title: An estimation of the incidence of tuberous sclerosis complex in a nationwide retrospective cohort study (1997-2010).
abstract: BACKGROUND
  Tuberous sclerosis complex (TSC) is caused by mutations in TSC1 and TSC2, leading to mammalian target of rapamycin hyperactivation. Patients with TSC develop hamartomas in brain, lungs, liver and skin. Two epidemiological studies, performed in Minnesota, U.S.A., have estimated the incidence of TSC to be 0·28-0·56 per 100 000 person-years (PY), based on < 12 patients. Furthermore, whether common comorbidities are associated with this rare disease is not known.
  
  
  OBJECTIVE
  To estimate the incidence of TSC and investigate the associations of TSC with other comorbidities, including diabetes, peptic ulcers, stroke and myocardial infarction.
  
  
  METHODS
  We estimated the incidence and prevalence of TSC and its comorbidities from 1997 to 2010, based on the Catastrophic Illness Certificate disease database and a beneficiary cohort of 1 million people.
  
  
  RESULTS
  The incidence of TSC in Taiwan is 0·153 per 100 000 PY. The number of patients identified with TSC in Taiwan doubled from 206 in 2006 to 471 in 2010. In 2010, the prevalence of TSC in Taiwan was estimated to be 1·58 in 100 000. We confirmed that female patients with TSC are more likely to develop renal tumours than male patients. Surprisingly, patients with TSC have a significantly decreased risk of developing peptic ulcers compared with controls.
  
  
  CONCLUSIONS
  This is the first large-scale and longitudinal incidence study of TSC. This study provides compelling evidence that TSC mutations in humans are associated with a decreased risk of peptic ulcers.
authors.affiliation: Department of Dermatology, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: C-H
authors.initials: CH
authors.lastname: Hong
authors.affiliation: Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: H-P
authors.initials: HP
authors.lastname: Tu
authors.affiliation: Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan.
authors.forename: J-R
authors.initials: JR
authors.lastname: Lin
authors.affiliation: Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.|Department of Dermatology, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: C-H
authors.initials: CH
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003704:Dementia / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D010437:Peptic Ulcer / Q000453:epidemiology; D012189:Retrospective Studies; D012640:Seizures / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology; D014402:Tuberous Sclerosis / Q000150:complications / Q000453:epidemiology*; D055815:Young Adult