Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan.
Department of Dermatology, National Yang-Ming University, Taipei, Taiwan.
J Eur Acad Dermatol Venereol. 2015 Jul;29(7):1362-9. doi: 10.1111/jdv.12870. Epub 2014 Dec 16.
The previous literature has demonstrated the association of autoimmune and atopic diseases with vitiligo, but there has been no large-scale nationwide study conducted to confirm this.
The present study was conducted to clarify the comorbid profiles in vitiligo patients and thereby better understand their clinical scenarios and underlying pathogenesis.
This was a retrospective population-based study conducted from 1996 to 2011 via the National Health Insurance Research Database in Taiwan. The differences in the prevalence of multiple autoimmune and atopic diseases between case subjects and controls were analysed by multiple logistic regression method.
A total of 14883 vitiligo patients and 59532 controls were enroled. The prevalence of vitiligo was 0.064% and the peak of onset age was 40-59 years old. The non-stratified analysis evidenced a significant association between vitiligo and several comorbid diseases, including alopecia areata, Hashimoto thyroiditis, myasthenia gravis, psoriasis, Graves' disease, Sjögren's syndrome, systemic lupus erythematosus and atopic dermatitis. Vitiligo patients also had higher prevalence of multiple comorbidities than controls. In the age- and gender-stratified analysis, increased risks of systemic lupus erythematosus and Sjögren's syndrome were observed only in subjects aged 60-79. The association of vitiligo with myasthenia gravis and rheumatoid arthritis was identified only in the subgroup aged 20-39 and in females aged 60-79 respectively.
Our study not only confirmed the significant association of vitiligo with multiple autoimmune and atopic diseases in Taiwan but also disclosed several unique findings, including the much lower prevalence of vitiligo, delayed onset of vitiligo by three decades, different associated comorbidity profiles comparing to westerners and the age- and gender-specific approach for the vitiligo-associated comorbidities.
以往的文献已经证明自身免疫性和过敏性疾病与白癜风之间存在关联，但尚未有大规模的全国性研究来证实这一点。
本研究旨在阐明白癜风患者的共病特征，从而更好地了解其临床情况和潜在发病机制。
这是一项基于人群的回顾性研究，于 1996 年至 2011 年通过台湾全民健康保险研究数据库进行。采用多变量逻辑回归方法分析病例组与对照组之间多种自身免疫性和过敏性疾病的患病率差异。
共纳入了 14883 例白癜风患者和 59532 例对照。白癜风的患病率为 0.064%，发病高峰年龄为 40-59 岁。非分层分析表明，白癜风与多种共病之间存在显著关联，包括斑秃、桥本甲状腺炎、重症肌无力、银屑病、格雷夫斯病、干燥综合征、系统性红斑狼疮和特应性皮炎。白癜风患者也比对照组更易发生多种共病。在年龄和性别分层分析中，仅在 60-79 岁的人群中观察到系统性红斑狼疮和干燥综合征的风险增加。仅在 20-39 岁和 60-79 岁的女性亚组中观察到白癜风与重症肌无力和类风湿关节炎的关联。
本研究不仅证实了白癜风与台湾多种自身免疫性和过敏性疾病之间的显著关联，还揭示了一些独特的发现，包括白癜风的患病率较低、发病时间延迟了三十年、与西方人相比，关联的共病谱不同以及针对白癜风相关共病的年龄和性别特定方法。
