{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T04:35:22Z","timestamp":1789274122755,"version":"build-2803163510"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,6,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Narcolepsy is linked to adverse cardiovascular disease (CVD) outcomes, but few studies have examined its associations with subclinical CVD, including in children. We assessed the relationship between narcolepsy and subclinical CVD outcomes, including hypertension, hyperlipidemia, diabetes, and nonalcoholic fatty liver disease\/nonalcoholic steatohepatitis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We conducted a retrospective cohort study using MarketScan Commercial and Medicare Supplemental databases from January 1, 2005 to December 31, 2021. Patients included N=22\u2009293 diagnosed with narcolepsy (NT1 and NT2) and N=63\u2009709 propensity\u2010score\u2013matched without. Patients with narcolepsy were identified as those with \u22652 outpatient insurance claims for narcolepsy (type 1 or type 2) within a 1\u2010year interval with 1 claim being nondiagnostic. Main outcomes were diagnosis of hypertension, hyperlipidemia, diabetes, and nonalcoholic fatty liver disease\/nonalcoholic steatohepatitis following index date, as well as a composite measure for CVD and major adverse cardiovascular events. Compared with propensity\u2010score\u2013matched patients without narcolepsy, patients with narcolepsy had an increased risk for hypertension (hazard ratio [HR], 1.40 [95% CI, 1.34\u20131.47]), hyperlipidemia (HR, 1.41 [95% CI, 1.35\u20131.47]), diabetes (HR, 1.50 [95% CI, 1.38\u20131.64), nonalcoholic fatty liver disease\/nonalcoholic steatohepatitis (HR, 1.48 [95% CI, 1.28\u20131.73]), CVD composite (HR,1.61 [95% CI, 1.35\u20131.47]), and major adverse cardiovascular events (HR,1.69 [95% CI, 1.43\u20132.00]). Results remained significant following adjustment for narcolepsy medications including stimulants, wake\u2010promoting agents, and oxybates. Results stratified by age groups showed similar findings, including heightened risk for those &lt;25\u2009years old.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Narcolepsy is associated with greater risk of subclinical CVD even in patients as early as childhood. Detection of these outcomes early in the course of narcolepsy could help reduce the burden of adverse cardiovascular events later in life.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.039899","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T05:54:51Z","timestamp":1744264491000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Narcolepsy Is Associated With Subclinical Cardiovascular Disease as Early as Childhood: A Big Data Analysis"],"prefix":"10.1161","volume":"14","author":[{"given":"Christopher N.","family":"Kaufmann","sequence":"first","affiliation":[{"name":"University of Florida","place":["Gainesville"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2242-1274","authenticated-orcid":false,"given":"Munaza","family":"Riaz","sequence":"additional","affiliation":[{"name":"University of Florida","place":["Gainesville"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3299-8111","authenticated-orcid":false,"given":"Haesuk","family":"Park","sequence":"additional","affiliation":[{"name":"University of Florida","place":["Gainesville"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6590-4770","authenticated-orcid":false,"given":"Wei\u2010Hsuan","family":"Lo\u2010Ciganic","sequence":"additional","affiliation":[{"name":"University of Pittsburgh","place":["Pittsburgh"]},{"name":"Geriatric Research Education and Clinical Center","place":["Gainesville"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1640-5497","authenticated-orcid":false,"given":"Debbie","family":"Wilson","sequence":"additional","affiliation":[{"name":"University of Florida","place":["Gainesville"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2858-7742","authenticated-orcid":false,"given":"Emerson M.","family":"Wickwire","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine","place":["Baltimore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atul","family":"Malhotra","sequence":"additional","affiliation":[{"name":"University of California San Diego School of Medicine","place":["La Jolla"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4882-5629","authenticated-orcid":false,"given":"Rakesh","family":"Bhattacharjee","sequence":"additional","affiliation":[{"name":"University of California San Diego School of Medicine","place":["La Jolla"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1500587"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/30.1.13"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.7326\/M16-2607"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000864"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsz091"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.035168"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2021.03.015"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-017-0473-z"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2021.05.010"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2023.10.029"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsad161"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40263-016-0337-4"},{"key":"e_1_3_2_14_2","first-page":"557","article-title":"Narcolepsy: current treatment options and future approaches","volume":"4","author":"Billiard M","year":"2008","unstructured":"Billiard M. 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