Nationwide Population-Based Epidemiological Study of Myasthenia Gravis in Taiwan

Background: Prednisone is a common treatment for myasthenia gravis (MG), and osteoporosis is a known potential risk of chronic prednisone therapy. Objective: Our aim was to evaluate the risk of serious fractures in a population-based cohort of MG patients. Methods: An inception cohort of patients with MG was identified from administrative health data in Ontario, Canada between April 1, 2002 and December 31, 2015. For each MG patient, we matched 4 general population comparators based on age, sex, and region of residence. Fractures were identified through emergency department and hospitalization data. Crude overall rates and sex-specific rates of fractures were calculated for the MG and comparator groups, as well as rates of specific fractures. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression. Results: Among 3,823 incident MG patients (followed for a mean of 5 years), 188 (4.9%) experienced a fracture compared with 741 (4.8%) fractures amongst 15,292 matched comparators. Crude fracture rates were not different between the MG cohort and matched comparators (8.71 vs. 7.98 per 1000 patient years), overall and in men and women separately. After controlling for multiple covariates, MG patients had a significantly lower risk of fracture than comparators (HR 0.74, 95% CI 0.63–0.88). Conclusions: In this large, population-based cohort of incident MG patients, MG patients were at lower risk of a major fracture than comparators. The reasons for this finding are unclear but may highlight the importance osteoporosis prevention.

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Absence of Association between Previous Mycoplasma pneumoniae Infection and Subsequent Myasthenia Gravis: A Nationwide Population-Based Matched Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147677 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7677

Author(s):

Kuan Chen ◽

James Cheng-Chung Wei ◽

Hei-Tung Yip ◽

Mei-Chia Chou ◽

Renin Chang

Keyword(s):

Cohort Study ◽

Myasthenia Gravis ◽

Mycoplasma Pneumoniae ◽

Pathogenic Bacteria ◽

Case Reports ◽

Statistical Significance ◽

Subsequent Development ◽

Population Based ◽

Cox Proportional Hazards ◽

The Impact

Mycoplasma pneumoniae (M. pneumoniae) is not only one of the most common pathogenic bacteria for respiratory infection but also a trigger for many autoimmune diseases. Its infection process shared many similarities with the pathogenesis of myasthenia gravis (MG) at cellular and cytokine levels. Recent case reports demonstrated patients present with MG after M. pneumoniae infection. However, no epidemiological studies ever looked into the association between the two. Our study aimed to investigate the relationship between M. pneumoniae infection and subsequent development of MG. In this population-based retrospective cohort study, the risk of MG was analyzed in patients who were newly diagnosed with M. pneumoniae infection between 2000 and 2013. A total of 2428 M. pneumoniae patients were included and matched with the non-M. pneumoniae control cohort at a 1:4 ratio by age, sex, and index date. Cox proportional hazards regression analysis was applied to analyze the risk of MG development after adjusting for sex, age, and comorbidities, with hazard ratios and 95% confidence intervals. The incidence rates of MG in the non-M. pneumoniae and M. pneumoniae cohorts were 0.96 and 1.97 per 10,000 person-years, respectively. Another case–control study of patients with MG (n = 515) was conducted to analyze the impact of M. pneumoniae on MG occurrence as a sensitivity analysis. The analysis yielded consistent absence of a link between M. pneumoniae and MG. Although previous studies have reported that M. pneumoniae infection and MG may share associated immunologic pathways, we found no statistical significance between M. pneumoniae infection and subsequent development of MG in this study.

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Population-based epidemiological study on characteristics of risk factors of hypercholesterolemia in Saudi Arabia

International Journal of Cardiology ◽

10.1016/s0167-5273(97)00164-2 ◽

1997 ◽

Vol 62 (1) ◽

pp. 47-54 ◽

Cited By ~ 6

Author(s):

Abdul Rahman Al-Nuaim ◽

Soleman Mirdad ◽

Khalid Al-Rubeaan ◽

Yagob Al-Mazrou ◽

Omer Al-Attas ◽

...

Keyword(s):

Risk Factors ◽

Saudi Arabia ◽

Epidemiological Study ◽

Population Based

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Increased risk of osteoporosis in patients with myasthenia gravis: A population-based cohort study

Neurology ◽

10.1212/wnl.0000000000000804 ◽

2014 ◽

Vol 83 (12) ◽

pp. 1075-1079 ◽

Cited By ~ 13

Author(s):

J.-H. Yeh ◽

H.-J. Chen ◽

Y.-K. Chen ◽

H.-C. Chiu ◽

C.-H. Kao

Keyword(s):

Cohort Study ◽

Myasthenia Gravis ◽

Population Based ◽

Increased Risk

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Sex-specific differences in prevalence and in the factors associated to the search for health services in a population based epidemiological study

Revista Brasileira de Epidemiologia ◽

10.1590/1809-4503201400020004eng ◽

2014 ◽

Vol 17 (2) ◽

pp. 323-340 ◽

Cited By ~ 5

Author(s):

Suzana Alves de Moraes ◽

Daniele Almeida Lopes ◽

Isabel Cristina Martins de Freitas

Keyword(s):

Epidemiological Study ◽

Associated Factors ◽

Access To Health Care ◽

Health Care Services ◽

Economic Indicator ◽

Population Based ◽

Cross Sectional ◽

Women Health ◽

Care Services ◽

Health Related

Objectives: To identify the access to health care services and associated factors in adults living in the city of Ribeirão Preto, São Paulo, Brazil, in 2007. Methods: A cross-sectional population-based epidemiological study with a sample developed in three stages. The variability introduced in the third sampling fraction was corrected by the attribution of weights, resulting in a sample of 2,471 participants. The outcome prevalence was estimated according to socio-demographic, behavioral and health-related variables. In order to identify associated factors, the regression of Poisson was used, obtaining crude and adjusted prevalence ratios. All estimates were calculated taking into account the effect of the sampling design. Results: The outcome prevalence increased according to the age, being higher in female individuals. A different set of variables remained in the final models, considering each gender separately. Among men, the monthly income > R$ 1,400.00; scores > 823.6 to the Economic Indicator of Ribeirão Preto (IERP) and daily average of sitting down time (154.4 - 240 min/day) constituted themselves into protective factors, whereas the increase of age and scholarship, hospitalization, diabetes and hypertension constituted risk factors for the use of the services. Among women, health self-reported as regular, hospitalization, diabetes and hypertension characterized factors positively associated to the outcome at matter. Conclusions: The results indicate the need for planning actions aimed at capturing male individuals, as well as the revaluation of detection and control of diabetes and hypertension programs, aimed at the primary prevention of terminal cardiovascular events.

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