Association of Alzheimer's Disease With Peripheral Vestibular Disorder: A Case-Control Study.

OBJECTIVES: Vestibular disorders can impact cognitive domains, including spatial orientation and memory, which are also affected in Alzheimer's disease. This study aimed to examine the association between Alzheimer's disease and a prior diagnosis of peripheral vestibular disorders in the elderly Taiwanese population. METHODS: The case-control study sample was retrieved from Taiwan's Longitudinal Health Insurance Database 2010. We included 3138 cases with Alzheimer's disease and 9414 propensity-matched controls. We conducted multivariable logistic regression modeling to investigate the association between Alzheimer's disease and a prior diagnosis of peripheral vestibular disorders after accounting for sociodemographic characteristics and medical comorbidities including diabetes, coronary heart disease, hypertension, hyperlipidemia, and hearing loss. RESULTS: The results revealed a statistically significant difference in the prevalence of prior peripheral vestibular disorders between patients with Alzheimer's disease and controls; 20.6% among patients with Alzheimer's disease and 11.4% among controls (p < 0.001). Multivariable logistic regression analysis found that patients with Alzheimer's disease were twice as likely as controls to have had a prior diagnosis of peripheral vestibular disorders, adjusted odds ratio 2.040 (95% confidence interval: 1.829-2.274). CONCLUSIONS: The findings suggest the possibility of shared or related pathophysiological pathways in Alzheimer's disease and vestibular dysfunction disorders. LEVEL OF EVIDENCE: 3 Laryngoscope, 2024.

Increased prevalence of peripheral vestibular disorder among patients with Fabry disease.

BACKGROUND: Although peripheral vestibular disorder is a non-fatal complication of Fabry disease, fatalities have been reported in some case reports and case series. To date, no studies have examined the relative risk of peripheral vestibular disorder in patients with Fabry disease compared to the general population without the condition. Due to the high prevalence of Fabry disease in East Asia and the potential shared pathogenic pathways between Fabry disease and vasculopathy, we conducted a study using a nationwide population-based dataset to compare the prevalence of peripheral vestibular disorder between patients with Fabry disease and matched comparison patients. METHODS: Data was sourced from Taiwan's Longitudinal Health Insurance Database 2010. this study consists of 11,668 sampled patients, 2917 study patients with Fabry disease and 8751 propensity-score-matching comparison patients. We conducted multiple logistic regression analysis to study the association between peripheral vestibular disorder and Fabry disease. RESULTS: The study identified notable differences in the prevalence of various vestibular disorders between the study and comparison groups. Specifically, there was a 7.2% increased prevalence of peripheral vestibular disorder in the study group (28.3%) compared to the comparison group (20.9%), Meniere's disease (5.4% vs. 3.7%), benign paroxysmal positional vertigo (5.1% vs. 3.3%), and other/ unspecified peripheral vestibular dizziness (15.6% vs. 11.8%) (all p < 0.001). The odds ratios for PVD, MD, BPPV, and other PVD were 1.44 (95% CI = 1.29-1.60), 1.50 (95% CI = 1.23-1.83), 1.59 (95% CI = 1.30-1.95), and 1.40 (95% CI = 1.24-1.58), respectively, among the Fabry disease group relative to the comparison group after adjusting for age, monthly income, geographic location, urbanization level, hyperlipidemia, diabetes, coronary heart disease, and hypertension. CONCLUSION: This study found that patients with Fabry disease had increased prevalence of peripheral vestibular disorder.

Prevalence of hearing loss, tinnitus, vertigo and sudden deafness among patients with polymyositis and dermatomyositis.

