiectasis increased as BMI decreased in a dose-dependent manner (p for trend <0.01). In multivariable Cox regression analysis, being underweight was an independent risk factor for the development of bronchiectasis, with a hazard ratio of 1.24 (95% confidence interval, 1.19–1.30) compared to being normal weight. In subgroup analysis, the effect of being underweight on the development of bronchiectasis was more evident in males and older individuals (30–40 years) than females and younger individuals (20–29 years), respectively (p for interaction <0.01 for both). These results remained significant in subgroup analysis in which subjects with comorbidities related to being underweight were excluded. Being underweight may be a novel risk factor for the development of bronchiectasis in young adults.

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Headache as a risk factor for dementia: A prospective population-based study

Cephalalgia ◽

10.1177/0333102413513181 ◽

2013 ◽

Vol 34 (5) ◽

pp. 327-335 ◽

Cited By ~ 22

Author(s):

Knut Hagen ◽

Eystein Stordal ◽

Mattias Linde ◽

Timothy J Steiner ◽

John-Anker Zwart ◽

...

Keyword(s):

Risk Factor ◽

Cohort Study ◽

Cox Regression ◽

Subsequent Development ◽

Population Based ◽

Health Study ◽

Cox Regression Analysis ◽

Hazard Ratios ◽

Increased Risk

Background Headache has not been established as a risk factor for dementia. The aim of this study was to determine whether any headache was associated with subsequent development of vascular dementia (VaD), Alzheimer’s disease (AD) or other types of dementia. Methods This prospective population-based cohort study used baseline data from the Nord-Trøndelag Health Study (HUNT 2) performed during 1995–1997 and, from the same Norwegian county, a register of cases diagnosed with dementia during 1997–2010. Participants aged ≥20 years who responded to headache questions in HUNT 2 were categorized (headache free; with any headache; with migraine; with nonmigrainous headache). Hazard ratios (HRs) for later inclusion in the dementia register were estimated using Cox regression analysis. Results Of 51,383 participants providing headache data in HUNT 2, 378 appeared in the dementia register during the follow-up period. Compared to those who were headache free, participants with any headache had increased risk of VaD ( n = 63) (multivariate-adjusted HR = 2.3, 95% CI 1.4–3.8, p = 0.002) and of mixed dementia (VaD and AD ( n = 52)) (adjusted HR = 2.0, 95% CI 1.1–3.5, p = 0.018). There was no association between any headache and later development of AD ( n = 180). Conclusion In this prospective population-based cohort study, any headache was a risk factor for development of VaD.

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Clinical Efficacy of Ruxolitinib in Patients with Myelofibrosis: A Nationwide Population-Based Study in Korea

Journal of Clinical Medicine ◽

10.3390/jcm10204774 ◽

2021 ◽

Vol 10 (20) ◽

pp. 4774

Author(s):

Byung-Hyun Lee ◽

Hyemi Moon ◽

Jae-Eun Chae ◽

Ka-Won Kang ◽

Byung-Soo Kim ◽

...

Keyword(s):

Propensity Scores ◽

Cox Regression ◽

Multivariable Analysis ◽

Previous History ◽

Population Based ◽

Population Based Study ◽

Cox Regression Analysis ◽

History Of ◽

Korean National Health Insurance ◽

Insurance Database

Previous studies have reported the survival benefit after ruxolitinib treatment in patients with myelofibrosis (MF). However, population-based data of its efficacy are limited. We analyzed the effects of ruxolitinib in MF patients with data from the Korean National Health Insurance Database. In total, 1199 patients diagnosed with MF from January 2011 to December 2017 were identified, of which 731 were included in this study. Patients who received ruxolitinib (n = 224) were matched with those who did not receive the drug (n = 507) using the 1:1 greedy algorithm. Propensity scores were formulated using five variables: age, sex, previous history of arterial/venous thrombosis, and red blood cell (RBC) or platelet (PLT) transfusion dependence at the time of diagnosis. Cox regression analysis for overall survival (OS) revealed that ruxolitinib treatment (hazard ratio (HR), 0.67; p = 0.017) was significantly related to superior survival. In the multivariable analysis for OS, older age (HR, 1.07; p < 0.001), male sex (HR, 1.94; p = 0.021), and RBC (HR, 3.72; p < 0.001) or PLT (HR, 9.58; p = 0.001) transfusion dependence were significantly associated with poor survival, although type of MF did not significantly affect survival. Considering evidence supporting these results remains weak, further studies on the efficacy of ruxolitinib in other populations are needed.

