Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Computer Science and Information Engineering, National Cheng Kung University, Tainan, Taiwan.
J Clin Sleep Med. 2022 Apr 1;18(4):1113-1120. doi: 10.5664/jcsm.9816.
The aim of this study is to evaluate the relationship between the month of birth (MOB) and the risk of narcolepsy.
We conducted a systematic review of the electronic databases PubMed, Embase, and Cochrane CENTRAL from their inception to September 30, 2021. We also added data on narcolepsy from the National Health Insurance Research Database in Taiwan. Then we extracted the relative risk (RR) ratios of narcolepsy in each month of birth to those of the general population and transformed them from MOB to season. A random-effects model was used to calculate pooled RR ratios from the meta-analysis and 95% confidence interval (CI).
The meta-analysis analyzed 7 studies and included 3,776 patients from 8 areas (Canada, China, France, Germany, Hong Kong, Netherlands, Taiwan, and United States). The RR ratio was highest in March (1.11; 95% CI, 0.99-1.26) and August (1.11; 95% CI, 0.98-1.26) and lowest in April (0.90; 95% CI, 0.78-1.03). However, none of the MOBs reached statistical significance. Moreover, the narcolepsy risk patterns on the 3 continents (Asia, Europe, and North America) were different. In North America, the highest and lowest significant risks were found in March (1.47; 95% CI, 1.20-1.79) and September (0.75; 95% CI, 0.56-0.99). In Asia, the lowest notable risk was in April (0.80; 95% CI, 0.66-0.97). In Europe, the risk of narcolepsy was not significantly related to any MOB. In terms of seasons, only spring MOBs in North America had a significantly higher risk (1.21; 95% CI, 1.06-1.38).
The findings indicated that the risk of narcolepsy and MOB differed across the 3 continents. This study indicates the important role of environmental factors in narcolepsy.
Registry: PROSPERO; Identifier: CRD42020186660.
Hsu C-W, Tseng P-T, Tu Y-K, et al. Month of birth and the risk of narcolepsy: a systematic review and meta-analysis. 2022;18(4):1113-1120.
本研究旨在评估出生月份（MOB）与嗜睡症风险之间的关系。
我们对电子数据库 PubMed、Embase 和 Cochrane CENTRAL 进行了系统回顾，检索时间从其建立到 2021 年 9 月 30 日。我们还从台湾全民健康保险研究数据库中添加了嗜睡症的数据。然后，我们提取了出生月份与一般人群相比的嗜睡症相对风险（RR）比值，并将其从 MOB 转换为季节。使用荟萃分析中的随机效应模型计算汇总 RR 比值和 95%置信区间（CI）。
荟萃分析分析了 7 项研究，共纳入来自 8 个地区（加拿大、中国、法国、德国、中国香港、荷兰、台湾和美国）的 3776 名患者。RR 比值最高的是 3 月（1.11；95%CI，0.99-1.26）和 8 月（1.11；95%CI，0.98-1.26），最低的是 4 月（0.90；95%CI，0.78-1.03）。然而，没有一个 MOB 达到统计学意义。此外，3 大洲（亚洲、欧洲和北美洲）的嗜睡症风险模式不同。在北美洲，最高和最低的显著风险出现在 3 月（1.47；95%CI，1.20-1.79）和 9 月（0.75；95%CI，0.56-0.99）。在亚洲，最低的显著风险出现在 4 月（0.80；95%CI，0.66-0.97）。在欧洲，嗜睡症的风险与任何 MOB 均无显著相关性。就季节而言，只有北美洲的春季 MOB 风险显著升高（1.21；95%CI，1.06-1.38）。
研究结果表明，嗜睡症和 MOB 的风险在 3 大洲之间存在差异。本研究表明环境因素在嗜睡症中起着重要作用。
PROSPERO；标识符：CRD42020186660。
Hsu C-W, Tseng P-T, Tu Y-K, et al. 出生月份与嗜睡症风险：系统评价和荟萃分析。 2022;18(4):1113-1120.
