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耳鸣与中青年患者缺血性脑血管病风险之间的关联:一项基于全国人群健康保险理赔数据库的二次病例对照分析

The association between tinnitus and the risk of ischemic cerebrovascular disease in young and middle-aged patients: A secondary case-control analysis of a nationwide, population-based health claims database.

作者信息

Huang Yung-Sung, Koo Malcolm, Chen Jin-Cherng, Hwang Juen-Haur

机构信息

Department of Neurology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan.

Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan.

出版信息

PLoS One. 2017 Nov 2;12(11):e0187474. doi: 10.1371/journal.pone.0187474. eCollection 2017.

Abstract

BACKGROUND

Tinnitus and ischemic cerebrovascular disease (ICVD) may share common pathophysiologic mechanisms. Nevertheless, no studies have investigated whether tinnitus is associated with a higher risk of ICVD. The aim of this study was to evaluate the risk of ICVD among young and middle-aged patients with tinnitus.

METHODS

Using the Taiwan's National Health Insurance Research Database, we identified 3,474 patients 20-45 years old with incident ICVD diagnosed between January 1, 2000 and December 31, 2010 and 17,370 controls, frequency matched on age interval, sex, and year of the index date. Risk of ICVD associated with tinnitus was assessed using multiple logistic regression analyses.

RESULTS

Tinnitus was significantly associated with a higher risk of incident ICVD among young and middle-aged patients (adjusted odds ratio [OR] 1.66, 95% confidence interval [CI] 1.34-2.04), adjusting for sex, age, and comorbidities. In addition, sex-stratified analysis showed that the associations were significant in both male (adjusted OR 1.55, 95% CI 1.16-2.07) and female patients (adjusted OR 1.77, 95% CI 1.30-2.41). Furthermore, tinnitus was significantly associated with a higher risk of ICVD in the 20.0-29.9 years (adjusted OR 4.11, 95% CI 1.98-8.52) and 30.0-39.9 years (adjusted OR 2.19, 95% CI 1.57-3.05) age groups, but not in the 40.0-45.0 years age group.

CONCLUSIONS

Tinnitus could be a novel risk factor or clinical indicator for young ischemic stroke, and further investigations are warranted.

摘要

背景

耳鸣与缺血性脑血管疾病(ICVD)可能具有共同的病理生理机制。然而,尚无研究调查耳鸣是否与ICVD的较高风险相关。本研究的目的是评估中青年耳鸣患者发生ICVD的风险。

方法

利用台湾地区国民健康保险研究数据库,我们确定了2000年1月1日至2010年12月31日期间诊断为新发ICVD的3474例20至45岁患者,并选取了17370例对照,根据年龄区间、性别和索引日期进行频率匹配。使用多因素逻辑回归分析评估与耳鸣相关的ICVD风险。

结果

在调整性别、年龄和合并症后,耳鸣与中青年患者发生ICVD的较高风险显著相关(调整后的优势比[OR]为1.66,95%置信区间[CI]为1.34 - 2.04)。此外,按性别分层分析显示,男性(调整后的OR为1.55,95% CI为1.16 - 2.07)和女性患者(调整后的OR为1.77,95% CI为1.30 - 2.41)中这种关联均显著。此外,耳鸣与20.0 - 29.9岁(调整后的OR为4.11,95% CI为1.98 - 8.52)和30.0 - 39.9岁(调整后的OR为2.19,95% CI为1.57 - 3.05)年龄组的ICVD较高风险显著相关,但在40.0 - 45.0岁年龄组中不相关。

结论

耳鸣可能是青年缺血性卒中的一个新的危险因素或临床指标,值得进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6051/5667787/802fc59ada2b/pone.0187474.g001.jpg

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