Vascular endothelial growth factor (VEGF) plays a significant role as a pro-angiogenic and pro-permeability factor within the kidney. Bevacizumab is a pharmaceutical monoclonal anti-VEGF antibody that inhibits the growth of new blood vessels, which blocks blood supply and thereby restricts tumor growth. Thus, we conducted a nationwide study to explore the risk of chronic kidney disease (CKD) development in Taiwan residents after bevacizumab therapy. We drew data from the extensive National Health Insurance Research Database (NHIRD), which encompasses data from >99% of Taiwan’s population from 1995 onwards. Individuals who received bevacizumab between 2012–2018 were identified as the bevacizumab cohort, with the index date set at the first usage. We randomly selected dates within the study period for the control group to serve as index dates. We excluded patients with a history of CKD prior to the index date or those <20 years old. In both cohorts, patients’ propensity scores matched in a 1:1 ratio based on sex, age, index year, income, urbanization level, comorbidities, and medications. We found patients treated with bevacizumab had a significantly higher risk of contracting CKD than patients without bevacizumab (adjusted hazard ratio = 1.35, 95% confidence interval = 1.35–1.73). The risk of CKD was 1.35-fold higher in participants with bevacizumab treatment than those in the control group. These findings suggest that close monitoring of CKD development after bevacizumab administration is needed.

Background and Objectives: The relationship between pregnancy complications and the risk of gynecological and breast cancer remains inconclusive, with limited research available. This study aimed to determine whether pregnancy complications, including preeclampsia, gestational diabetes mellitus (GDM), large for gestational age (LGA), or intrauterine growth restriction (IUGR) are associated with the development of endometrial cancer (EC), ovarian cancer (OC), or breast cancer (BC). Materials and Methods: This was a population-based case–control study linked to the National Health Insurance Research Database from 2008 to 2020, using ICD codes to identify parous gynecological cases (n = 6714). The propensity score matching method was used to match control groups (n = 1,153,346). Multivariable logistic regression models were used to determine the association between EC, OC, BC risk and pregnancy complications. Results: In adjusted multivariable logistic regression models, women with a history of preeclampsia did not have a significantly increased risk of endometrial, ovarian, or breast cancer compared to controls. Although women with GDM complications had a significantly increased risk of breast cancer, the increased risk of EC or OC was not significant. The risk of BC in women with a history of IUGR or LGA was not significant, whereas risk statistics for EC or OC in women with a history of IUGR or LGA could not be shown because of the small sample size. Conclusions: GDM is associated with BC risk. Future studies should aim to determine whether there is a causal relationship. Therefore, cancer screening is warranted in women with GDM.

Background: Microvascular complications in type 2 diabetes (T2D) and cancer share biological pathways, including chronic inflammation, dysregulated angiogenesis, and endothelial dysfunction, yet their impact on cancer risk and mortality remains unclear. This study evaluated whether T2D patients with microvascular complications face increased cancer incidence or cancer-related mortality. Methods: Using the Taiwan National Health Insurance Research Database, we identified individuals newly diagnosed with T2D (2008–2021) and assessed the outcomes with multivariable Cox proportional hazards models. Results: Our findings indicate that T2D patients with diabetic neuropathy, retinopathy, or chronic kidney disease do not have a significantly increased risk of major cancers, including those of the oral cavity, thyroid, breast, respiratory tract, digestive system, or lymphoid tissues. Similarly, microvascular complications were not associated with higher cancer-related mortality. However, microvascular complications significantly increased all-cause mortality in a dose-dependent manner: adjusted hazard ratio (aHR) 1.16 [95% CI: 1.15–1.17] for one complication, aHR 1.42 [1.38–1.45] for two, and aHR 1.71 [1.60–1.83] for three. Conclusions: In this nationwide cohort study, we demonstrate that while microvascular complications are associated with increased all-cause mortality in T2D, they do not appear to elevate cancer risk or cancer-specific mortality. These findings provide crucial epidemiological insights into the relationship between diabetes complications and cancer.

