OBJECTIVE:
METHODS:
RESULTS:
CONCLUSION:
Individual cyclooxygenase-2 inhibitors on the risk of peptic ulcer disease: a population-based cohort in Taiwan
Background
Estimated glomerular filtration rate (eGFR) is a powerful predictor of mortality in diabetic patients with limited proteinuria data. In this study, we tested whether concomitant proteinuria increases the risk of mortality among patients with type 2 diabetes.
Methods
Participants included 6523 patients > 30 years with type 2 diabetes who were enrolled in a management program of a medical center before 2007. Renal function was assessed by eGFR according to the Modification of Diet in Renal Disease Study equation for Chinese. Proteinuria was assessed by urine dipstick.
Results
A total of 573 patients (8.8%) died over a median follow-up time of 4.91 years (ranging from 0.01 year to 6.42 years). The adjusted expanded cardiovascular disease (CVD)-related mortality rates among patients with proteinuria were more than three folds higher for those with an eGFR of 60 mL/min/1.73 m2 or less compared with those with an eGFR of 90 mL/min/1.73 m2 or greater [hazard ratio, HR, 3.15 (95% confidence interval, CI, 2.0–5.1)]. The magnitude of adjusted HR was smaller in patients without proteinuria [1.98 (95% CI, 1.1–3.7)]. An eGFR of 60 mL/min/1.73 m2 to 89 mL/min/1.73 m2 significantly affected all-cause mortality and mortality from expanded CVD-related causes only in patients with proteinuria. Similarly, proteinuria affected all outcomes only in patients with an eGFR of <60 mL/min/1.73 m2.
Conclusion
The risks of all-cause mortality, as well as expanded and non-expanded mortality from CVD-related causes associated with proteinuria or an eGFR of 90 mL/min/1.73 m2 or greater are independently increased. Therefore, the use of proteinuria measurements with eGFR increases the precision of risk stratification for mortality.
Patients with systemic lupus erythematosus (SLE) are suggestive to have a higher cancer risk. The aim of this study is to evaluate the possible association of malignancy and SLE in Taiwan. We used the data of the National Health Insurance system of Taiwan to assess this issue. The SLE cohort contained 2,150 patients, and each patient was randomly frequency matched to 8 people without SLE on age and sex. The Cox's proportion hazard regression analysis was conducted to estimate the effects of SLE on the cancer risk. In patients with SLE, the risk of developing overall cancer was marginally significantly higher [adjusted Hazard ratio (HR) = 1.26, 95% confidence interval (95% CI) = 0.99-1.59] and was significantly higher for developing prostate cancer (adjusted HR = 3.78, 95% CI = 1.30-11.0). Our study unexpectedly found that Taiwanese patients with SLE have a higher risk to develop prostate cancer.
BACKGROUND:
METHODS:
RESULTS:
CONCLUSIONS: