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Several studies have indicated that air pollution induces systemic as well as tissue-specific inflammation. Chronic inflammatory diseases such as rheumatoid arthritis and chronic obstructive pulmonary disease reduce bone mineral density (BMD), leading to increased release of immune cells from the bone marrow. However, the association between air pollution and osteoporosis remains poorly defined. Therefore, we conducted this population-based retrospective cohort study to evaluate the risk of osteoporosis in Taiwanese residents exposed to air pollution.We combined 2 nationwide databases in this study. The National Health Insurance Research Database of Taiwan was available from 2000 to 2010. Detailed daily data on air pollution were collected by Taiwan Environmental Protection Agency (EPA) from 1998 to 2010. We calculated the yearly average concentrations of air pollutants from the study start to the date of osteoporosis occurrence, or withdrawal from the NHI program, or December 31, 2010. The yearly average concentrations of air pollutants were categorized into quartiles, and the risks of osteoporosis were evaluated among 4 stages of air pollutants.Among Q1, Q2, Q3, and Q4 of pollutants in all subjects, the adjusted hazard ratios (HRs) of osteoporosis in Q2, Q3, and Q4 were compared with Q1. For carbon monoxide (CO), the adjusted HRs were 1.05 (95% confidence interval [CI], 0.97-1.14), 1.78 (95% CI, 1.65-1.92), and 1.84 (95% CI, 1.71-1.98), respectively. For nitrogen dioxide (NO2), the adjusted HRs were 1.35 (95% CI, 1.25-1.45), 1.24 (95% CI, 1.15-1.35), and 1.60 (95% CI, 1.48-1.73), respectively, in all subjects.The findings of the present study show that CO and NO2 exposure is associated with an increased risk of osteoporosis in the Taiwanese population.
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The purpose of this study was to evaluate the relationship between glycated hemoglobin (HbA1c) and chronic obstructive pulmonarydisease (COPD) in patients with type 2 diabetes.We conducted a retrospective cohort study involving 45,753 patients with type 2 diabetes, who participated in the National Diabetes Case Management Program in Taiwan. HbA1c at baseline and COPD events over the subsequent years were analyzed.After multivariate adjustment, the COPD risk increased among patients with HbA1c levels <6.0%, compared with that in patients with HbA1c levels ranging from 6.0% to 7.0% (hazard ratio: 1.19, 95% confidence interval (CI): 1.06-1.34). Similarly, high HbA1c levels (≥10%) were independently associated with COPD (1.19, 95% CI: 1.06-1.32). A U-shaped relationship was observed between HbA1c levels and COPD incidence.HbA1c levels lower than 6.0% and higher than 10% are associated with an increased risk of COPD in patients with type 2 diabetes. These findings suggest that meeting the recommended HbA1c targets might reduce the risk of COPD, but care should be taken not to pose risks to this population.
The aim of this study was to examine whether there is an association between finasteride use and the risk of acute pancreatitis. This population-based case-control study used the database of the Taiwan National Health Insurance Program. There were 2,530 male subjects aged 40-84 years with a first-attack of acute pancreatitis during the period of 1998-2011 as the case group and 10,119 randomly selected subjects without acute pancreatitis as the control group. Both groups were matched by age and index year of diagnosing acute pancreatitis. Subjects who never had finasteride prescription were defined as "never use." Subjects who at least received 1 prescription for finasteride before the date of diagnosing acute pancreatitis were defined as "ever use." The association of acute pancreatitis with finasteride use was examined by the odds ratio (OR) and 95% confidence interval (CI) using the multivariable unconditional logistic regression model. The crude OR of acute pancreatitis was 1.78 (95%CI 1.33, 2.39) for subjects with ever use of finasteride, when compared with subjects with never use of finasteride. After adjusting for potential confounders, the adjusted OR of acute pancreatitis decreased to 1.25 (95%CI 0.90, 1.73) for subjects with ever use of finasteride, but no statistical significance was seen. No association can be detected between finasteride use and the risk of acute pancreatitis.