Little is known about a possible association of autoimmune inner ear disease among patients diagnosed with polymyositis (PM)/dermatomyositis (DM). This study aimed to explore differences in the prevalence of inner ear symptoms among patients with and without PM/DM using a nationwide population-based dataset. Data for this study were retrieved from the Taiwan National Health Insurance Research Database. The study sample included 1622 patients diagnosed with PM/DM and 8109 propensity-score matched comparison patients without PM/DM. We performed multivariate logistic regressions to calculate odds ratios (ORs) and 95% confidence interval (CI) for tinnitus, hearing loss, sudden deafness, and vertigo among patients with PM/DM versus comparison patients. Chi-square tests showed statistically significant differences between patients with PM/DM and comparison patients in the prevalence of tinnitus (16.1% vs. 12.7%, p < 0.001), non-conductive hearing loss (9.2% vs. 6.8%, p < 0.001), and vertigo (14.4% vs. 11.1%, p < 0.001). The adjusted ORs for tinnitus, non-conductive hearing loss, and vertigo, respectively, were 1.332 (95% CI = 1.147-1.547), 1.399 (95% CI = 1.154-1.696), and 1.374 (95% CI = 1.173-1.611) for patients with PM/DM when compared to comparison patients. Our study finds that patients with PM/DM have higher prevalence rates of tinnitus, non-conductive hearing loss, and vertigo than comparison patients.

Association of thyroid cancer with human papillomavirus infections.

While Human Papillomavirus (HPV) particles have been detected in a small proportion of benign thyroid nodules or thyroid cancer cases, a role of HPV in these thyroid conditions has not been established. This study aims to investigate the association of HPV infection with thyroid cancer (TC) using a nationwide population-based study. We retrieved data for this case-control study from Taiwan's Longitudinal Health Insurance Database 2010. The study sample included 3062 patients with TC and 9186 propensity-scored matched controls. We employed multivariate logistic regression models to quantitatively evaluate the association of TC with HPV infections after taking age, sex, monthly income, geographic location and urbanization level of the patient's residence, diabetes, hypertension, and hyperlipidemia into considerations. Chi-squared test revealed that there was a significant difference in the prevalence of prior HPV infections between patients with TC and controls (15.3% vs. 7.6%, p < 0.001). The adjusted odds ratio of prior HPV infections for patients with TC was 2.199 (95% CI = 1.939-2.492) relative to controls. The adjusted ORs of prior HPV infections for patients with TC was similar for males and females. Our research suggests a significant link between HPV infection and the development of TC.

Increased prevalence of hearing loss, tinnitus and sudden deafness among patients with Sjögren's syndrome.

BACKGROUND: This study aimed to provide an updated prevalence of hearing loss, tinnitus, vertigo and sudden deafness on patients with Sjögren's syndrome and matched comparison patients. METHODS: Data for this study were retrieved from the Taiwan Longitudinal Health Insurance Database and Taiwan's registered catastrophic illness dataset. This study included 20 266 patients with Sjögren's syndrome as the study group and 60 798 propensity score-matched comparison patients as the comparison group. We used multivariable logistic regressions to estimate the ORs and 95% CI for tinnitus, hearing loss, vertigo and sudden deafness among Sjögren's syndrome patients versus comparison patients. RESULTS: χ2 tests showed there were statistically significant differences between the study group and comparison group in the prevalence of tinnitus (10.1% vs 6.3%, p<0.001), hearing loss (5.6% vs 3.3%, p<0.001), vertigo (4.6% vs 3.2%, p<0.001) and sudden deafness (0.8% vs 0.6%, p<0.001). Multiple logistic regression revealed that patients with Sjögren's syndrome had a greater tendency to have tinnitus (OR=1.690, 95% CI 1.596-1.788), sudden deafness (OR=1.368, 95% CI 1.137-1.647), hearing loss (OR=1.724, 95% CI 1.598-1.859) and vertigo (OR=1.473, 95% CI 1.360-1.597) relative to comparison patients after adjusting for age, income, geographic location, residential urbanisation level, diabetes, hypertension, hyperlipidaemia and rheumatoid arthritis. CONCLUSIONS: We found higher prevalence of hearing loss, vertigo, tinnitus and sudden deafness among patients with Sjögren's syndrome relative to comparison patients. Findings may provide guidance to physicians in counselling patients with Sjögren's syndrome regarding a higher risk of hearing loss, tinnitus, sudden deafness and vertigo.