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Low Alanine Aminotransferase as a Risk Factor for Chronic Obstructive Pulmonary Disease in Males: A Retrospective Population-based Cohort Study

10.21203/rs.3.rs-206981/v1 ◽

2021 ◽

Author(s):

Yong Jun Choi ◽

Do Sun Kwon ◽

Taehee Kim ◽

Jae Hwa Cho ◽

Hyung Jung Kim ◽

...

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Risk Factor ◽

Pulmonary Disease ◽

Alanine Aminotransferase ◽

Cox Regression ◽

Significant Risk ◽

Population Based ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Cox Regression Analysis

Abstract Alanine aminotransferase (ALT) levels reflect skeletal muscle volume and general performance scales, which are significantly associated with chronic obstructive pulmonary disease (COPD) development and prognosis. The aim of this study was to investigate the ALT levels as a risk factor for COPD development. This 13-year population-based retrospective cohort observational study included patients registered in the health check-up cohort database of the Korean National Health Insurance Service. A total of 422,452 participants were analysed. We classified groups according to the baseline ALT levels (groups 1–5: ALT (IU/L) < 10; 10–19; 20–29; 30–39; and ≥ 40, respectively). The incidence of COPD was highest in group 1, decreasing as the group number increased among in males. Cox regression analysis in males revealed that lower ALT level was a significant risk factor for COPD development (univariable, HR: 0.992, 95% CI: 0.991–0.994; multivariable, HR: 0.998, 95% CI: 0.996–0.999). In addition, in the low ALT level groups (< 40 IU/L), COPD was more likely to be developed (univariable, HR: 1.341, 95% CI: 1.263–1.424; multivariable, HR: 1.097, 95% CI: 1.030–1.168). Our findings suggest that males with low ALT levels should be carefully monitored for COPD development.

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Association of Hospitalised Infection With Socioeconomic Status in Patients With Rheumatoid Arthritis Receiving Biologics or Tofacitinib: A Population-Based Cohort Study

Frontiers in Medicine ◽

10.3389/fmed.2021.696167 ◽

2021 ◽

Vol 8 ◽

Author(s):

Hsin-Hua Chen ◽

Ching-Heng Lin ◽

Chen-Yu Wang ◽

Wen-Cheng Chao

Keyword(s):

Rheumatoid Arthritis ◽

Socioeconomic Status ◽

Risk Factor ◽

Cox Regression ◽

Population Based ◽

Research Database ◽

Inverse Association ◽

Cox Regression Analysis ◽

High Income Category ◽

The Impact

Objectives: Use of biologics or targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) is associated with infection in patients with rheumatoid arthritis (RA). Socioeconomic status is substantial in infectious diseases; however, the impact of socioeconomic status on risk for infection in patients with RA receiving b/tsDMARD remains unclear.Methods: We used the 2003–2017 Taiwanese National Health Insurance Research Database to identify patients with RA receiving b/tsDMARDs. A Cox regression analysis was used to estimate the associations of covariates with the risk of hospitalised infection shown as hazard ratios (HRs) with 95% confidence interval (CIs).Results: We identified 7,647 RA patients who started their first bDMARD/tsDMARD treatment. Log-rank analyses demonstrated the association between age (p < 0.001), urbanisation (p = 0.001), the insured amount (p = 0.021), and the hospitalisation. Cox proportional regression analyses showed that age was independently associated with hospitalised infection in a dose–response manner, whereas a high-income category had an inverse association (HR 0.48, 95% CI 0.23–0.96). Hospitalisation for infection within 5 years was a strong risk factor (HR 5.63, 95% CI 1.91–16.62), and living in a rural area tended to be a risk factor (HR 1.76, 95% CI 0.98–3.14) for incident hospitalised infection.Conclusions: This study showed the crucial impacts of age, socioeconomic status, and history of infection on hospitalised infection in patients with RA receiving b/tsDMARDs. These findings highlight the largely ignored role of socioeconomic status in risk stratification among patients receiving b/tsDMARDs for RA.

