Harnod Tomor, Chen Hsuan-Ju, Li Tsai-Chung, Sung Fung-Chang, Kao Chia-Hung
Department of Neurosurgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; College of Medicine, Tzu Chi University, Hualien, Taiwan.
Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
Ann Epidemiol. 2014 Dec;24(12):910-4. doi: 10.1016/j.annepidem.2014.09.008. Epub 2014 Sep 28.
This study evaluated the effect of epilepsy on the development of hyperlipidemia (HL) in Taiwan.
We conducted a nationwide population-based cohort study based on data obtained from the National Health Insurance Research Database of Taiwan. We identified 990 cases involving patients whose epilepsy was newly diagnosed between 2000 and 2005, and we also selected a comparison cohort comprising 3960 patients without epilepsy. Cox proportional hazards regression models were used to examine the association between epilepsy and HL.
The mean follow-up period was 6.63 years for the epilepsy cohort and 7.49 years for the comparison cohort. The incidence rate of HL was 1.28-fold higher in the epilepsy cohort than it was in the comparison cohort (34.14 vs. 26.96 per 1000 person-years), with an adjusted hazard ratio of 1.17 (95% confidence interval, 1.01-1.36) after adjusting the model to account for the effects of sex and comorbidities. The most at-risk patients were those aged 50 to 59 years (hazard ratio, 1.35; 95% confidence interval, 1.04-1.79). For the epilepsy patients, the combined effect of ischemic heart disease, hypertension, and diabetes was associated with a significantly higher risk of developing HL compared with the patients with neither epilepsy nor any comorbidity.
Middle-aged epilepsy patients are at a significantly higher risk of developing HL. The results could assist in explaining the high risk of cerebral and cardiac vascular disease in epilepsy patients.
本研究评估了癫痫对台湾地区高脂血症(HL)发生发展的影响。
我们基于从台湾地区国民健康保险研究数据库获取的数据,开展了一项全国性的基于人群的队列研究。我们确定了990例在2000年至2005年间新诊断为癫痫的患者,同时还选取了一个由3960例无癫痫患者组成的对照队列。采用Cox比例风险回归模型来检验癫痫与HL之间的关联。
癫痫队列的平均随访期为6.63年,对照队列的平均随访期为7.49年。癫痫队列中HL的发病率比对照队列高1.28倍(每1000人年分别为34.14例和26.96例),在对模型进行性别和合并症影响调整后,调整后的风险比为1.17(95%置信区间,1.01 - 1.36)。风险最高的患者是年龄在50至59岁之间的人群(风险比,1.35;95%置信区间,1.04 - 1.79)。对于癫痫患者,与既无癫痫也无任何合并症的患者相比,缺血性心脏病、高血压和糖尿病的综合作用与发生HL的风险显著更高相关。
中年癫痫患者发生HL的风险显著更高。这些结果有助于解释癫痫患者发生脑血管和心血管疾病的高风险。