Objectives: The aim was to determine whether different maturity levels and birth weights could change the risk of long-term ophthalmological complications in preterm infants.Design: This was a cohort study.Setting: This was a nationwide population-based study.Participants: Newborns born between 2009 and 2012 were identified; newborns with congenital deformities, newborns with missing data on urban area, sex, gestational week at birth or birth weight and newborns who died before the age of 8 years were excluded.Interventions: Infants were divided into full-term, preterm and preterm with retinopathy of prematurity (ROP) cohorts based on their basic characteristics at birth.Primary outcome measures: The primary outcomes were ophthalmological complications, including strabismus, refractive error, amblyopia, cataracts and glaucoma.Results: Ultimately, 735 702 infants were included in the analysis. There were 727 403, 7165 and 1134 newborns in the full term, preterm without ROP and preterm with ROP cohorts, respectively. Premature infants, whether without ROP or with ROP, had an elevated risk of various ophthalmic complications, with adjusted ORs (aORs) ranging from 1.48 to 2.74 and 1.90 to 10.34, respectively. Extremely low birth weight contributes to an increased risk of various ophthalmic complications, with aORs ranging from 2.21 to 6.55. Moreover, a higher number of negative variables, such as preterm birth or low body weight, increased the risk of various ophthalmological complications, with the aOR falling within the range of 1.03–23.86.Conclusions: Immaturity and low body weight were risk factors for ophthalmological complications in preterm infants. The presence of both of these two risk factors increased the risk of ophthalmological complications. Our results are essential for caregivers and health policy-makers to design comprehensive follow-up plans for preterm infants.

Recent research has established an association between insomnia and an elevated risk of stroke. Given the severe global impact of stroke on public health, exploring nonpharmacological interventions, such as acupuncture, that can mitigate stroke risk among individuals with insomnia is crucial. In this retrospective cohort study, we used data from the Taiwan National Health Insurance Database (NHIRD) to examine the relationship between acupuncture and the risk of stroke among individuals who received a diagnosis of insomnia between 2000 and 2017. The study participants were divided into two cohorts: the acupuncture group that received acupuncture and a matched control group that did not. The primary outcome was the occurrence of stroke. Of the 217,356 patients included in the study, 3668 individuals in the acupuncture group and 4913 in the control group experienced stroke. The incidence rate of stroke was lower in the acupuncture group (4.51 per 1000 person-years) than in the control group (6.86 per 1000 person-years). After adjustment for various potential confounders, patients who received acupuncture exhibited a notably reduced risk of stroke, with an adjusted hazard ratio of 0.66 (95 % confidence interval [CI]: 0.63, 0.69). Furthermore, a dose–response relationship was evident, in that individuals who received 6–11 acupuncture sessions experienced a 24 % reduction in stroke risk, whereas those who received 12–17 sessions, 18–29 sessions, and ≥30 sessions exhibited reductions of 31 %, 34 %, and 42 %, respectively. Acupuncture treatment was significantly associated with a reduced risk of stroke among patients with insomnia.

Abatract: Background : Sensorineural hearing loss (SNHL) is a common but underrecognized complication of type 2 diabetes mellitus (T2DM). Sodium-glucose cotransporter-2 inhibitors (SGLT2i) use was associated with favorable renal and cardiovascular outcomes beyond glycemic control, but their impact on auditory outcomes remains unclear. Methods: We conducted a nationwide cohort study using Taiwan’s National Health Insurance Research Database (2000–2021). Patients with T2DM who received SGLT2i for ≥ 90 days were compared with matched non-users. Propensity score matching was applied 1:1 based on demographic, clinical, and treatment characteristics. The primary outcome was the incidence of SNHL, confirmed by audiometric testing. Results: A total of 381,592 patients with type 2 diabetes mellitus (T2DM) were included. Compared with non-users, SGLT2i users exhibited a significantly lower risk of SNHL (adjusted hazard ratios (aHRs) = 0.84; 95% CI: 0.75–0.94). Subgroup analyses confirmed a consistent lower risk across sex, age, urbanization, and comorbidity strata. Notably, long-term SGLT2i use (≥ 366 days) showed a strong dose–response association with reduced SNHL risk (aHR = 0.32; 95% CI: 0.27–0.39). Conclusion: SGLT2i use in T2DM patients is associated with a reduced risk of SNHL, particularly with sustained therapy. These findings highlight a potential association between SGLT2i use and a lower risk of auditory complications in diabetes, underscoring the importance of considering hearing health within comprehensive diabetes management.