Clinical Research Papers:
Dry eye syndrome and the subsequent risk of chronic fatigue syndrome—a prospective population-based study in Taiwan
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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: [email protected]; [email protected]
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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