Abstract Purpose Both atopic diseases (AD) and attention-deficit/hyperactivity disorders (ADHD) are common pediatric disorders that may lead to mental and physical complications. This ...population-based, case-control design is to correlate the risk of ADHD with AD among a pediatric population. Methods By using a Longitudinal Health Insurance Database ranged from 2002 to 2009, 4692 children with ADHD and 18,768 randomly selected controls were enrolled. Odds ratios (OR) of ADHD were calculated for the association with AD. Results The children with ADHD had a higher rate of AD than controls, particularly allergic rhinitis and allergic conjunctivitis. The corresponding ORs were 1.81 (95% confidence interval CI, 1.69–1.93) and 1.69 (95% CI, 1.58–1.81), respectively. Despite the lower prevalence, children with atopic dermatitis and asthma were also at higher risk of ADHD, with ORs of 1.80 (95% CI, 1.58–2.05) and 1.48 (95% CI, 1.24–1.78). Logistic regression analysis estimated ORs showed ADHD risk was higher for those living in urban areas. The risk of ADHD increased with numbers of AD and age. Conclusions Most of the children with ADHD had a strong association with AD, especially allergic rhinitis. Awareness of these comorbidities may help clinicians to provide better comprehensive management and reduce the burden of disease.
Background The association between chronic hepatitis C virus (HCV) infection and end-stage renal disease (ESRD) has been widely debated. Study Design National population-based cohort study. Setting & ...Participants Insurance claims data from the Taiwan National Health Insurance Research Database in 2000-2005. Predictor Chronic HCV infection as defined by the International Classification of Diseases, Ninth Revision, Clinical Modification. Outcomes ESRD as defined by the International Classification of Diseases, Ninth Revision, Clinical Modification. Results We identified 6,291 adults with chronic HCV infection. The control group included 31,455 sex- and age-matched individuals without evidence of chronic hepatitis. The incidence of ESRD was 2.14-fold higher in patients with chronic HCV infection (HR, 1.53; 95% CI, 1.17-2.01; P = 0.002) than in patients without HCV infection. Age stratification analysis showed that patients aged 50-59 years with chronic HCV infection (HR, 7.77; 95% CI, 4.23-14.3; P < 0.001) had the highest risk of developing ESRD relative to patients aged 20-49 years without chronic HCV infection (interaction P < 0.001). Limitations Lack of clinical data. Conclusions Patients with chronic HCV infection are at greater risk of developing ESRD than individuals without chronic HCV infection. In addition, the risk of developing ESRD is highest in younger patients with HCV infection. Early renal screening programs should be initiated for this high-risk group of young individuals with chronic HCV infection.
To assess risks of postpartum hypertension and diabetes mellitus (DM) for women with hypertension during pregnancy (HDP) with and without gestational DM (GDM).
From insurance data of 15- to ...44-year-old women with pregnancy in 2000-2011, we established an HDP/GDM cohort (n=1270), an HDP/non-GDM cohort (n=5077), and a comparison cohort without either disorder (n=12,594), frequency matched by age and year of pregnancy. Postpartum hypertension and DM were assessed before 2012.
The postpartum hypertension incidence increased with age in all cohorts, with overall rates of 13.1, 8.82, and 0.79 per 1000 person-years in the HDP/GDM, HDP/non-GDM, and comparison cohorts, respectively. The adjusted hazard ratios (aHRs) of hypertension were 16.8 (95% CI, 11.8-24.1) for the HDP/GDM cohort and 11.2 (95% CI, 8.19-15.2) for the HDP/non-GDM cohort relative to the comparison cohort. The corresponding incident DM rates were 41.9 and 8.06 vs 2.55 per 1000 person-years in the 3 cohorts, respectively, with aHRs of 16.2 (95% CI, 13.2-19.9) for the HDP/GDM cohort and 3.15 (95% CI, 2.55-3.89) for the HDP/non-GDM cohort relative to the comparison cohort. Incident DM in the HDP/GDM cohort was 44% greater in 15- to 29-year-old women vs 40- to 44-year-old women (49.1 vs 34.2 per 1000 person-years), with aHRs of 39.2 (95% CI, 24.5-62.7) and 5.52 (95% CI, 2.92-10.4), respectively, relative to comparisons of respective age groups.
Subsequent hypertension and DM risks are greater in women with HDP/GDM than in women with HDP only compared with women without these complications. Younger women with HDP/GDM should be particularly cautious.