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The Importance of Metabolic Syndrome Status for the Risk of Non-Viral Hepatocellular Carcinoma: A Nationwide Population-Based Study

10.21203/rs.3.rs-1072970/v1 ◽

2021 ◽

Author(s):

Yuri Cho ◽

Eun Ju Cho ◽

Jeong-Ju Yoo ◽

Young Chang ◽

Goh Eun Chung ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Metabolic Syndrome ◽

Cox Regression ◽

Positive Association ◽

Population Based ◽

Cox Regression Analysis ◽

Hazard Ratios ◽

Development Data ◽

Baseline Status ◽

Korean National Health Insurance

Abstract The positive association between metabolic syndrome (MetS) and hepatocellular carcinoma (HCC) has been suggested. However, no studies have yet looked at how the risk of developing HCC varies with changes in MetS status. Therefore, we aimed to investigate the association between changes in MetS and subsequent HCC development. Data were obtained from the Korean National Health Insurance Service. 5,975,308 individuals who participated in health screenings both in 2009–2010 and 2011–2012 were included. Subjects were divided into four groups according to change in MetS status during the two-year interval screening (from 2009 to 2011): sustained non-MetS, transition to MetS, transition to non-MetS, and sustained MetS. Cox regression analysis was used to examine the hazard ratios of HCC. During a median of 7.3 years follow-up, 25,880 incident HCCs were identified. Compared to the sustained non-MetS group, age, sex, smoking, alcohol, regular exercise, and body mass index-adjusted hazard ratios (95% confidence interval) for HCC development were 1.01 (0.97–1.05) for the transition to MetS group; 1.05 (1.003–1.09) for the transition to non-Met group; and 1.07 (1.03–1.10) for the sustained MetS group. Stratified analyses according to age, sex, smoking, alcohol intake, exercise, diabetes mellitus, hypertension, dyslipidemia, and chronic kidney disease showed similar results. A significantly increased HCC risk was observed in the sustained MetS and transition to non-MetS groups. The baseline status of MetS was associated with the risk of HCC development. Strategies to improve MetS, especially targeting insulin resistance might prevent HCC development.

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P5665The independent effect of insulin resistance on incidence of atrial fibrillation in non-diabetics

European Heart Journal ◽

10.1093/eurheartj/ehz746.0608 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

J K Park ◽

J H Park ◽

Y G Lee ◽

J H Shin ◽

Y H Lim ◽

...

Keyword(s):

Atrial Fibrillation ◽

Insulin Resistance ◽

Subgroup Analysis ◽

Cox Regression ◽

Population Based ◽

Independent Effect ◽

Model Assessment ◽

Cox Regression Analysis ◽

Patients With Diabetes

Abstract Purpose Patients with diabetes mellitus have an elevated risk of atrial fibrillation (AF). However, whether insulin resistance may elevate risk of AF incidence in non-diabetic is inconsistent. The aim of our study was to verify the association between insulin resistance and incidence of AF in non-diabetics. Methods We evaluated population-based cohorts embedded in the Korean Genome Epidemiology Study. Insulin resistance was expressed as Homeostasis Model Assessment for Insulin resistance (HOMA-IR). Baseline data including HOMA-IR and electrocardiography (ECG) were obtained at 2001. Subsequent biennial ECG was performed for identification of AF until 2016. Results Among the 8220 participants (46.8% male; median age 49 years), 25 participants had AF (0.3%) at baseline and 101 participants developed AF (1.2%) during follow up of 12 years. In multivariate Cox regression analysis, high HOMA-IR (≥1.4) was significantly associated with incident AF compared with low HOMA-IR (<1.40) (adjusted hazard ratio [HR] 1.9, 95% confidence interval [CI] 1.3–3.0). In subgroup analysis, these association was consistent regardless of obesity (BMI<25; adjust HR 1.8, 95% CI 1.1–3.0, BMI≥25; adjust HR 2.3, 95% CI 1.3–4.0) Subgroup analysis Conclusion Based on prospective cohort study, insulin resistance (HOMA-IR) was associated with AF independently of obesity in non-diabetics.

