Patients with juvenile idiopathic arthritis are at increased risk for obstructive sleep apnoea: a population-based cohort study

Abstract

Background and objectives Juvenile idiopathic arthritis (JIA), an autoimmune disease, has been proposed to be comorbid with obstructive sleep apnoea (OSA). We aimed at testing the hypothesis that patients with JIA may presented with high risk of OSA in a cohort study. Subjects and methods This is a cohort study including patients with JIA from 1999 to 2013 identified from a longitudinal health registry. A matched non-JIA control group was also included. The primary outcome variable was presence of OSA. A Cox proportional hazard model was developed to estimate the risk of OSA in patients with JIA. A cumulative probability model was adopted to assess the time-dependent effect of JIA on OSA development, implying a causal link of the association. Results A total of 2791 patients with JIA were included, and 11 164 individuals without JIA were selected as matched controls. A total of 95 included subjects had OSA: 31 in the JIA group and 64 in the control group. Patients with JIA were more likely to have OSA compared with controls (adjusted hazard ratio, aHR = 1.922, 95% confidence interval [CI] = 1.244–2.970). The incidence of developing OSA was particularly high among patients with JIA-associated deformity that presented at age 18–30 years (aHR = 1.993, 95% CI = 1.277–3.113) and males (aHR = 1.786, 95% CI = 1.097–2.906). The risk of developing OSA increased over 60 months (aHR = 2.523, 95% CI = 1.322–4.815) of follow-up after the JIA diagnosis. Conclusions Patients with JIA have a significantly increased risk of developing OSA compared with matched individuals without JIA.

Human Papillomavirus Infection and the Risk of Erectile Dysfunction: A Nationwide Population-Based Matched Cohort Study

“…In this cohort study, we employed a nationwide population-based registry to provide epidemiological evidence on the risks of new-onset ED in patients with HPV infection. The effect of measurable confounders was minimized by PS matching [ 71 , 72 , 73 , 74 , 75 ]. Sensitivity and negative control analyses were conducted to manage residual confounding and to ascertain the impact of HPV infection on ED development.…”

Fibromyalgia and periodontitis: Bidirectional associations in population‐based 15‐year retrospective cohorts

“…Standard mean difference (SMD) was estimated to ensure that the selection of (A) periodontitis cases and matched non‐periodontitis controls in Study A, and (B) fibromyalgia cases and matched non‐fibromyalgia controls in Study B, were not biased. When the SMDs were equal to or less than 0.05, the characteristics of both groups were considered similar 21 . Hence, matching the propensity score may balance the heterogeneity of baseline characteristics and underlying comorbidities between each arm in the two studies.…”

“…When the SMDs were equal to or less than 0.05, the characteristics of both groups were considered similar. 21 Hence, matching the propensity score may balance the heterogeneity of baseline characteristics and underlying comorbidities between each arm in the two studies.…”

Tonsillectomy as a risk factor of periodontitis: A population‐based cohort study

“…As tonsils gradually regress with age, it was suggested that their absence is conventionally considered not affecting the health of patients receiving tonsillectomy, and the adverse effects of tonsillectomy could be masked by inductive growth of the lymphoid tissue in other regions of nasopharyngeal associated lymphoid tissues (NALTs) 3 . Therefore, tonsillectomy is commonly performed in patients with indications including recurrent throat infections, recurrent infections with modifying factors such as peritonsillar abscess and multiple antibiotic allergies or intolerance, as well as obstructive sleep apnoea (OSA) 4,5 …”