Abstract Background Cohort study on the association between hypertensive disorders in pregnancy (HDP) and postpartum diabetes is limited. This retrospective cohort study investigated the incidence of ...diabetes mellitus after delivery among women with HDP using claims data of a universal insurance system. Methods We defined the HDP group as women aged 19-40 years with their first HDP in 2003, excluding those with a history of gestational diabetes mellitus, diabetes mellitus, or hypertension before the date of diagnosis with HDP. Women who had normal pregnancy without HDP were randomly chosen as our comparison group, frequency matched with age and index year of the HDP group. Both groups were followed until December 31, 2008 to evaluate the occurrence of diabetes. Results This study consisted of 1139 women with HDP cases and 4527 non-HDP pregnant women. Overall, the subsequent incidence of diabetes mellitus was 5.08-fold higher in the HDP group than in the non-HDP group, with an adjusted hazard ratio of 3.42 (95% confidence interval CI, 2.07-5.64) after controlling for age, occupation, income, and comorbidity. The hazard ratio of developing diabetes increased to 39.5 (95% CI, 13.0-120.6) for women having HDP, hyperlipidemia, and obesity simultaneously. Conclusions Women with HDP have a high risk of subsequent diabetes. HDP women with obesity and hyperlipidemia are at an extremely high risk of diabetes mellitus. Early identification of women with HDP is needed for prevention, particularly those with other comorbidities.
Objectives To investigate the association of blood pressure elevation with body mass index (BMI) and total cholesterol levels in children who screened positive for proteinuria, glucosuria, and/or ...hamaturia. Study design From 1992 to 2000, a mass urine screening program was conducted annually for nearly 3 000 000 students aged 6 to 18 years. Of 99 350 students with positive results on urine tests, further examination found 17 548 students (17.7%) had blood pressure elevation. A case-control analysis was performed with randomly selected subjects with normal blood pressure who were frequency matched by sex and age. Results The adjusted odds ratio for blood pressure elevation in obese students was 3.45 (95% CI, 3.20-3.72), compared with students of normal weight. The odds ratio for blood pressure elevation increased to 6.15 (95% CI, 4.12-9.18) for students with a total cholesterol level ≥250 mg/dL and obesity, compared with students with a total cholesterol level <200 mg/dL and normal weight. Conclusion This study found a high prevalence of elevated blood pressure in children with abnormal urinalysis results, with a strong association with BMI and total choleterol level.
Abstract This study investigated the association between pterygium and skin cancer linking to ultraviolet (UV) radiation using claims data from 1997-2010, obtained from the Taiwan National Health ...Insurance Research Database. The study included 19,701 patients with pterygium and 78,804 sex- and age-frequency-matched comparison subjects. Multivariate Cox regression analyses were performed to assess the relationship between pterygium and risk of skin cancer by the end of 2010. The incidence rates of malignant melanoma (MM) and nonmelanoma skin cancer (NMSC) in two cohorts and adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of the diseases were measured. Results showed that the incidences of MM and NMSC were both higher in the pterygium cohort than in the comparison cohort (5.5 vs 3.2 and 32.3 vs 15.0 per 100,000 person years, respectively). After adjusting for age, sex, UV index, occupation, and the other comorbidities, pterygium remained a significant predictor of NMSC (hazard ratio HR, 1.64; 95% confidence interval CI, 1.11-2.42), but not MM (HR, 1.46; 95% CI, 0.59-3.65). These results suggest that pterygium patients are associated with an increased risk of NMSC, but not significant for MM.
Objective To investigate whether birth weight and paternal education may have independent and interactive effects on the learning achievement of adolescents. Study design We linked birth weights, ...gestational ages (term or preterm) and paternal education of a 4-year birth cohort to the Basic Competence Test (BCT) scores in Mandarin, mathematics and science for junior high school students age 15 to 16 years. The study groups comprised infants with term low birth weight (TLBW; n = 33 507), preterm normal birth weight (PNBW; n =19 905), and preterm low birth weight (PLBW; n = 25 840), as well as randomly selected term infants with normal birth weight (TNBW; n = 83 756). Paternal education levels were categorized. Results Compared with the TNBW adolescents, the TLBW adolescents consistently showed larger deficits in mean scores for Mandarin (β = −2.36), mathematics (β = −2.89), and science (β = −2.11). The corresponding significant deficit scores for the PLBW adolescents were −1.93, −2.80, and −1.92. The deficit scores were very small for the PNBW adolescents. Paternal education was inversely associated with scores of all 3 groups. Lower paternal education level tended to worsen the negative impact of low birth weight on BCT scores. Conclusions Both lower birth weight and lower paternal education exert an independent and interactive effect on adolescent learning achievement.
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