Browsing by Author "Fan, Hueng-Chuen"

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Association between Gastroenterological Malignancy and Diabetes Mellitus and Anti-Diabetic Therapy: A Nationwide, Population-Based Cohort Study
(2015-05-15)
Lin, Chien-Ming
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Huang, Hui-Ling
;
Chu, Fang-Ying
;
Fan, Hueng-Chuen
;
Chen, Hung-An
Background The relationship between diabetes mellitus (DM) and cancer incidence has been evaluated in limited kinds of cancer. The effect of anti-diabetic therapy (ADT) on carcinogenesis among diabetic patients is also unclear. Materials and Methods Using population-based representative insurance claims data in Taiwan, 36,270 DM patients and 145,080 comparison subjects without DM were identified from claims from 2005 to 2010. The association between the top ten leading causes of cancer-related death in Taiwan and DM was evaluated. Whether ADT altered the risk of developing cancer was also investigated. Results Incidence of cancer at any site was significantly higher in patients with DM than in those without (p<0.001). The risk of carcinogenesis imparted by DM was greatest in gastroenterological malignancies (liver, pancreas, and colorectal cancer) as well as lung, breast and oral cancer (p<0.001). Among the oral types of ADT, metformin decreased the risk of lung and liver cancer, but had less effect on reducing the risk of colorectal cancer. alpha-glucosidase inhibitor decreased the risk of developing liver, colorectal, and breast cancer. Apart from intermediateacting insulin, rapid-acting, long-acting, and combination insulin treatment significantly reduced the overall cancer risk among all DM patients. In subgroup analysis, long-acting insulin treatment significantly decreased the risk of lung, liver, and colorectal cancer. Conclusion Our results supported the notion that pre-existing DM increases the incidence of gastroenterological cancer. ADT, especially metformin, alpha-glucosidase inhibitor, and long-acting insulin treatment, may protect patients with DM against these malignancies. It is crucial that oncologists should closely collaborate with endocrinologists to provide an optimal cancerspecific therapy and diabetic treatment to patients simultaneously with cancer and DM.
Polymorphisms of the beta(2)-Adrenergic Receptor Correlated to Nocturnal Asthma and the Response of Terbutaline Nebulizer
(2011-02-01)
Lee, Ming-Yung
;
Cheng, Shin-Nan
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Chen, Shyi-Jou
;
Huang, Hui-Ling
;
Wang, Chih-Chien
Background: Inhaled beta(2)-adrenergic receptor (beta(2)-AR) agonists are the mainstay of treatment of acute asthma. Polymorphisms of the beta(2)-AR, especially codons 16, 27, and 164, may affect the functions of the receptor. This study was conducted to investigate whether different polymorphisms of the beta(2)-AR are related to the treatment responses of an inhaled beta(2)-AR agonist in children with nocturnal and nonnocturnal asthma in Taiwan. Methods: The nocturnal asthma group consisted of 27 children (mean age of 10.3 +/- 2.4 years), and the nonnocturnal asthma group consisted of 24 patients (mean age of 9.9 +/- 3.0 years). Allele-specific polymerase chain reaction was performed to determine 16, 27, and 164 loci alleles of beta(2)-AR genetic polymorphisms, and peak expiratory flow (PEF) was measured before and 1 hour after inhalation of 0.2 mg/kg/dose of terbutaline to determine the treatment response in these patients. Results: The polymorphisms of beta(2)-AR 27 but not 16 or 164 were significantly associated with the response to terbutaline nebulizer (p < 0.05). The polymorphism of beta(2)-AR 16 was associated with nocturnal asthma (p = 0.027). The Gly16 allele was more prevalent in the nocturnal asthma group (9/27; 33.3%) than in the nonnocturnal asthma group (3/24; 12.5%). Arg16 allele was less prevalent in the nocturnal asthma (3/27; 11.1%) than in the nonnocturnal asthma group (10/24; 41.7%). There was also a linkage disequilibrium found between beta(2)-AR 16 (Arg/Arg) and beta(2)-AR 27 (Gln/Gln). Conclusion: These findings suggest that polymorphisms of beta(2)-AR 16 are related to nocturnal asthma and polymorphisms of beta(2)-AR 27 are associated with the variable responses to the inhaled terbutaline in children with nocturnal and nonnocturnal asthma. Copyright (C) 2011, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. All rights reserved.
The use of adjunctive traditional Chinese medicine therapy and survival outcome in patients with head and neck cancer: a nationwide population-based cohort study
(2015-12-01)
Lin, Hung-Che
;
Lin, Cheng-Li
;
Huang, Wen-Yen
;
Shangkuan, Wei-Chuan
;
Kang, Bor-Hwang
Background: Traditional Chinese medicine (TCM) is widely used in the treatment of patients with several types of cancer. However, no large-scale clinical studies have evaluated whether TCM is associated with better survival in patients with head and neck cancer (HNC). Methods: The Taiwan National Health Insurance Research Database was used to conduct a retrospective cohort study of patients with HNC between 2001 and 2011. The patients with HNC were separated into TCM users and non-users, and Cox regression models were applied to determine the association between the use of TCM and survival outcome. Results: The TCM and comparison cohorts comprised data for 2966 and 2670 patients, respectively. The mean age was 51.3 years in the TCM cohort and 51.7 years in the comparison cohort. Multivariate analysis demonstrated that the use of TCM was significantly associated with lower risk of all-cause mortality by 32% (adjusted hazard ratio, 0.68; 95% confidence interval, 0.62-0.75). Patients with longer TCM use had a lower mortality rate (P for trend<0.001). Conclusions: Our study showed that adjunctive therapy with TCM is associated with higher survival outcome. However, some limitations exist, such as the lack of information of cancer stage. In addition, causality cannot be assessed with this retrospective study. A randomized controlled trial to test the effect of adjunctive TCM therapy in HNC patients is needed.