Diabetes and risk of bladder cancer: a study using the National Health Insurance database in Taiwan

Aims/hypothesis  

Studies on the link between diabetes and bladder cancer in Asians are rare. We investigated the association between diabetes and incidence of bladder cancer by using a large national insurance database.     

Seasonal variation in undiagnosed HIV infection on the general medicine and trauma services of two urban hospitals

OBJECTIVE: To examine the seroprevalence of undiagnosed HIV and variation by season among patients admitted to the general internal medicine (GIM) and trauma services of two urban hospitals. DESIGN: A cross-sectional blinded HIV-1 seroprevalence survey. SETTING: A 725-bed academic medical center's hospital and an affiliated 324-bed tertiary care hospital. PARTICIPANTS: Residual serological specimens were obtained for unique patients aged 17 to 65 to study services in summer (June 16 to September 4, 2001) and fall to winter (November 1, 2001 to January 8, 2002). METHODS: Hospital files provided data on demographics, service type, and discharge clinical categories (fall-winter group only). HIV ELISA (enzyme-linked immunosorbent assay) tests with confirmatory Western blot were linked to subjects' de-identified files. We excluded 34 subjects with known HIV. Of the remaining unique admissions in summer (n=604) and fall-winter (n=978), 60% and 55% were tested, respectively. Predictors of undiagnosed HIV infection were examined using multivariate analysis. RESULTS: The summer cohort (n=362) had significantly lower unadjusted seroprevalence of undiagnosed HIV infection (1.4%; 95% confidence interval [CI], 0.4% to 3.2%) than the fall-winter cohort (n=539; 3.7%; 95% CI, 2.3% to 5.7%; P=.04). Overall, undiagnosed HIV was somewhat less likely in women (adjusted odds ratio [AOR], 0.45; 95% CI, 0.19 to 1.07) but more likely in black patients (AOR, 3.46; 95% CI, 0.70 to 17.06). In the fall-winter cohort, undiagnosed HIV was more likely for discharges with the following clinical categories versus those with a cardiac condition: dermatologic/breast (AOR, 14.90; 95% CI, 1.20 to 184.77), renal/urological (AOR, 22.43; 95% CI, 2.12 to 236.75), or infectious (AOR, 31.08; 95% CI, 2.40 to 402.98). CONCLUSIONS: The higher seroprevalence of undiagnosed HIV in the fall-winter admissions to GIM and trauma services supports especially targeting HIV testing in these months.     

Linking a hospital diabetes database and the National Health Service Central Register: a way to establish accurate mortality and movement data

We have established a records linkage between ‘Diabeta’ (the computerized clinical records system in the Diabetes Unit of St Thomas’ Hospital) and the National Health Services Central Register (NHSCR) of the United Kingdom. Over 7000 diabetic patient records have been collected since 1973. Demographic data on all diabetic patients were retrieved and submitted to the NHSCR via a floppy disk. A matching system (automatic or manual) was used by the NHSCR to identify deceased patients and the most recent demographic data was provided on patients alive. This linkage resulted in an update of 91 % of records in Diabeta. The findings of the update included: (1)86 % of diabetic patient’s death had not been notified to the hospital and were not recorded on Diabeta. Mortality can now be assessed accurately as an outcome measure in our diabetic population. (2)Provision of the NHS number to Diabeta, as before it was not available on many patients seen in the hospital. The NHS number is a key patient identifier which can be used to exchange information within the NHS-wide network. (3)Diabetes was recorded as a cause of death in only 36% of death certificates. Analyses of death certificates alone must thus give poor information about mortality in diabetes. (4)Geographical location of patients on the database was updated, enabling tracing of patients for long-term studies and analyses of movement. © 1997 John Wiley & Sons, Ltd.     

Statin use increased new-onset diabetes in hypercholesterolemic individuals: Data from the Korean National Health Insurance Service-National Health Screening Cohort database (NHIS-HEALS)

AimWe investigated the association between statin use and new-onset diabetes (NODM) in Korean adults with hypercholesterolemia.MethodsThis study performed based on data from the National Health Insurance Service-National Health Screening Cohort for the years from 2002 to 2015. Statin users classified as high- or low- users according to medication possession ratio. Statin non-users consisted of hypercholesterolemic participants who never used statin over the entire follow-up period. 21,469 participants (10,880 statin users, 10,589 statin non-users) with a median follow-up period of 12.5 years were included. We estimated the NODM risk based on the survival analyses. In particular, to adjust for confounding effects, we considered Cox proportional hazards regression models over three stages.ResultsCompared to non-users, statin users had a significantly higher risk for NODM. The fully adjusted hazard ratios (aHRs) (95% confidential intervals [95% CIs]) of statin users for NODM were 1.43 (1.31–1.57) in men, and 1.86 (1.66–2.10) in women, respectively after adjusted confounding factors including age and lifestyle factors. Compared to high-users, aHRs (95% CIs) of low-users for NODM were 1.16 (1.03–1.30) and 1.28 (1.16–1.43) in men and women, respectively.ConclusionsIn hypercholesterolemic patients, statin users have a higher risk of NODM than non-users.     

