Ching-Heng Lin

Association between a history of periodontitis and the risk of rheumatoid arthritis: a nationwide, population-based, case–control study

Objective To investigate the association between the risk of rheumatoid arthritis (RA) and a history of periodontitis. Methods This nationwide, population-based, case–control study used administrative data to identify 13 779 newly diagnosed patients with RA (age ≥16 years) as the study group and 137 790 non-patients with RA matched for age, sex, and initial diagnosis date (index date) as controls. Using conditional logistic regression analysis after adjustment for potential confounders, including geographical region and a history of diabetes and Sjögrens syndrome, ORs with 95% CI were calculated to quantify the association between RA and periodontitis. To evaluate the effects of periodontitis severity and the lag time since the last periodontitis visit on RA development, ORs were calculated for subgroups of patients with periodontitis according to the number of visits, cumulative cost, periodontal surgery and time interval between the last periodontitis-related visit and the index date. Results An association was found between a history of periodontitis and newly diagnosed RA (OR=1.16; 95% CI 1.13 to 1.21). The strength of this association remained statistically significant after adjustment for potential confounders (OR=1.16; 95% CI 1.12 to 1.20), and after variation of periodontitis definitions. The association was dose- and time-dependent and was strongest when the interval between the last periodontitis-related visit and the index date was <3 months (OR=1.64; 95% CI 1.49 to 1.79). Conclusions This study demonstrates an association between periodontitis and incident RA. This association is weak and limited to lack of individual smoking status.

Prevalence and incidence of schizophrenia among national health insurance enrollees in Taiwan, 1996–2001

Abstract  As many as 96% of all residents of Taiwan have been enrolled in the National Health Insurance (NHI) program since 1996. The NHI database was used to examine the prevalence and incidence of schizoprenia. The National Health Research Institute provided a database of 200 432 random subjects, about 1% of the population, for study. By means of exclusion criteria, a random sample of 136 045 subjects as a fixed cohort dated from 1996–2001 was obtained. Those study subjects who had at least one service claim during these years for either ambulatory or inpatient care, with a principal diagnosis of schizophrenia, were identified. The cumulative prevalence increased from 3.34 per 1000 to 6.42 per 1000 from 1996 to 2001. The annual incidence density decreased from 0.95 per 1000/year to 0.45 per 1000/year from 1997 to 2001. Male subjects had higher treated prevalence in younger age groups than did female subjects. Higher prevalence was associated with the 25–44 and 45–64 age groups, insurance amount less than US

Prevalence of diabetes in patients with schizophrenia in Taiwan: A population-based National Health Insurance study

640, the eastern region, and suburban areas. Lower incidence was associated with the 45–64 age group. Higher incidence was associated with insurance amount less than US

The Prevalence and Incidence of Treated Major Depressive Disorder among National Health Insurance Enrollees in Taiwan, 1996 to 2003

640, and the eastern region. According to the trends of cumulative prevalence and incidence density, the treated prevalence and incidence rate will be approximate to community rates gradually. Most persons with schizophrenia had received treatment in Taiwan after the NHI program was implemented. Future studies should focus on outcome and cost evaluation.

Prevalence of diabetes in patients with bipolar disorder in Taiwan: a population-based national health insurance study

OBJECTIVE We conducted this study to investigate the prevalence and correlates of diabetes in patients with schizophrenia in Taiwan. METHODS The National Health Research Institute provided a database of 1,000,000 random subjects for study. We obtained a random sample aged 18 years and over of 766,427 subjects in 2005. Those study subjects who had at least one service claim during this year for either ambulatory or inpatient care, with a primary diagnosis of schizophrenia or with a prescription for treatment of diabetes, were identified. RESULTS The prevalence of diabetes in patients with schizophrenia was higher than in the general population (7.90% vs. 5.57%, odds ratio [OR], 1.81; 95% confidence interval [CI], 1.61-2.03). Compared with the general population, patients with schizophrenia revealed a higher prevalence of diabetes in all age groups, except age 70 or more years; among females (10.30% vs. 5.42%, p<0.001), and males (5.93% vs. 5.73%, p<0.001); among all insurance amount groups; among those living in the northern (7.56% vs. 4.89%, p<0.001), central (8.26% vs. 5.61%, p<0.001), southern regions (8.45% vs. 6.62%, p<0.001); and among residents living in urban (8.18% vs. 5.19%, p<0.001) and rural areas (7.99% vs. 6.15%, p<0.001). CONCLUSIONS Patients with schizophrenia had a much higher prevalence of diabetes in younger adult age groups and in females than in the general population, a finding that deserves further biological and psychosocial study in the future.