Association of prostate cancer with human papillomavirus infections: a case-control study.

BACKGROUND: The highly oncogenic human papillomavirus (HPV) is associated with numerous cancer types. While the role of viruses in the development of certain cancers is well established, the association between HPV infections and prostate cancer remains a subject of ongoing debate. This study aimed to investigate a potential association of prostate cancer with HPV infections utilizing a case-control study. METHODS: We extracted data from the Taiwan Longitudinal Health Insurance Database 2010. We retrieved 5137 patients with prostate cancer as cases and a 3:1 ratio of propensity score-matched patients without prostate cancer (15,411 patients) as controls. Multiple logistic regression analyses were carried out to scrutinize the association of prostate cancer with HPV infections while taking into account age, monthly income category, geographic location and urbanization level of the patient's residence as well as hyperlipidemia, diabetes, hypertension and chronic prostatitis, tobacco use disorder, and alcohol abuse/alcohol dependence syndrome. RESULTS: The data indicate that out of all sampled patients, 1812 (8.8%) had a prior diagnosis of HPV infections before the index date. Among cases and matched controls, HPV infections were diagnosed in 743 (14.5%) and 1069 (6.9%) patients, respectively. The results from the chi-square test demonstrate that individuals with prostate cancer exhibited a significantly higher incidence rate of HPV infections than their control counterparts (p < 0.001). Furthermore, in comparison to controls, individuals with a history of HPV infections had an adjusted odds ratio of 2.321 (95% CI: 2.097~2.568) for developing prostate cancer. Notably, individuals diagnosed with chronic prostatitis were also more likely to be subsequently diagnosed with prostate cancer (adjusted odds ratio=1.586; 95% CI = 1.338~1.879), which aligns with expectations in this context. CONCLUSIONS: We found prostate cancer to be significantly associated with HPV infections, contributing to the mounting body of evidence indicating a plausible connection between the two.

Increased prevalences of head and neck cancers in patients with Sjögren's syndrome.

OBJECTIVE: This study aimed to investigate prevalences of head and neck cancers in patients with and those without Sjögren's syndrome using a population-based dataset. METHODS: We retrieved sampled patients from Taiwan's Longitudinal Health Insurance Database. This study included 38 930 patients with Sjögren's syndrome and 155 720 propensity-score matched comparison patients without Sjögren's syndrome. RESULTS: Chi-squared tests revealed that there was a statistically significant difference in the prevalences of head and neck cancers between patients with Sjögren's syndrome and comparison patients (1.77% vs. 1.22%, p < 0.001). The odds ratio for head and neck cancers for patients with Sjögren's syndrome relative to the comparison group was 1.452 (95% CI = 1.325-1.592). CONCLUSIONS: Our study demonstrated that patients with Sjögren's syndrome face increased odds of head and neck cancers, encompassing several sites including the oral cavity, oropharynx, nasopharynx, and thyroid.

Associations of Head and Neck Cancer with Hepatitis B Virus and Hepatitis C Virus Infection.

This case-control study investigates the associations between head and neck cancer (HNC), hepatitis B virus (HBV), and hepatitis C virus (HCV) infection. We included 5603 patients who had received a diagnosis of HNC as cases and 16,809 propensity score matching controls. We employed multivariate logistic regression models to evaluate the association of HNC with HBV and HCV infection after taking sociodemographic characteristics and diabetes, hypertension, hyperlipidemia, HPV infection, tobacco use disorder, and alcohol abuse/alcohol dependence syndrome into considerations. Results show that 7.9% of the total sample had been previously diagnosed with HBV infection, with 9.0% prevalence among cases and 7.6% among controls (p < 0.001). The chi-squared test suggests a significant difference in the prevalence of HCV infection between cases and controls (3.3% vs. 2.7%, p = 0.019). The covariate-adjusted odds ratio (OR) of HBV infection in patients with HNC relative to controls was 1.219 (95% CI = 1.093~1.359). Additionally, the adjusted OR of HCV infection in patients with HNC was 1.221 (95% CI = 1.023~1.457) compared to controls. Furthermore, patients with oropharyngeal cancer were more likely to have HCV infection than controls (adjusted OR = 2.142, 95% CI = 1.171~3.918). Our study provides evidence that suggests a potential association between HBV and HCV infections and the risk of HNC.