Prevalence of liver cirrhosis based on the metabolic health and weight criteria: Report from the Korea National Health and Nutrition Examination Survey (KNHANES) data analysis

Introduction and ObjectivesRecent studies have proposed two distinctive types of obesity, metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO), based on various physiological factors. This study sought to explore the relationship between the metabolic obesity types and the incidence of liver cirrhosis (LC) in a large nationally-representative population.Materials and MethodsData on 27,629 adults with MHO or MUHO, were analyzed from the Korea National Health and Nutrition Examination Survey (KNHANES) obtained from 2015 through 2019. Four categories of metabolic health and weight (MHW) were generated for analysis: (1) MHO, (2) MUHO, (3) Metabolically unhealthy normal weight (MUHNW), and (4) Metabolically healthy normal weight (MHNW). Statistical analyzes were performed with univariate and multivariate logistic regression.ResultsThe prevalence of LC did not show statistically significant differences among the MHW categories: 0.5% in MHO, 0.4% in MUHO, 0.2% in MHNW, and 0.3% in MUHNW. The unadjusted analysis showed a significant association between self-reported LC and MUHO, but this association was not evident in the adjusted analysis. In the adjusted analysis of the prevalence of laboratory LC, a significant association emerged in the MUHO group, followed in descending order of magnitude by the MHO and MUHNW groups. A favorable fasting blood glucose level was the only factor associated with increased prevalence of reported LC in MUHO.ConclusionsThe study demonstrated a difference in the prevalence of LC between MHO and MUHO. Our study concludes that the MHO phenotype is a transient status with regard to metabolic abnormalities, and caution is necessary when evaluating MHO.     

Statin use and site-specific risk of colorectal cancer in individuals with hypercholesterolemia from the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS)

Background and aimsWe investigated the association between statin use and site-specific risk of colorectal cancer in individuals with hypercholesterolemia.Methods and resultsThis study is based on the National Health Insurance Service-National Health Screening Cohort, conducted during 2002–2015. Statin users were classified as high and low users according to medication possession ratio (MPR). Statin nonusers comprised participants who did not use statins during the entire follow-up period. In total, 17,737 statin users and 13,412 statin nonusers were included in the analysis, with a median follow-up period of 12.7 years. Cox proportional hazards regression models were adopted after stepwise adjustment for confounders to investigate prospective association between statin usage and colorectal cancer risk. In total, 378 (2.3%) of 16,588 male participants and 239 (1.6%) of 14,561 female participants had colorectal cancer during the follow-up period. Compared to nonusers, fully adjusted hazard ratios (HRs) (95% confidence intervals [95% CIs]) for colorectal cancer risk in high statin users were 0.56 (0.42–0.75) in men and 0.64 (0.46–0.90) in women. In men, the fully adjusted HRs for proximal and rectal cancer for high users were 0.29 (0.15–0.56) and 0.52 (0.35–0.78), respectively, compared to those for nonusers. In women, statistical significance was seen only in rectal cancer (HR 0.43 [0.25–0.72]) but not in proximal or distal colon cancer.ConclusionsHigh statin users with hypercholesterolemia were associated with lower risk of overall colorectal cancer, especially proximal colon cancer in men and rectal cancer in both sexes.     

Trends in inferior turbinate surgery: analysis of patients using the Medicare database

Background

The aim of this study was to characterize trends in turbinate reduction procedures from 2000 to 2015.

Methods

Annual procedure data were obtained for the period 2000–2015 and detailed Medicare provider and payment data were obtained for 2012–2015. Turbinate procedures analyzed included turbinate soft tissue mucosal ablation (TMA), turbinate soft tissue submucosal ablation (TSMA), turbinate excision (TE), and turbinate submucous resection (TSR). TMA and TSMA were grouped as turbinate soft tissue ablation (TA) for analysis. From 2012 to 2015, the type and location—facility (F) or nonfacility (NF)—of the providers performing the procedures were assessed.

Results

From 2000 to 2015, the total number of turbinate reduction procedures increased by an average of 3.8% annually. TSR had the highest annual increase at 5.4%. TE is the only procedure to show a decrease, by an average of ?2.3% annually. From 2012 to 2015, the number of turbinate reduction procedures changed by ?1.6% and 107.7% at F and NF locations, respectively. NF TSMA and TSR had the largest increases at 121.6% and 260.1%, respectively. Of the NF TA procedures, there was an average annual increase of 50% by non‐otolaryngologists. For TA, the average F charge was 78.0% more than the NF charge, and the average NF otolaryngologist charge 11.5% more than the non‐otolaryngologist charge.

Conclusion

The number of turbinate reduction procedures increased steadily between 2000 and 2015, with the majority being TSRs. This is consistent with previous studies demonstrating that TSR leads to better outcomes. There has been a significant increase in turbinate reduction procedures performed in outpatient/ambulatory settings by otolaryngologists, non‐otolaryngologists, and midlevel providers.

