Oncotarget

Clinical Research Papers:

Dry eye syndrome and the subsequent risk of chronic fatigue syndrome—a prospective population-based study in Taiwan

Chih-Sheng Chen, Hui-Man Cheng, Hsuan-Ju Chen, Shin-Yi Tsai, Chia-Hung Kao, Hui-Ju Lin, Lei Wan and Tse-Yen Yang _

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Oncotarget. 2018; 9:30694-30703. https://doi.org/10.18632/oncotarget.25544

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Abstract

Chih-Sheng Chen1,2,3,*, Hui-Man Cheng4,5,*, Hsuan-Ju Chen6,7,8, Shin-Yi Tsai9,10, Chia-Hung Kao11,12,13, Hui-Ju Lin14,15, Lei Wan5,16,17,18,* and Tse-Yen Yang19,20,21,*

1Department of Chinese Traumatology, Division of Chinese Traumatology Medicine, China Medical University Hospital, China Medical University, Taichung, Taiwan

2Department of Traditional Chinese Medicine, Asia University Hospital, Taichung, Taiwan

3Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan

4Department of Integration of Traditional Chinese and Western Medicine, China Medical University Hospital, Taichung, Taiwan

5School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan

6Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

7Department of Public Health, China Medical University, Taichung, Taiwan

8Asia University, Taichung, Taiwan

9Department of Laboratory Medicine, Mackay Memorial Hospital, Mackay Medical College, New Taipei City, Taiwan

10Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA

11Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan

12Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan

13Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan

14School of Chinese Medicine, China Medical University, Taichung, Taiwan

15Department of Ophthalmology, China Medical University Hospital, Taichung, Taiwan

16Department of Biotechnology, Asia University, Taichung, Taiwan

17Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung, Taiwan

18Research Center for Chinese Medicine and Acupuncture, China Medical University, Taichung, Taiwan

19Molecular and Genomic Epidemiology Center, China Medical University Hospital, China Medical University, Taichung, Taiwan

20Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan

21Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung, Taiwan

*These authors contributed equally to this work

Correspondence to:

Tse-Yen Yang, email: yang_t_y@yahoo.com.tw; hardawayoung@hotmail.com

Keywords: fatigue; dry eye syndrome; national health insurance research database (NHIRD); prospective cohort study

Received: November 03, 2017     Accepted: May 19, 2018     Published: July 17, 2018

ABSTRACT

Background and Aim: The clinical association between dry eye syndrome (DES) and chronic fatigue syndrome (CFS) remain unclear with less evidences. We aimed to investigate the relationship between CFS and DES using a national insurance and prospective cohort study.

Methods: Data from the Longitudinal Health Insurance Database 2000 was applied to estimate the incidence of CFS among patients with DES, and their age- and sex-matched controls without DES over a long-term follow-up period. All participants were CFS free at baseline, before the interval (2005–2007), but were later diagnosed with CFS. DES patients and its relative matched controls were excluded prevalent CFS before the same interval.

Results: We identified 884 patients with DES and 3,536 matched controls in baseline and estimated the hazard ratios for incident CFS in the follow-up period. Patients with DES had a 2.08-fold considerably increasing risk of developing CFS, compared to non-DES group. An elevated risk of developing CFS remained (1.61-fold risk) even after adjusting for age, sex, and comorbidities. There was a presence of increasing risk in DES-related CFS when CFS-related comorbidities existing (adjusted hazard ratio, 1.98, 95% confidence interval, 1.19–3.29; p < 0.01). The subsequent risk for CFS between DES and non-DES patients was significant increased with three or more annual medical visits, the adjusted risk for CFS was 4.88-fold risk (95% CI, 2.26–10.58, p < 0.001).

Conclusion: We recommended that physicians should be aware of the increased risk of CFS among DES patients and adequately assess the health impacts among these patients.


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