national healthcare data

  • 文章类型: Journal Article
    胃癌(GC)幸存者可能更容易发展为骨质疏松症。然而,关于GC与骨质疏松症之间关系的研究很少在大量患者人群中进行。我们旨在通过使用韩国国家健康保险服务-国家样本队列(KNHIS-NSC)将患者与GC和匹配的对照进行比较来确定骨质疏松症的发生率并确定相关因素。这项研究包括9078例GC患者和36,312例对照(1:4倾向评分匹配性别,年龄,residence,和收入)。根据Charlson合并症指数(CCI)评分调整模型(调整后的HR=1.13),GC患者骨质疏松症的风险比(HR)明显高于对照组。Kaplan-Meier分析显示,从索引日期开始的随访期间,GC患者的骨质疏松症累积发生率明显高于对照组(p=0.0087)。在年龄<65岁的人群中,骨质疏松与GC呈正相关。男性,和那些与CCI分数=0。总之,研究结果表明,年龄<65岁的GC男性患骨质疏松症的风险增加。需要研究其他风险因素和最佳干预时机,以预防骨折并最大程度地减少GC幸存者的骨丢失。
    Gastric cancer (GC) survivors may be more likely to develop osteoporosis. However, few studies on the relationship between GC and osteoporosis have been conducted on large patient populations. We aimed to determine the incidence of osteoporosis and identify related factors by comparing patients with GC and matched controls using the Korean National Health Insurance Service-National Sample Cohort (KNHIS-NSC). This study included 9078 patients with GC and 36,312 controls (1:4 propensity score-matched for sex, age, residence, and income). The hazard ratio (HR) for osteoporosis was significantly greater for GC patients than for controls according to Charlson Comorbidity Index (CCI) score-adjusted models (adjusted HR = 1.13). Kaplan-Meier analysis revealed that the cumulative incidence of osteoporosis during the follow-up period commencing from the index date was significantly greater in GC patients than in the controls (p = 0.0087). A positive correlation of osteoporosis with GC was detected for those aged < 65 years, males, and those with CCI scores = 0. In conclusion, the study findings suggest that men with GC aged < 65 years may be at an increased risk for osteoporosis. Research into additional risk factors and the optimal timing of interventions are needed to prevent fractures and minimize bone loss in GC survivors.
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  • 文章类型: Journal Article
    鉴于痛风和胃癌(GC)作为具有相互关联影响的主要健康问题的全球重要性,我们检查了韩国痛风患者GC的发展。我们使用来自韩国国家健康保险服务-国家样本队列数据库的10,174例GC患者和40,696例对照患者的数据进行了嵌套病例对照研究。使用倾向评分匹配(1:4)和倾向评分重叠加权调整来减少选择偏倚,并估计痛风与GC之间关联的比值比(OR)和95%置信区间(CI)。痛风患者的GC校正OR值并不显著高于对照组患者(1.02;95%CI,0.93-1.12;p=0.652)。此外,在性别等亚组分析中没有观察到痛风和GC之间的关联,年龄,收入水平,居住地区,或Charlson合并症指数评分。总之,这些结果表明,痛风不是朝鲜族人群中GC的重要独立危险因素.需要额外的调查来确定痛风和GC之间的因果关系,并将这些结果推广到一般人群。
    Given the global significance of gout and gastric cancer (GC) as major health problems with interrelated impacts, we examined the development of GC in Korean patients with gout. We conducted a nested case-control study using data from 10,174 GC patients and 40,696 control patients from the Korean National Health Insurance Service-National Sample Cohort database. Propensity score matching (1:4) with propensity score overlap-weighted adjustment was used to reduce selection bias and estimate the odds ratio (OR) and 95% confidence intervals (CIs) for the association between gout and GC. An adjusted OR for GC was not significantly higher in patients with gout than in control patients (1.02; 95% CI, 0.93-1.12; p = 0.652). Additionally, no association between gout and GC was observed in subgroup analyses such as sex, age, level of income, region of residence, or Charlson Comorbidity Index score. In conclusion, these results suggest that gout is not a significant independent risk factor for GC among the Korean population. Additional investigation is required to establish a causal association between gout and GC, and to generalize these results to general populations.