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Abstract MP05: N Terminal Pro B Type Natriuretic Peptide as a Stroke Risk Factor in the European Population: Results From the Biomarcare Consortium

Circulation ◽

10.1161/circ.137.suppl_1.mp05 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Augusto Filippo Di Castelnuovo ◽

Giovanni Veronesi ◽

Simona Costanzo ◽

Marialaura Bonaccio ◽

Tanja Zeller ◽

...

Keyword(s):

Cardiovascular Disease ◽

Risk Factor ◽

Natriuretic Peptide ◽

Stroke Risk ◽

Cox Regression ◽

Hdl Cholesterol ◽

Population Based ◽

European Population ◽

Stroke Risk Factor ◽

Cox Regression Analysis

Introduction: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a risk factor for atrial fibrillation and a marker of cardiac function used in detection of heart failure. Few studies evaluated the role of NT-proBNP as risk factor for stroke. Hypothesis: Given the link between cardiac dysfunction and stroke, NT-proBNP is a candidate marker of stroke risk. Our aim was to evaluate the association of NT-proBNP with stroke outcomes and to determine the predictive value beyond a panel of established risk factors for stroke. Methods: Based on the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE)-project we analysed data of 43,815 participants (48.3% men; mean age 52 yr) free of cardiovascular disease from 6 prospective population-based cohorts across Europe with a maximum follow-up of 22 years. All NT-proBNP measurements were performed on frozen samples in the central BiomarCaRE laboratory. The endpoints considered were validated fatal and non-fatal stroke. Results: We observed 565 stroke events (78 fatal) in men and 290 (54) in women. Growing quartiles of NT-proBNP were associated with increasing risk of stroke (Table; multivariable cox regression analysis adjusted for the base model: age, centre, smoking, BMI, diabetes, hypertension medication, systolic and diastolic blood pressure, total and HDL cholesterol), both in men (p for trend <0.0001) and in women (P<0.0001). Examining C-statistics for prediction of stroke we could observe only very small changes after the addition of NT-proBNP to the base model (delta AUC=0.0053 and 0.0048 in men and women, respectively). Conclusions: In European individuals free of cardiovascular disease, levels of NT-proBNP in the top quartile (>87.7 pg/mL) are associated with a doubled risk of stroke. However, the addition of NT-proBNP to variables of established risk score poorly improves prediction of stroke disease.

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Does Hospitalization Predict the Disease Course in Ulcerative Colitis? Prevalence and Predictors of Hospitalization and Re- Hospitalization in Ulcerative Colitis in a Population-based Inception Cohort (2000-2012)

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.243.pag ◽

2015 ◽

Vol 24 (3) ◽

pp. 287-292 ◽

Cited By ~ 5

Author(s):

Petra A. Golovics ◽

Laszlo Lakatos ◽

Michael D. Mandel ◽

Barbara D. Lovasz ◽

Zsuzsanna Vegh ◽

...

Keyword(s):

Ulcerative Colitis ◽

Cox Regression ◽

Diagnostic Procedures ◽

Population Based ◽

Disease Course ◽

Inception Cohort ◽

Disease Extent ◽

Cox Regression Analysis ◽

Hospitalization Rates

Background & Aims: Limited data are available on the hospitalization rates in population-based studies. Since this is a very important outcome measure, the aim of this study was to analyze prospectively if early hospitalization is associated with the later disease course as well as to determine the prevalence and predictors of hospitalization and re-hospitalization in the population-based ulcerative colitis (UC) inception cohort in the Veszprem province database between 2000 and 2012. Methods: Data of 347 incident UC patients diagnosed between January 1, 2000 and December 31, 2010 were analyzed (M/F: 200/147, median age at diagnosis: 36, IQR: 26-50 years, follow-up duration: 7, IQR 4-10 years). Both in- and outpatient records were collected and comprehensively reviewed. Results: Probabilities of first UC-related hospitalization were 28.6%, 53.7% and 66.2% and of first re-hospitalization were 23.7%, 55.8% and 74.6% after 1-, 5- and 10- years of follow-up, respectively. Main UC-related causes for first hospitalization were diagnostic procedures (26.7%), disease activity (22.4%) or UC-related surgery (4.8%), but a significant percentage was unrelated to IBD (44.8%). In Kaplan-Meier and Cox-regression analysis disease extent at diagnosis (HR extensive: 1.79, p=0.02) or at last follow-up (HR: 1.56, p=0.001), need for steroids (HR: 1.98, p<0.001), azathioprine (HR: 1.55, p=0.038) and anti-TNF (HR: 2.28, p<0.001) were associated with the risk of UC-related hospitalization. Early hospitalization was not associated with a specific disease phenotype or outcome; however, 46.2% of all colectomies were performed in the year of diagnosis. Conclusion: Hospitalization and re-hospitalization rates were relatively high in this population-based UC cohort. Early hospitalization was not predictive for the later disease course.

