Hsin Chien Lee

A 5-year follow-up study on the relationship between obstructive sleep apnea and Parkinson disease

STUDY OBJECTIVEnSleep disturbances are among the most common nonmotor symptoms of Parkinson disease. However, no large epidemiological data regarding the association between obstructive sleep apnea (OSA) and Parkinson disease have been reported. The goal of this study was to investigate the risk for Parkinson disease during a 5-y follow-up period after a diagnosis of OSA using a population-based dataset.nnnMETHODSnThe data for this retrospective longitudinal cohort study were retrieved from the Taiwan Longitudinal Health Insurance Database 2000. We identified 1,532 patients with OSA as the study cohort and randomly selected 7,660 patients as the comparison cohort. Each subject was individually followed up for a 5-y period to identify those in whom Parkinson disease subsequently developed. Stratified Cox proportional hazard regressions were performed as a means of comparing the 5-y risk of subsequent Parkinson disease between the study cohort and comparison cohort.nnnRESULTSnOf the 9,192 total patients, Parkinson disease developed in 0.73% during the 5-y follow-up period: 1.24% and 0.63% in the OSA and control cohorts, respectively. After censoring patients who died during the follow-up period and adjusting for socio-demographic characteristics, the hazard ratio (HR) of Parkinson disease during the 5-y follow-up period for patients with OSA was 2.26 (95% confidence interval [CI] = 1.32-3.88) compared with comparison patients. In addition, among females, the adjusted HR of Parkinson disease was 3.54 (95% CI = 1.50-8.34) for patients with OSA compared to patients without OSA. However, among males, there was no significantly increased hazard of Parkinson disease for patients with OSA compared to those without OSA.nnnCONCLUSIONSnFemale patients with OSA were found to be at a significant risk of subsequent Parkinson disease during a 5-y follow-up period.

Sialolithiasis is associated with nephrolithiasis: a case-control study

Abstract Conclusions This study demonstrates an association between sialolithiasis and nephrolithiasis. The results call for more awareness of this association among physicians and patients with nephrolithiasis. Objective Very few empirical studies have been conducted to explore the potential association between sialolithiasis and nephrolithiasis. As such, the association between sialolithiasis and nephrolithiasis still remains unclear. This study aimed to explore the possible association between sialolithiasis and nephrolithiasis using a population-based dataset. Methods Using data from the Taiwan Longitudinal Health Insurance Database 2005, this case-control study identified 966 patients with sialolithiasis as cases and 2898 sex- and age-matched subjects without sialolithiasis as controls. Conditional logistic regressions were conducted to examine the association of sialolithiasis with previously diagnosed nephrolithiasis. Results Out of 3864 sampled patients, 165 (4.27%) had prior nephrolithiasis. Using Chi-square test, it was found that there was a significant difference in the prevalence of prior nephrolithiasis between the cases and controls (10.25% vs 2.28%, pu2009<u20090.001). Moreover, by conditional logistic regression analysis, the odds ratio of prior nephrolithiasis for cases was 4.74 (95% CIu2009=u20093.41–6.58, pu2009<u20090.001) when compared to controls after adjusting for monthly income, geographic location, urbanization level of residence, diabetes, hypertension, heart failure, chronic renal disease, and tobacco use.

The association of annual air pollution exposure with blood pressure among patients with sleep-disordered breathing

While sleep-disordered breathing (SDB), high blood pressure (BP) and air pollution exposure have separately been associated with increased risk of cardiopulmonary mortality, the association linking air pollution exposure to BP among patients with sleep-disordered breathing is still unclear. We collected 3762 participants data from the Taipei Medical University Hospitals Sleep Center and air pollution data from the Taiwan Environmental Protection Administration. Associations of 1-year mean criteria air pollutants [particulate matter with aerodynamic diameters ≤10 μm (PM10), particulate matter with aerodynamic diameters ≤2.5 μm (PM2.5), nitrogen dioxide (NO2) and ozone (O3)] with systolic BP (SBP) and diastolic BP (DBP) were investigated by generalized additive models. After controlling for age, sex, body mass index (BMI), temperature and relative humidity, we observed that increases in air pollution levels were associated with decreased SBP and increased DBP. We also found that patients with apnea-hypopnea index (AHI) ≥30 showed a stronger BP response to increased levels of air pollution exposure than those with AHI<30. Stronger effects of air pollution exposure on BP were found in overweight participants than in participants with normal BMI. We concluded that annual exposure to air pollution was associated with change of BP among patients with sleep-disordered breathing. The association between annual air pollution exposure and BP could be modified by AHI and BMI.

Healthcare Service Utilization by Patients with Obstructive Sleep Apnea: A Population-Based Study

Objective Although obstructive sleep apnea (OSA) is not a life-threatening disease, very few studies have compared differences in healthcare service utilization between patients with and those without OSA in an Asian population according to different age groups. This study attempted to investigate differences in healthcare service utilization between patients with and those without OSA in different age groups in Taiwan. Methods Sampled subjects and data on their health service utilization were retrieved from the Taiwan Longitudinal Health Insurance Database 2005. We included 568 patients with OSA and 2840 subjects without OSA. Each subject was followed for a 1-year period to evaluate their healthcare resource utilization. Wilcoxon-Mann-Whitney tests were performed to compare differences in healthcare utilization between patients with and those without OSA during the 1-year follow-up period. Results As to all healthcare service utilization, patients with OSA had significantly more outpatient visits (30.3 vs. 18.6), outpatient costs (US

Appendectomy increased the risk of ischemic heart disease

1231.2 vs. US

Increased risk of depressive disorder following a diagnosis of neovascular age-related macular degeneration

764.8), inpatient days (1.8 vs. 1.2), inpatient costs (US

Poor clinical outcomes among pneumonia patients with depressive disorder.

563.6 vs. US

A population-based study on the association between chronic periodontitis and sialolithiasis.

276.7), and total costs (US

Risk of new-onset type II diabetes after appendicectomy

1794.8 vs. US

Prediction of the severity of obstructive sleep apnea by anthropometric features via support vector machine

1041.5) than comparison subjects during the 1-year follow-up period. Moreover, patients with OSA aged 40~49 and 50~59 years respectively incurred 2.11- and 2.02-fold higher total costs compared to patients without OSA. However, patients with OSA aged over 70 years did not have higher total costs compared to those without OSA. Conclusions This study found that patients with OSA had greater healthcare service utilization than those without OSA. Additionally, patients with OSA in the 40~49- and 50~59-year age groups had about 2-fold higher total costs of healthcare services than those without OSA.