- 著者
- Chung-Yi Li Chia-Lun Kuo Ya-Hui Chang Chin-Li Lu Santi Martini Wen-Hsuan Hou
- 出版者
- Japan Epidemiological Association
- 雑誌
- Journal of Epidemiology (ISSN:09175040)
- 巻号頁・発行日
- vol.32, no.9, pp.423-430, 2022-09-05 (Released:2022-09-05)
- 参考文献数
- 54
- 被引用文献数
- 2 5
Background: We aimed to investigate associations between exposure to various trajectories of severe hypoglycemic events and risk of dementia in patients with type 2 diabetes.Methods: In 2002–2003, 677,618 patients in Taiwan were newly diagnosed as having type 2 diabetes. Among them, 35,720 (5.3%) experienced severe hypoglycemic events during the 3-year baseline period following diagnosis. All patients were followed from the first day after baseline period to the date of dementia diagnosis, death, or the end of 2011. A group-based trajectory model was used to classify individuals with severe hypoglycemic events during the baseline period. Cox proportional hazard models with the competing risk method were used to relate dementia risk to various severe hypoglycemia trajectories.Results: After a median follow-up 6.70 and 6.10 years for patients with and without severe hypoglycemia at baseline, respectively, 1,952 (5.5%) individuals with severe hypoglycemia and 23,492 (3.7%) without developed dementia during follow-up, for incidence rates of 109.80 and 61.88 per 10,000 person-years, respectively. Four groups of severe hypoglycemia trajectory were identified with a proportion of 18.06%, 33.19%, 43.25%, and 5.50%, respectively, for Groups 1 to 4. Groups 3 (early manifestation but with later decrease) and 4 (early and sustained manifestation) were associated with a significantly increased risk of dementia diagnosis, with a covariate-adjusted subdistribution hazard ratio of 1.22 (95% confidence interval, 1.14–1.31) and 1.25 (95% confidence interval, 1.02–1.54), respectively.Conclusion: Our analysis highlighted that early manifestation of severe hypoglycemic events may contribute more than does late manifestation to the risk of dementia among individuals newly diagnosed as having type 2 diabetes.
- 著者
- Wan-Ru HUANG Po-Han HUANG Ya-Hui CHANG Chao-Tzuen CHENG Huang-Hsiung HSU Chia-Ying TU Akio KITOH
- 出版者
- Meteorological Society of Japan
- 雑誌
- 気象集誌. 第2輯 (ISSN:00261165)
- 巻号頁・発行日
- vol.97, no.2, pp.481-499, 2019 (Released:2019-04-03)
- 参考文献数
- 58
- 被引用文献数
- 9
By using the Weather Research and Forecasting (denoted as WRF) model driven by two super-high-resolution global models, High Resolution Atmospheric Model (denoted as HiRAM) and Meteorological Research Institute Atmospheric General Circulation Model (denoted as MRI), this study investigates the dynamical downscaling simulation and projection of extreme precipitation activities (including intensity and frequency) in Taiwan during the Mei-Yu seasons (May and June). The analyses focus on two time period simulations: the present-day (1979-2003, historical run) and the future (2075-2099, RCP8.5 scenario). For the present-day simulation, our results show that the bias of HiRAM and MRI in simulating the extreme precipitation activities over Taiwan can be reduced after dynamical downscaling by using the WRF model. For the future projections, both the dynamical downscaling models (i.e., HiRAM-WRF and MRI-WRF) project that extreme precipitation will become more frequent and more intense over western Taiwan but less frequent and less intense over eastern Taiwan. The east-west contrast in the projected changes in extreme precipitation in Taiwan are found to be a local response to the enhancement of southwesterly monsoonal flow over the coastal regions of South China, which leads to an increase in water vapor convergence over the windward side (i.e., western Taiwan) and a decrease in water vapor convergence over the leeward side (i.e., eastern Taiwan). Further examinations of the significance of the projected changes in extreme precipitation that affect the agriculture regions of Taiwan show that the southwestern agriculture regions will be affected by extreme precipitation events more frequently and more intensely than the other subregions. This finding highlights the importance of examining regional differences in the projected changes in extreme precipitation over the complex terrain of East Asia.