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  • 文章类型: Journal Article
    The potential connection between proton pump inhibitors (PPIs) and colorectal cancer (CRC) risk remains unclear, with specific ethnic genetic backgrounds playing a role in PPI-induced adverse effects. In this nested case-control study, we investigated the risk of CRC in relation to preceding PPI use and the duration of use using data from the Korean National Health Insurance Service-National Sample Cohort database, including 9374 incident CRC patients and 37,496 controls. To assess the impact of preceding PPI exposure (past vs. current) and use duration (days: <30, 30-90, and ≥90) on incident CRC, we conducted propensity score overlap-weighted multivariate logistic regression analyses, adjusted for confounding factors. Our findings revealed that past and current PPI users had an increased likelihood of developing CRC. Regardless of duration, individuals who used PPIs also had higher odds of developing CRC. Subgroup analyses revealed that CRC occurrence increased independent of history or duration of prior PPI use, consistent across various factors such as age, sex, income level, and residential area. These findings suggest that PPI use, regardless of past or present use and duration of use, may be related to an increased risk of developing CRC in the Korean population.
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  • 文章类型: Journal Article
    Considering the global importance of both gout and colorectal cancer (CRC) as significant health issues with mutual relevance, we aimed to examine the risk of colorectal cancer in Korean patients with gout. In this nested case-control study, we used data from 9920 CRC patients and 39,680 controls the Korean National Health Insurance Service-National Sample Cohort database. Propensity score overlap-weighted multivariate logistic regression analyses, adjusted for confounders, were used to assess the odds ratio (OR) and 95% confidence interval (CI) of the association between gout and CRC. Adjusted OR for CRC were similar between patients with gout and the control group (0.95; 95% CI, 0.86-1.04; p = 0.282). However, after adjustment, subgroup analysis revealed an 18% reduction in the probability of CRC among patients younger than 65 years with gout (95% CI, 0.70-0.95; p = 0.009). Conversely, absence of an association between gout and subsequent CRC persisted regardless of sex, income, residence, and Charlson Comorbidity Index score, even among individuals aged 65 years or older. These results imply that gout may not be a significant independent risk factor for CRC among the general population. However, in patients younger than 65 years with gout, a slightly reduced likelihood of CRC was observed. Further research is necessary to establish a causal relationship between gout and CRC and to generalize these findings to other populations.
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  • 文章类型: Journal Article
    关于慢性牙周炎(CP)与胃癌之间潜在关联的信息有限,尤其是在韩国人口中。本研究旨在探讨这种关系。这项巢式病例对照研究使用倾向得分匹配分析了来自韩国国家健康保险服务-国家样本队列的10,174名胃癌患者和40,696名对照的数据。标准化差异用于比较研究组之间的基线特征。进行校正混杂因素的Logistic回归分析,以评估CP病史与胃癌发生率之间的关联。评估了指数日期前1年和2年的CP历史和综合亚组分析。在1年和2年期间有CP病史的个体显示患胃癌的可能性增加。亚组分析在年龄<65岁的男性参与者和不同收入水平或居住在居民区的个体中始终支持这些发现。然而,在≥65岁的参与者中未观察到显著关联.总之,CP可能是韩国人群中胃癌发展的潜在危险因素。对于高危人群来说,定期筛查胃癌可能是必要的,特别是年龄<65岁有CP病史的男性。
    There is limited information regarding the potential association between chronic periodontitis (CP) and gastric cancer, especially in the Korean population. This study aimed to explore this relationship. This nested case-control study analyzed data from 10,174 patients with gastric cancer and 40,696 controls from the Korean National Health Insurance Service-National Sample Cohort using propensity score matching. Standardized differences were used to compare baseline characteristics between study groups. Logistic regression analyses adjusted for confounders were conducted to assess the association between history of CP and gastric cancer occurrence. CP histories and comprehensive subgroup analyses in the 1- and 2-year periods preceding the index date were evaluated. Individuals with a history of CP within the 1-year and 2-year periods showed an increased likelihood of developing gastric cancer. Subgroup analyses consistently supported these findings in male participants aged <65 years and individuals with various income levels or living in residential areas. However, no significant associations were observed among participants aged ≥65 years. In conclusion, CP may be a potential risk factor for gastric cancer development in the Korean population. Regular screening for gastric cancer may be necessary for high-risk individuals, specifically men aged <65 years with a history of CP.