Prevalence and Incidence of Autism Spectrum Disorders Among National Health Insurance Enrollees in Taiwan from 1996 to 2005

Objective: We used the National Health Insurance (NHI) database to examine the prevalence and incidence of treated major depressive disorder (MDD) and their associated factors. Method: The National Health Research Institute provided a database of 200 432 randomly selected subjects for study. We obtained a population-based random sample aged 15 years or older (n = 136 045) as a fixed cohort dated 1996 to 2003. We identified study subjects with a principal diagnosis of MDD who had at least one service claim during these years for either ambulatory or inpatient care. Results: From 1996 to 2003, the cumulative treated prevalence increased from 1.67 per 1000 to 17.24 per 1000. From 1997 to 2003, the annual treated incidence increased from 1.89 per 1000 to 2.58 per 1000. A higher incidence of treated MDD was detected in the groups aged 25 to 44 years (hazard ratio [HR] 1.28; 95% confidence interval [CI], 1.13 to 1.45), 45 to 64 years (HR 1.90; 95%CI, 1.66 to 2.16), and 65 years or older (HR 1.87; 95%CI, 1.59 to 2.20); in female subjects (HR 1.97; 95%CI, 1.80 to 2.15); in those with with an insurance amount of US

Type 2 Diabetes and Antidiabetic Medications in Relation to Dementia Diagnosis

1281 or more (HR 1.15; 95%CI, 1.01 to 1.31); in those with a fixed premium (HR 1.44; 95%CI, 1.27 to 1.62); and among those who lived in urban areas (HR 1.22; 95%CI, 1.10 to 1.35). Conclusions: For treated MDD, the prevalence and incidence in Taiwan were lower than in community studies in Western countries. Individuals with MDD are underdiagnosed and undertreated in Taiwan.

CHADS2 Score, Statin Therapy, and Risks of Atrial Fibrillation

OBJECTIVE We investigated the prevalence and correlates of diabetes in patients with bipolar disorder in Taiwan. METHODS The National Health Research Institute provided a database of 1,000,000 random subjects from which we selected a sample of 766,427 subjects aged 18 years and over. We identified study subjects who had at least one service claim during 2005, with a primary diagnosis of bipolar disorder or with a prescription for treatment of diabetes. RESULTS The prevalence of diabetes in patients with bipolar disorder was higher than in the general population (10.77% vs. 5.57%, OR, 2.01; 99% CI, 1.64-2.48). Compared with the general population, patients with bipolar disorder had a higher prevalence of diabetes in all age groups under 60 years; among females and males; among lower insurance amount groups; among those living in the northern, central and southern regions and among residents living in urban and rural areas. Antipsychotic use was associated with a higher prevalence of diabetes in persons with bipolar disorder. CONCLUSIONS Patients with bipolar disorder had a higher prevalence of diabetes than the general population. Prevention, early detection and treatment of diabetes are important issues for patients with bipolar disorder.

Increased risk of hypertension in patients with major depressive disorder: A population-based study

The authors used a national database to examine the prevalence and incidence of autism spectrum disorders. The National Health Research Institute provided a database of 1 000 000 random participants for study. A population-based sample of 372 642 aged younger than 18 was obtained as a dynamic cohort. Those study participants who had at least one service claim from 1996 to 2005 with a principal diagnosis of autism spectrum disorders were identified. The cumulative prevalence of autism spectrum disorders increased from 1.79 to 28.72 per 10 000 from 1996 to 2005. The annual incidence of autism spectrum disorders increased from 0.91 to 4.41 per 10 000 per year from 1997 to 2005. Higher incidence was detected in the 0 to 5 age group, in males, and in those who lived in northern, southern, and eastern regions and urban areas. Our findings suggest increases in the prevalence and incidence of treated autism spectrum disorders in Taiwan.

The incidence and characterisation of hospitalised acute spinal trauma in Taiwan—A population-based study

BACKGROUND Type 2 diabetes (T2D) has been shown to increase dementia risk, but few studies evaluated the relationship between antidiabetic treatment and dementia. METHODS We followed up 67,731 participants who were nondemented, nondiabetic, aged 65 or over at baseline from January 2004 to December 2009, to observe the onset of T2D (median follow-up 2.4 years), and to compare the risk of the development of dementia associated with particular types of antidiabetic medication among participants with T2D who had solely one type of antidiabetic agents throughout the follow-up period (median follow-up for participants with T2D 3.1 years). RESULTS The hazard ratio for dementia diagnosis in the new-onset T2D participants compared with the non-T2D participants was 1.56 (95%CI: 1.39-2.18). The relative rate of dementia was 5.31 (95% CI: 1.89-14.96) for participants taking thiazolidinediones (n = 28) and 1.22 (95% CI: 0.78-1.91) for those taking sulfonylureas (n = 796) compared to those taking metformin (n = 1,033). The risk of dementia was higher in ever (n = 841) versus never users (n = 4,579) of thiazolidinediones: 1.44 (95% CI: 1.12-1.86). CONCLUSIONS Diabetes is associated with an increased risk of dementia. The risk effect becomes weaker provided that participants take sulfonylureas or metformin rather than thiazolidinediones for a longer period.