ABSTRACT
Background There are few studies on the association with Kawasaki disease in children and the family's history of cardiovascular disease (CVD). The aim of this study was to identify the association of increased risks for Kawasaki disease in children with a family history of CVD. Methods and Results Clinical data of children born in 2008 and 2009 (n=917 707) were obtained from the National Health Insurance Service and the National Health Screening Program for Infants and Children for this study. The cohort consisted of 495 215 participants (53.8%) who completed the family history questionnaire for children 54 to 60 months old. Family history of CVD included 5 medical conditions: hypertension, dyslipidemia, myocardial infarction, stroke, and diabetes. Kawasaki disease was defined using the disease code, intravenous immunoglobulin prescription, and use of antipyretics for more than 25 days. Severe Kawasaki disease was defined as diagnosis of accompanied cardiac/coronary artery complications or intravenous immunoglobulin use ≥2 times. The incidence rate of Kawasaki disease was 124/100 000 person-years (95% CI, 117.5-131.5) for children <2 years old, 95/100 000 person-years (95% CI, 90.5-100.4) in children 2 to 5 years old, and 14/100 000 person-years (95% CI, 12.6-15.6) in children >5 years old. After propensity-score matching, 829 participants with a family history of CVD were diagnosed as having Kawasaki disease (0.68% [95% CI, 0.63-0.72]), and 690 patients with Kawasaki disease (0.56% [95% CI, 0.52-0.61]) had no family history of CVD. The family history of CVD was associated with increased risk for Kawasaki disease (risk ratio, 1.20 [95% CI, 1.08-1.32]) but not for severe Kawasaki disease (risk ratio, 1.23 [95% CI, 0.92-1.65]). Conclusions In this nationwide propensity-score matched study, those with a family history of CVD had a significantly greater risk of Kawasaki disease compared with those who had no family history of CVD.
Subject(s)
Cardiovascular Diseases , Diabetes Mellitus , Dyslipidemias , Hypertension , Mucocutaneous Lymph Node Syndrome , Myocardial Infarction , Stroke , Adolescent , Cardiovascular Diseases/epidemiology , Child , Child, Preschool , Dyslipidemias/diagnosis , Dyslipidemias/epidemiology , Dyslipidemias/genetics , Humans , Hypertension/complications , Hypertension/epidemiology , Immunoglobulins, Intravenous , Infant , Mucocutaneous Lymph Node Syndrome/complications , Mucocutaneous Lymph Node Syndrome/diagnosis , Mucocutaneous Lymph Node Syndrome/epidemiology , Myocardial Infarction/etiology , Myocardial Infarction/genetics , Risk Factors , Stroke/complications , Stroke/etiologyABSTRACT
OBJECTIVE: The objective of this study was to analyze the effect of consuming formula powder prepared with tap water or purified water during the first 4 to 6 months of life on the subsequent development of irritable bowel syndrome (IBS). STUDY DESIGN AND SETTING: A total of 917,707 children who were born in Korea between 2007 and 2008 were analyzed. All children were followed up until they lost eligibility for health care services or until 2017. Data on the water used to prepare formula powder were from questionnaires answered by the parents when the child was 4 to 6 months old. IBS was defined as two or more diagnoses of IBS after the age of 4 years. Inverse probability of treatment weighting (IPTW) using the propensity score was used to balance the two groups. The risk of IBS was evaluated using a Cox proportional hazards model. RESULTS: After weighting, there were 73,355 children in the tap water group and 73,351 in the purified water group. The purified water group had a higher risk of IBS (HR: 1.05; 95% CI: 1.01, 1.09). This relationship was also present after the subgroup analyses of males and females and the sensitivity analysis that used different definitions of IBS. CONCLUSIONS: Drinking formula powder prepared with purified water rather than tap water during the first 4 to 6 months of age was found to be associated with IBS.