     

Association of renal function with muscle strength in Korean adults: A population-based study using the Korea National Health and Nutrition Examination Surveys (KNHANES) from 2014 to 2018

Hand grip strength (HGS), a simple measure of upper limb muscle function, can be used to assess overall muscular strength, and reduced HGS in patients with poor renal functions has been observed. This study examined the associations between renal function and HGS, a surrogate marker of muscular strength, among a stratified sample of Korean adults. This study obtained data from the Korea National Health and Nutrition Examination Survey from 2014 to 2018, a cross-sectional and nationally representative survey conducted by the Korea Centers for Diseases Control and Prevention. In men, low muscle strength (LMS) and normal muscle strength (NMS) were defined as HGS < 28.9 kg and HGS ≥ 28.9 kg, respectively. In women, LMS and NMS were considered as HGS < 16.8 kg and HGS ≥ 16.8 kg, respectively. Of the 25,746 subjects in this study, there were 3603 (14.0%) and 22,143 (86.0%) subjects who displayed LMS and NMS, respectively. Subjects with estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m² had a higher risk of developing LMS than those with eGFR ≥ 60 mL/min/1.73 m² after adjusting for age (odds ratio, 1.772; 95% CI, 1.498–2.096); the significant differences remained after adjusting for other factors including age. Similar tendencies were shown in men and women when analyzed according to gender; however, the risk of developing LMS was higher in men than in women. Results showed that decreased renal function was likely to contribute to an increased prevalence of LMS based on HGS. This association may assist in developing better strategies to estimate renal function in clinical or public health practice.     

Prevalence of taste and smell impairment in adults with diabetes: A cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES)

Aim

This study investigates the prevalence of smell and taste impairment in adults with diabetes and potential risk factors for sense deterioration and its influence of daily food intake.

Old age and male sex are associated with increased risk of asymptomatic erosive esophagitis: analysis of data from local health examinations by the Korean National Health Insurance Corporation

Background and Aims: Silent gastroesophageal reflux disease (GERD) is often detected during routine screening esophagogastroduodenoscopy (EGD). However, the risk factors and clinical implications of silent GERD remain unclear. In the present study, we investigated the risk factors for asymptomatic erosive esophagitis by analyzing the local area health examination data. Methods: The Korean National Health Insurance Corporation provides a bi‐annual health examination performed by qualified local hospitals for the early detection of cancer in medical insurance holders over 40 years of age. Participants who completed self‐reported questionnaires on health, followed by EGD at the Myongji Hospital (Goyang, Korea), were enrolled in this study. Results: The data of a total of 5301 participants who underwent EGD between January 2005 and December 2008 were analyzed. The prevalence of erosive esophagitis was 6%. In the multivariate analysis, erosive esophagitis was strongly associated with an age greater than 60 years (odds ratio [OR]: 0.7, 95% confidence interval [CI]: 0.6–1.0), male sex (OR: 2.3, 95% CI: 1.7–3.0), hiatus hernia (OR: 2.9, 95% CI: 2.1–4.0), duodenal ulcer (OR: 1.6, 95% CI: 1.1–2.5), hypertension (OR: 1.5, 95% CI: 1.2–2.0), and smoking (OR: 1.4, 95% CI: 1.0–1.8). Of the 320 participants with erosive esophagitis, 145 (45.3%) were asymptomatic participants, and those who were more frequently greater than 60 years (OR: 1.8, 95% CI: 1.1–3.1) and male (OR: 1.8, 95% CI: 1.1–3.2). Conclusions: Asymptomatic erosive esophagitis in adults older than 40 years is strongly associated with old age (≥ 60 years) and male sex compared with symptomatic erosive esophagitis.     

Epidemiology of overweight and obesity in Indian adults - A secondary data analysis of the National Family Health Surveys

AimsNational Family Health Survey (NFHS) conducted in India provide nationally comparable data on socio-demographic characteristics and anthropometric estimates. Present study was conducted to examine the prevalence of Indian adults who are living with overweight/obesity, their correlates, and trends observed between the last two rounds of the NFHS 2005-06 to 2015–16).MethodsSocio-demographic characteristics and anthropometric estimates of respondents from NFHS round III & IV were analysed. Asian cut-offs were used for obesity classification. Of the total 198,754 and 811,808 eligible respondents, adults ≥18 years of age were included in the analysis. Prevalence and correlates were presented after taking into account stratification, clustering and sampling weights. GIS mapping was done to depict regional variations.ResultsPrevalence of men and women living with overweight/obesity were observed to be 38.4% and 36.2% respectively. Wide variations were observed in prevalence across the regions of India. Results of multivariate analysis showed that the strongest predictors for being overweight or obese were older age, currently in union, higher education, richest wealth quintile, and living in urban areas.ConclusionThe present study highlights the rising prevalence across the urban and rural locations and has implications for policy change based on the prevalence estimates.