Association of Nasopharynx Cancer with Human Papillomavirus Infections.

This population-based study aims to examine the association between nasopharyngeal carcinoma and human papillomavirus infections. This study included 2747 individuals aged 20 years and older who were diagnosed with nasopharynx cancer as cases and 13,735 propensity-score-matching controls. Multivariate logistic regression models were employed to quantitatively assess the association of nasopharynx cancer with human papillomavirus infections while considering age, sex, monthly income, geographic location, and urbanization level of the patient's residence as well as diabetes, hypertension, and hyperlipidemia. Our chi-squared test indicated a significant dissimilarity in previous human papillomavirus infection rates between nasopharynx cancer patients and controls (12.7% vs. 7.2%, p < 0.001). The adjusted odds ratio (OR) for prior human papillomavirus infections was found to be significantly higher for nasopharyngeal carcinoma cases compared to controls at a value of 1.869 with confidence interval ranging from 1.640 to 2.128. Among female participants, compared to controls, the adjusted OR of prior human papillomavirus infections was 2.150 (95% CI = 1.763-2.626) in patients with nasopharynx cancer. In male participants sampled in this study, we observed a statistically significant association between prior human papillomavirus infections and nasopharynx cancer (adjusted OR = 1.689; 95% CI = 1.421-2.008). Our study indicates a noteworthy association between previous human papillomavirus infections and nasopharyngeal carcinoma.

Does peripheral vestibular disorder increase the risk of attempted suicide: A retrospective cohort study.

BACKGROUND: This study aimed to investigate the risk of attempted suicide in the population of patients diagnosed with peripheral vestibular disorders (PVD). METHODS: We conducted a retrospective cohort study. We extracted data on patients diagnosed with PVD (72,569 study patients) and a 3:1 ratio of propensity-score matched comparison patients without PVD (217,707 patients) from Taiwan's Longitudinal Health Insurance Database 2010. The claims records of sampled patients were tracked for a one-year period from their index date to identify claims showing a diagnosis of suicide attempt. Cox proportional hazards regression analyses were performed to calculate the one-year hazard ratio (HR) of suicide attempt following the PVD diagnosis among PVD patients relative to comparison patients. RESULTS: Of total 290,276 sampled patients, the rate of attempted suicide was 0.158 per 100 person-years, being 0.460 and 0.057, respectively, among PVD patients and comparison patients. Cox proportional hazard analysis showed that PVD patients had a high relative hazard of suicide attempt (adjusted HR = 7.622, 95 % CI = 6.196-9.376) during one-year follow-up relative to comparison patients. We also found that subcategories of PVD, showed similar adjusted hazard ratios as all PVDs: Meniere's disease (HR = 7.608, 95 % CI = 4.350-13.305), benign paroxysmal positional vertigo (HR = 8.201, 95 % CI = 4.716-14.260), and vestibular neuritis (HR = 9.399, 95 % CI = 5.036-17.544). LIMITATIONS: The incidence of suicide attempts could be underestimated in both the study group and comparison group, if the suicide attempt did not cause a medical emergency and the patient did not seek medical assistance. CONCLUSIONS: We found a high magnitude of association between PVD and subsequent suicide attempt.

Association of Chronic Otitis Media with Sjogren's Syndrome: A Case-Control Study.

