Purpose Some evidence suggests that male infertility increases the risk of cardiovascular diseases (CVDs). However, the evidence in Asian populations is relatively scarce. The aim of this study is to determine whether male infertility increases the risk of CVDs. Materials and Methods We used inpatient and outpatient data for the years 2000 to 2015 from the Taiwanese Longitudinal Health Insurance Database. We enrolled 7,016 males over 18 years old and diagnosed with male infertility. Of these, 2,326 matched our inclusion criteria and were assigned to the study group. For each infertility patient, four comparison patients were frequency-matched by age and index date to form a control cohort comprising 9,304 patients. Cox proportional hazards analysis was used to estimate the association between male infertility and CVDs. Results After a 15-year follow-up, the incidence rate of CVDs was higher in the infertility group than the control group (1,460.23 and 1,073.70 per 100,000 person-years, respectively). The Cox proportional hazards regression analysis revealed that the adjusted HR for CVDs was 1.472 for the infertility group (95% CI, 1.288–1.683; p<0.001) relative to the control group. The Kaplan–Meier analysis of the cumulative incidence of CVDs in the two groups showed that the cumulative risk curve for CVDs was significantly higher for the infertility group than the control group. Conclusions This study shows that men with infertility have a higher risk of developing incident CVDs. In the future, healthcare providers should pay attention to these patients because of their higher health risks.
Objective This study aimed to investigate the short- and long-term prognostic effects of glycemic management on stroke recurrence and mortality in patients with acute first-ever ischemic stroke (FIS) without previous diabetes. Methods In total, 484,952 patients aged ≥20 years with FIS and nonprevious diabetes were retrieved from the 2000 to 2015 Taiwan’s National Health Insurance Research Database. Patients were categorized into the following cohorts: FIS without hyperglycemia (FISw/oHG), FIS with hyperglycemia without glycemic treatment (FISHGw/oGT), and FIS with hyperglycemia with glycemic treatment (FISHGw/GT). The short-term (within 1 year) and long-term (at the endpoint of 9.3 ± 8.6 years) prognostic effects of glycemic treatment and blood glucose monitoring on stroke recurrence and mortality among the cohorts were tested through Cox regression analysis.Results The mortality risk was lower in the FISHGw/GT cohort than in the FISHGw/oGT cohort at 3 months, 6 months, and 1 year (adjusted hazard ratio = 0.68, 0.62, 0.69, respectively, p < 0.001) as well as at the study endpoint, but no difference was observed in stroke recurrence at any time point (p > 0.05). Furthermore, compared with FISHGw/oGT without blood glucose monitoring, FISHGw/GT combined with blood glucose monitoring led to decreased risks of stroke recurrence within 1 year (p < 0.001) and mortality within 1 year and at the study endpoint (p < 0.001). Conclusion For optimal glycemic management in the acute phase and improved prognoses for patients with FIS and nonprevious diabetes with hyperglycemia, intensive blood glucose monitoring combined with glycemic treatment is needed.
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