The aim of this study was to investigate the association between ocular motor cranial nerve palsies (OMCNP) and the occurrence of primary malignant brain tumors in a Korean population, using the national sample cohort database from Korea National Health Insurance Service (KNHIS). KNHIS data between 2010 and 2017 were analyzed. Our sample encompassed 118,686 participants, including 19,781 from a recently diagnosed OMCNP cohort and 98,905 from a matched control cohort through a 1:5 propensity score matching based on age and gender. To counteract the issue of reverse causation, we integrated a one-year time lag in our sensitivity analysis. Study participants were followed up until 31 December 2019. Cox proportional hazard regression analysis was used to compute the adjusted hazard ratio (HR) for primary malignant brain tumors according to the OMCNP diagnosis. Additionally, we performed a subgroup analysis to discern effects of various factors on the association between OMCNP and primary malignant brain tumors. HR for primary malignant brain tumors was 3.272 (95% confidence interval [CI]: 2.294 to 4.665) in the OMCNP cohort compared to the control cohort in a fully adjusted model for age, sex, socio-economic status, smoking, drinking, regular physical exercise, hypertension, diabetes, dyslipidemia, obesity, chronic kidney disease, and human immunodeficiency virus infection. Further subgroup analysis revealed that the risk of primary malignant brain tumors was significantly increased in women with OMCNP compared to men with OMCNP (HR: 5.118 in women vs. 2.441 in men,p= 0.0440), and in those aged <65 years than in those aged ≥65 years (HR: 6.951 in age < 65 years vs. 1.899 in age ≥ 65 years,p= 0.0006). Our population-based cohort study demonstrated a significantly increased risk of subsequent primary malignant brain tumors in patients with OMCNP. Particularly, OMCNP-afflicted women aged below 65 manifested a heightened probability of developing primary malignant brain tumors compared to those devoid of OMCNP.
本研究旨在利用韩国国民健康保险服务（KNHIS）的国家样本队列数据库，探讨韩国人群中眼动颅神经麻痹（OMCNP）与原发性恶性脑肿瘤发生之间的关联。分析数据涵盖2010年至2017年期间的KNHIS记录。研究样本共纳入118,686名参与者，包括19,781名新近诊断为OMCNP的队列成员，以及通过年龄和性别进行1:5倾向评分匹配的98,905名对照队列成员。为排除反向因果关系的干扰，我们在敏感性分析中引入了一年的时间滞后。研究对象随访至2019年12月31日。采用Cox比例风险回归模型计算根据OMCNP诊断调整后的原发性恶性脑肿瘤风险比（HR）。此外，通过亚组分析评估不同因素对OMCNP与原发性恶性脑肿瘤关联的影响。 在完全调整年龄、性别、社会经济地位、吸烟、饮酒、规律体育锻炼、高血压、糖尿病、血脂异常、肥胖、慢性肾脏病及人类免疫缺陷病毒感染等因素的模型中，OMCNP队列相较于对照队列的原发性恶性脑肿瘤HR为3.272（95%置信区间[CI]：2.294-4.665）。进一步亚组分析显示：女性OMCNP患者较男性患者发生原发性恶性脑肿瘤的风险显著增高（HR：女性5.118 vs. 男性2.441，p=0.0440）；年龄<65岁患者较≥65岁患者风险显著升高（HR：<65岁组6.951 vs. ≥65岁组1.899，p=0.0006）。 这项基于人群的队列研究表明，OMCNP患者后续发生原发性恶性脑肿瘤的风险显著增加。特别是65岁以下女性OMCNP患者，相较于未患OMCNP人群，表现出更高的原发性恶性脑肿瘤发生概率。
肿瘤(癌症)患者之家