There is a paucity of large-scale population-based study whether patients with Sjögren's syndrome are at higher risk of chronic otitis media. This study aimed to investigate the association of chronic otitis media with Sjögren's syndrome by utilizing the representative dataset of the Taiwanese population. We identified 9473 patients with chronic otitis media as cases. We used propensity score matching to select 28,419 controls. We used multiple logistic regression analysis to examine the association of chronic otitis media with prior Sjögren's syndrome after adjusting for age, sex, monthly income category, geographic location and urbanization level of the patient's residence, allergic rhinitis, chronic rhinosinusitis and tonsillitis and adenoiditis. Chi-square tests showed a statistically significant difference in Sjögren's syndrome between patients with chronic otitis media and controls (4.89% vs. 2.93%, p < 0.001). In addition, we found patients with chronic otitis media were more likely to have Sjögren's syndrome (OR = 1.698, 95% CI = 1.509~1.910) relative to controls after adjusting for age, income, geographic location, residential urbanization level, allergic rhinitis, chronic rhinosinusitis and tonsillitis and adenoiditis. We also found that of the male patients, patients with chronic otitis media had a greater tendency to Sjögren's syndrome than controls (adjusted OR = 1.982, 95% CI = 1.584~2.481). Similarly, a statistically significant association between Sjögren's syndrome and chronic otitis media remains in female sampled patients (adjusted OR = 1.604, 95% CI = 1.396~1.842). We found that patients with Sjögren's syndrome were associated with the occurrence of chronic otitis media. It may guide physicians as they counsel patients with Sjögren's syndrome on the possibility of chronic otitis media occurrence.

Trends in the incidence of head and neck cancer: A nationwide population-based study.

OBJECTIVE: This study aimed to demonstrate the temporal trend in incidence of head and neck cancer (HNC) in Taiwan. MATERIALS AND METHODS: Patients with a HNC were retrieved from the Taiwan's Health Insurance Database. We identified 16,894 patients aged ≥20 years who had received a first-time diagnosis of cancer of the oral cavity, oropharynx, larynx, hypopharynx, nasopharynx, sinonasal, salivary gland or thyroid gland between 2010 and 2018. We calculated the annual incidence rate per 100,000 population, overall, and classified by gender and cancer type. We also used the annual percent change (APC) to characterize trends in head and neck cancer rates over time. RESULTS: The incidence rate showed a gradual decline during this period from 2010 to 2018 with an APC of -2.81% (p < 0.001). Within gender groups, the decline was not statistically significant among females (APC = -1.69, 95% CI = -3.58 âˆ¼ 0.23, p = 0.080). Within cancer types, strikingly high magnitude and statistically significant declines were observed in respect of cancer of the nasopharynx (APC = -7.89%, 95% CI = -9.43%∼-6.31%, p < 0.001), sinonasal cancer (APC = -10.08%, 95% CI = -16.66%∼-2.99%, p = 0.012) and oropharyneal cancer (APC = -9.47%, 95% CI = -15.15%∼-3.42%, p = 0.013) over the study period. In contrast, there was a statistically significant increase in incidence on thyroid cancer over the study period with an APC of 4.75% (95% CI = -2.81%∼6.75%, p < 0.001). CONCLUSIONS: HNCs in Taiwan are showing a decreasing trend, led by the upper respiratory and oropharyngeal cancers. However, there was a concurrent increasing trend of the incidence on thyroid cancer. These trends may be attributable to changing lifestyles and behavioral choices in Taiwan.

Tinnitus and risk of attempted suicide: A one year follow-up study.

BACKGROUND: Tinnitus causes emotional stress that can be extreme, bringing on anxiety, depression, or sleep disorders. We used a nationwide, population-based database to study the risk of attempted suicide among adults with tinnitus. METHODS: Data for this retrospective cohort study were extracted from the Taiwan National Health Insurance Research Database, on 386,055 patients with tinnitus and propensity score-matched controls. We performed Cox proportional hazards regression analysis to calculate the one-year hazard of a suicide attempt and 95 % confidence intervals (CI) following a first-time diagnosis of tinnitus. RESULTS: The results shows that the incidence of attempted suicide was 0.253 (95 % CI = 0.237-0.269) and 0.123 (95 % CI = 0.113-0.135) for the study cohort and comparison cohort, respectively. The log-rank test suggested that the study cohort had significantly lower suicide attempt-free survival at one year than the comparison cohort (p < 0.001). Cox proportional analysis shows that the hazard ratio of attempted suicide within the one-year follow-up period was 2.04 (95 % CI = 1.83-2.28) for patients with tinnitus than those in the comparison cohort after adjusting for the patients' age, sex, monthly income, geographic region, urbanization level of the patient's residence, hyperlipidemia, diabetes, coronary heart disease, and hypertension. LIMITATIONS: The database lacks information on socioeconomic problems, specific personal characteristics or traits, marital status, or other factors associated with attempts to commit suicide. Notably, our study addressed suicide attempts as detected from claims-based ICD codes which do not cover suicidal ideation or suicidal death. CONCLUSIONS: We found increased likelihood of attempted suicide among patients with tinnitus.