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  • 文章类型: Journal Article
    抑郁和焦虑在痴呆症患者(PLWD)中很常见且有害。目前尚不清楚常规提供的心理治疗是否可以帮助减轻PLWD的这些症状。这项研究旨在调查在PLWD的初级保健心理治疗服务中提供的治疗过程中抑郁和焦虑症状的改善,并比较无痴呆症患者的预后。
    来自英格兰改善获得心理治疗服务(IAPT)的国家数据与医院事件统计数据相关联,心理健康服务数据集,和HES-ONS死亡率数据用于确定2012-2019年期间完成IAPT心理治疗的1,549名PLWD和倾向评分匹配的对照组,未发现痴呆.结果指标包括干预前后抑郁(PHQ-9)和焦虑(GAD-7)症状的变化和治疗结果(可靠的改善,recovery,恶化)。
    在心理治疗过程中,抑郁(t(1548)=31·05,p<·001)和焦虑(t(1548)=30·31,p<·001)的症状得到了改善(抑郁:d=-0·83;焦虑:d=-0·80)。然而,PLWD不太可能可靠地改善(OR=·75,95CI[·63,·88],p<·001)或恢复(OR=·75,95CI[·64,·88],p=·001),更有可能恶化(OR=1·35,95CI[1·03,1·78],p=·029)比没有痴呆的匹配对照样品。
    心理治疗可能对患有抑郁或焦虑的PLWD有益,但它目前不如没有痴呆症的人有效。需要更多的研究来改善获得心理治疗的机会,并了解这种差异以及如何调整治疗以进一步改善结果。
    这项工作得到了阿尔茨海默氏症协会的支持。
    UNASSIGNED: Depression and anxiety are common and deleterious in people living with dementia (PLWD). It is currently unknown whether routinely provided psychological therapy can help reduce these symptoms in PLWD. This study aimed to investigate improvements in depression and anxiety symptoms over the course of therapy offered in primary care psychological therapy services in PLWD and to compare outcomes to people without dementia.
    UNASSIGNED: National data from Improving Access to Psychological Therapies services (IAPT) across England linked with Hospital Episode Statistics data, the Mental Health Services Dataset, and HES-ONS mortality data were used to identify 1,549 PLWD who completed a course of psychological treatment in IAPT between 2012-2019 and a propensity score matched control group without identified dementia. Outcome measures included pre-post intervention changes in depression (PHQ-9) and anxiety (GAD-7) symptoms and therapy outcomes (reliable improvement, recovery, deterioration).
    UNASSIGNED: Symptoms of depression (t(1548)=31·05, p<·001) and anxiety (t(1548)=30·31, p<·001) improved in PLWD over the course of psychological therapy with large effect sizes (depression: d=-0·83; anxiety: d=-0·80). However, PLWD were less likely to reliably improve (OR=·75, 95%CI[·63,·88], p<·001) or recover (OR=·75, 95%CI[·64,·88], p=·001), and more likely to deteriorate (OR=1·35, 95%CI[1·03,1·78], p=·029) than a matched control sample without dementia.
    UNASSIGNED: Psychological therapy may be beneficial for PLWD with depression or anxiety, but it is currently not as effective as for people without dementia. More research is needed to improve access to psychological therapies and to understand this discrepancy and how therapies can be adapted to further improve outcomes.
    UNASSIGNED: This work was supported by the Alzheimer\'s Society.
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