Dataset Information

Association between tonsillitis and newly diagnosed ankylosing spondylitis: A nationwide, population-based, case-control study.

ABSTRACT: OBJECTIVES:To investigate the association between tonsillitis and the risk of newly diagnosed ankylosing spondylitis (AS). METHODS:We used 2003-2012 data from Taiwan's National Health Insurance Research Database to conduct this nationwide, population-based, case-control study. We identified AS patients newly diagnosed between 2005 to 2012 as the study group and selected age, sex and index-year matched (1:6) non-AS individuals as controls. The association between tonsillitis and risk of newly diagnosed AS was determined by calculating odds ratios (ORs) with 95% confidence intervals (CIs) using conditional logistic regression analysis. RESULTS:We identified 37,002 newly diagnosed AS cases and 222,012 matched non-AS controls. Patients with AS were more likely to have tonsillitis (aOR 1.46, 95% CI 1.43-1.50), appendicitis (aOR 1.29, 95% CI 1.13-1.48) and periodontitis (aOR 1.35, 95% CI 1.31-1.38) than non-AS control subjects. The association between tonsillitis and AS was consistent using varying definitions for tonsillitis, and we further found that a high frequency of visits for tonsillitis, a high medical cost for tonsillitis and a long interval between diagnosis were associated with newly diagnosed AS in a dose-response manner. Furthermore, the association between tonsillitis and AS appeared to be stronger in females (aOR 1.59, 95% CI 1.53-1.65) than those in males (aOR 1.39, 95% CI 1.35-1.44). CONCLUSIONS:The present study revealed an association between AS risk and prior tonsillitis and indicates the need for vigilance of AS-associated symptoms in patients who had been diagnosed with tonsillitis, particularly in females.

SUBMITTER: Chao WC

PROVIDER: S-EPMC6675079 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Association between tonsillitis and newly diagnosed ankylosing spondylitis: A nationwide, population-based, case-control study.

Chao Wen-Cheng WC Lin Ching-Heng CH Chen Yi-Ming YM Jiang Rong-San RS Chen Hsin-Hua HH

PloS one 20190801 8

<h4>Objectives</h4>To investigate the association between tonsillitis and the risk of newly diagnosed ankylosing spondylitis (AS).<h4>Methods</h4>We used 2003-2012 data from Taiwan's National Health Insurance Research Database to conduct this nationwide, population-based, case-control study. We identified AS patients newly diagnosed between 2005 to 2012 as the study group and selected age, sex and index-year matched (1:6) non-AS individuals as controls. The association between tonsillitis and ri ...[more]

PMID: 31369625

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Project description:BackgroundOutdoor air pollution has been found to trigger systemic inflammatory responses and aggravate the activity of certain rheumatic diseases. However, few studies have explored the influence of air pollution on the activity of ankylosing spondylitis (AS). As patients with active AS in Taiwan can be reimbursed through the National Health Insurance programme for biological therapy, we investigated the association between air pollutants and the initiation of reimbursed biologics for active AS.MethodsSince 2011, hourly concentrations of ambient air pollutants, including PM2.5, PM10, NO2, CO, SO2, and O3, have been estimated in Taiwan. Using Taiwanese National Health Insurance Research Database, we identified patients with newly diagnosed AS from 2003 to 2013. We selected 584 patients initiating biologics from 2012 to 2013 and 2336 gender-, age at biologic initiation-, year of AS diagnosis- and disease duration-matched controls. We examined the associations of biologics initiation with air pollutants exposure within 1 year prior to biologic use whilst adjusting for potential confounders, including disease duration, urbanisation level, monthly income, Charlson comorbidity index (CCI), uveitis, psoriasis and the use of medications for AS. Results are shown as adjusted odds ratio (aOR) with 95% confidence intervals (CIs).ResultsThe initiation of biologics was associated with exposure to CO (per 1 ppm) (aOR, 8.57; 95% CI, 2.02-36.32) and NO2 (per 10 ppb) (aOR, 0.23; 95% CI, 0.11-0.50). Other independent predictors included disease duration (incremental year, aOR, 8.95), CCI (aOR, 1.31), psoriasis (aOR, 25.19), use of non-steroidal anti-inflammatory drugs (aOR, 23.66), methotrexate use (aOR, 4.50; 95% CI, 2.93-7.00), sulfasalazine use (aOR, 12.16; 95% CI, 8.98-15.45) and prednisolone equivalent dosages (mg/day, aOR, 1.12).ConclusionsThis nationwide, population-based study revealed the initiation of reimbursed biologics was positively associated with CO levels, but negatively associated with NO2 levels. Major limitations included lack of information on individual smoking status and multicollinearity amongst air pollutants.

Dataset Information

Association between tonsillitis and newly diagnosed ankylosing spondylitis: A nationwide, population-based, case-control study.

Publications

Association between tonsillitis and newly diagnosed ankylosing spondylitis: A nationwide, population-based, case-control study.

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