Absence of Association of Tinnitus With Pre-existing Hypertension: A Population-based Study.

OBJECTIVES: Whether tinnitus is associated with pre-existing hypertension remains uncertain. This study explored the association between tinnitus and pre-existing hypertension. METHODS: We obtained data on a retrospective cohort of 542 884 cases ≥18 years old with a first-time tinnitus diagnosis from Taiwan's National Health Insurance Research Database. We used propensity-score matching to select 542 884 matched controls and performed multiple logistic regression analyses to estimate the adjusted odds of prior hypertension among patients with tinnitus versus controls. RESULTS: Bivariate analysis showed no significant difference in the prevalence of prior hypertension between the tinnitus and no-tinnitus groups (35.58% vs 35.5%, P = .617). Univariable logistic regression analysis confirmed the bivariate analysis finding, unadjusted odds of prior hypertension among the tinnitus group relative to controls, 1.002, 95% CI: 0.994-1.010, P = .617). After adjusting for age, sex, monthly income, geographic location and urbanization level, hyperlipidemia, diabetes, hearing loss, obesity, anemia, rheumatoid arthritis, alcohol abuse, nicotine dependence, anxiety disorder, depressive disorder and idiopathic intracranial hypertension, the odds of prior hypertension were similar among the tinnitus and no-tinnitus groups (OR = 1.006, 95% CI: 0.997-1.016, P = .178). CONCLUSIONS: Our population-based study found no evidence for an association between tinnitus and pre-existing hypertension.

Trends in the incidence of peripheral vestibular disorders: a Nationwide population-based study.

Purpose: This study aimed to examines the long-term trend of incidence of peripheral vestibular disorders between 2010 and 2018 in Taiwan. Methods: Study-eligible patients were identified from Taiwan's Longitudinal Health Insurance Database 2005 maintained by the Ministry of Health and Welfare in Taiwan. We retrieved 230,566 patients with a first-time diagnosis of peripheral vestibular disorders between 2010 and 2018. We calculated annual incidence rates of peripheral vestibular disorders per 100,000 population. We used the annual percent change (APC) to test the trend of peripheral vestibular disorders over time. Results: The mean annual incidence rate of peripheral vestibular disorders during the study period was 1489.6 per 100,000 population. Incidence showed a statistically significant steady decrease from 2010 to 2018 with a mean APC of -6.15% (95% CI = -6.97% ~ -5.32%). The decline was led by Meniere's disease (APC = -9.83, 95% CI = -10.66% ~ -8.99%), followed by benign paroxysmal positional vertigo (APC = -3.69, 95% CI = -4.53% ~ -3.03%), vestibular neuritis (APC = -7.85, 95% CI = -8.96 ~ -6.73), and other peripheral vestibular dizziness (APC = -5.56, 95% CI = -6.69% ~ -4.43%). Conclusion: The incidence of peripheral vestibular disorders, overall, and the four major subgroups, benign paroxysmal positional vertigo, Meniere's disease, vestibular neuritis, and other peripheral vestibular dizziness, all decreased substantially, year by year within the 2010-2018 period.

Association of Fabry Disease with Hearing Loss, Tinnitus, and Sudden Hearing Loss: A Nationwide Population-Based Study.