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Effects of marital status on overall and cancer-specific survival in laryngeal cancer patients: a population-based study

Scientific Reports ◽

10.1038/s41598-020-80698-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Zhao Ding ◽

Deshun Yu ◽

Hefeng Li ◽

Yueming Ding

Keyword(s):

Marital Status ◽

Cancer Patients ◽

Laryngeal Cancer ◽

Cox Regression ◽

Group Analysis ◽

Population Based ◽

Cancer Specific Survival ◽

Cox Regression Analysis ◽

Prognostic Effect ◽

The Difference

AbstractMarital status has long been recognized as an important prognostic factor for many cancers, however its’ prognostic effect for patients with laryngeal cancer has not been fully examined. We retrospectively analyzed 8834 laryngeal cancer patients in the Surveillance Epidemiology and End Results database from 2004 to 2010. Patients were divided into four groups: married, widowed, single, and divorced/separated. The difference in overall survival (OS) and cancer-specific survival (CSS) of the various marital subgroups were calculated using the Kaplan–Meier curve. Multivariate Cox regression analysis screened for independent prognostic factors. Propensity score matching (PSM) was also conducted to minimize selection bias. We included 8834 eligible patients (4817 married, 894 widowed, 1732 single and 1391 divorced/separated) with laryngeal cancer. The 5-year OS and CSS of married, widowed, single, and separated/divorced patients were examined. Univariate and multivariate analyses found marital status to be an independent predictor of survival. Subgroup survival analysis showed that the OS and CSS rates in widowed patients were always the lowest in the various American Joint Committee on Cancer stages, irrespective of sex. Widowed patients demonstrated worse OS and CSS in the 1:1 matched group analysis. Among patients with laryngeal cancer, widowed patients represented the highest-risk group, with the lowest OS and CSS.

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Prognostic Association between Common Laboratory Tests and Overall Survival in Elderly Men with De Novo Metastatic Castration Sensitive Prostate Cancer: A Population-Based Study in Canada

Cancers ◽

10.3390/cancers13112844 ◽

2021 ◽

Vol 13 (11) ◽

pp. 2844

Author(s):

Christopher J. D. Wallis ◽

Bobby Shayegan ◽

Scott C. Morgan ◽

Robert J. Hamilton ◽

Ilias Cagiannos ◽

...

Keyword(s):

Prostate Cancer ◽

Overall Survival ◽

Clinical Decision Making ◽

Cox Regression ◽

De Novo ◽

Population Based ◽

Population Based Study ◽

Cox Regression Analysis ◽

Lymphocyte Ratio ◽

Laboratory Markers

De novo cases of metastatic prostate cancer (mCSPC) are associated with poorer prognosis. To assist in clinical decision-making, we aimed to determine the prognostic utility of commonly available laboratory-based markers with overall survival (OS). In a retrospective population-based study, a cohort of 3556 men aged ≥66 years diagnosed with de novo mCSPC between 2014 and 2019 was identified in Ontario (Canada) administrative database. OS was assessed by using the Kaplan–Meier method. Multivariate Cox regression analysis was performed to evaluate the association between laboratory markers and OS adjusting for patient and disease characteristics. Laboratory markers that were assessed include neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), albumin, hemoglobin, serum testosterone and PSA kinetics. Among the 3556 older men with de novo mCSPC, their median age was 77 years (IQR: 71–83). The median survival was 18 months (IQR: 10–31). In multivariate analysis, a statistically significant association with OS was observed with all the markers (NLR, PLR, albumin, hemoglobin, PSA decrease, reaching PSA nadir and a 50% PSA decline), except for testosterone levels. Our findings support the use of markers of systemic inflammation (NLR, PLR and albumin), hemoglobin and PSA metrics as prognostic indicators for OS in de novo mCSPC.

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