Hearing loss and the related otologic manifestations are receiving increased scrutiny as significant causes of morbidity in Fabry disease. However, the relative risks of auditory deficits among patients with Fabry disease relative to the general population without a diagnosis of Fabry disease have not been studied. This study aims to explore the associations between Fabry disease and hearing-related manifestations using a nationwide population-based dataset. We identified study patients for this cross-sectional study from the 2015−2017 claims databases of the Taiwan Longitudinal Health Insurance Database 2005. We first identified 2312 patients aged over 20 years with a diagnosis of Fabry disease. We used propensity score matching to select five comparison patients per patient with Fabry disease and 11,560 comparison patients without Fabry disease. We used multivariable logistic regressions to estimate the odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for tinnitus, hearing loss, and sudden deafness among Fabry disease patients vs. comparison patients. Chi-square tests showed statistically significant differences between patients with and without Fabry disease in the prevalence rates of tinnitus (16.7% vs. 11.7%, p < 0.001), hearing loss (7.5% vs. 6.2%, p = 0.014) and sudden deafness (1.7% vs. 1.0%, p = 0.005). Multiple logistic regression revealed that patients with Fabry disease were more likely to suffer from tinnitus, hearing loss and sudden deafness, with adjusted odds ratios of 1.513 (95% CI = 1.336−1.713), 1.246 (95% CI = 1.047−1.483), and 1.681 (95% CI = 1.166−2.423), respectively. We found that Fabry disease is significantly associated with certain auditory manifestations, including hearing loss, sudden deafness, and tinnitus.

Association of Chronic Kidney Disease with Prior Tinnitus: A Case-Control Study.

This population-based, case−control study aims to explore the relationship between prior tinnitus and the occurrence of chronic kidney disease (CKD) using a nationwide, population-based cohort study. We used data from the Taiwan National Health Insurance Research Database to explore the association of CKD with tinnitus. We identified 15,314 patients aged ≥40 years old with a first-time diagnosis of CKD as the cases. We used propensity-scored matching to select 45,942 controls (1:3 ratio). We performed multivariate logistic regression to estimate the odds ratio (OR) of a prior tinnitus diagnosis among the CKD group vs. the control group. Analysis showed that 770 (1.26%) out of the 61,256 sampled patients had previously diagnosed tinnitus. Chi-square testing revealed a significant difference in the rate of previously diagnosed tinnitus between cases and controls (3.86% vs. 0.93%, p < 0.001). Univariate logistic regression analysis showed an OR of prior tinnitus for cases of 10.249 (95% confidence interval (CI): (8.662~12.126)) relative to controls. In adjusted analysis, cases were more likely than controls to have a prior diagnosis of tinnitus (OR = 10.970, 95% CI = 9.255~13.004, p < 0.001) after adjusting for age, sex, monthly income, geographic location, urbanization level, hypertension, diabetes, coronary heart disease, hyperlipidemia, obesity, and autoimmune disease. Our study shows that CKD patients have a higher likelihood of having suffered from tinnitus before CKD was diagnosed, but we have no data suggesting that tinnitus is a predictor of subsequent CKD. Patients diagnosed with tinnitus may benefit from proactive measures to prevent CKD and detect it early through lifestyle modifications and regular renal function examinations, regardless of CKD-related symptoms.

Association of Age-Related Macular Degeneration with Prior Hyperthyroidism and Hypothyroidism: A Case-Control Study.

Prior studies suggest a possible association between thyroid disease and the subsequent development of age-related macular degeneration (AMD), although it remains inconclusive. This study aimed to evaluate the association of AMD with prior hyper-/hypothyroidism based on nationwide population-based data. We retrieved records of the study patients from the National Health Insurance Research Database, 7522 patients with a first-time diagnosis of AMD and 7522 propensity score-matched controls. Multiple logistic regression analyses were performed to explore the association of neovascular AMD with previously diagnosed hyperthyroidism or hypothyroidism. The Chi-square test shows that there was a statistically significant difference in the prevalence of prior hyperthyroidism between cases and controls (1.18 vs. 0.13%, p < 0.001). Furthermore, there was a statistically significant difference the prevalence of prior hypothyroidism between cases and controls (0.44 vs. 0.69%, p < 0.001). Multiple logistic regression analysis reveals that AMD was statistically and significantly associated with prior hyperthyroidism after adjusting for age, sex, monthly income, geographical location, urbanization level, hypertension, hyperlipidemia, diabetes, and coronary heart disease (odds ratio (OR) = 9.074, 95% CI = 4.713−17.471). The adjusted OR of prior hypothyroidism in patients with AMD was 3.794 (95% CI: 2.099~6.858) when compared to the controls. We conclude that patients with thyroid dysfunction are at higher risk of developing AMD Results suggest that these patients could benefit from proactive regular eye checkups to detect evolving eye pathology, even while vision remains normal during the initial phases.

Increased Risk of Major Depressive Disorder Following Tinnitus: A Population-Based Study.

Background and Purpose: In this study, we aimed to evaluate the relationship between tinnitus and a subsequent diagnosis of major depressive disorder (MDD) by studying the incidence of both entities. Design: A retrospective cohort study. Methods: Data for this observational follow-up study were retrieved from the Taiwan's National Health Insurance Dataset. A total of 375,272 patients with newly diagnosed tinnitus (study group) were retrieved. The date of first diagnosis of tinnitus was assigned as their index date. Comparison patients were selected by propensity score matching (one per case, n = 375,272 controls) from the same dataset, with their index date being the date of their first health service claim in the year of diagnosis of their matched index case. We tracked each patient's claims records for 1 year from the index date to identify those who received a diagnosis of MDD. Cox proportional hazards regression was performed to calculate the MDD hazard ratio for cases vs. controls. Results: We found that the overall incidence rate for MDD was 0.78 (95% CI = 0.76~0.80) per 100 person-years, being 1.17 (95% CI = 1.14~1.21) among the study cohorts and 0.38 (95% CI = 0.36~0.40) among the comparison cohorts. The log-rank test revealed that the patients in the study cohort had significantly lower one-year MDD-free survival when compared to the comparison cohort (p < 0.001). Cox proportional hazards analysis showed that the patients in the study cohort had a higher hazard of developing MDD than the patients in the comparison cohort (adjusted HR = 3.08, 95% CI = 2.90~3.27). Conclusions: In this study, we demonstrate that tinnitus is associated with an increased hazard of subsequent MDD in Taiwan.

Association of Primary Open-angle Glaucoma With Tinnitus: A Nationwide Population-Based Study.

PRCIS: This study aims to investigate the association between primary open-angle glaucoma (POAG) and tinnitus. We found that tinnitus was significantly associated with preexisting POAG [adjusted odds ratio (OR)=1.298]. PURPOSE: The purpose of this study was to investigate the association between POAG and tinnitus using nationwide population-based data from Taiwan. METHODS: Data for this case-control study were retrieved from the Taiwan National Health Insurance Research Database for all 542,682 patients with a first-time diagnosis of tinnitus (cases), and 1,628,046 propensity score-matched controls from Taiwan's National Health Insurance system. We performed multiple logistic regression analysis to estimate the odds (ORs) of prior POAG among cases versus controls. RESULTS: Of total 2,170,728 study patients, 85,257 (3.93%) had POAG before the index date of tinnitus, 25,496 (4.70%) among cases and 59,761 (3.67%) among controls (P<0.001). Multiple logistic regression analysis showed a significant association between prior POAG and tinnitus (OR=1.298, 95% confidence interval: 1.278-1.318) after adjusting for age, sex, monthly income, geographic location and residential urbanization level, hyperlipidemia, diabetes, obesity, anemia, rheumatoid arthritis, alcohol abuse, nicotine dependence, anxiety disorder, depressive disorder, and hypertension. CONCLUSIONS: Patients with POAG have a higher risk of tinnitus compared with those without the disease. Ophthalmologists should be aware of this association and further studies are needed to understand underlying mechanisms.