台湾全国队列研究：酒渣鼻患者发生炎症性肠病的风险。

Risk of inflammatory bowel disease in patients with rosacea: Results from a nationwide cohort study in Taiwan.

机构信息

Faculty of Medicine and Graduate Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Public Health and Graduate Institute of Clinical Medical Sciences, China Medical University, Taichung, Taiwan; Department of Life Sciences and Rong Hsing Research Center for Translational Medicine, National Chung-Hsing University, Taichung, Taiwan.

Faculty of Medicine and Graduate Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Dermatology, Taipei Veterans General Hospital, Taichung, Taiwan.

出版信息

J Am Acad Dermatol. 2017 May;76(5):911-917. doi: 10.1016/j.jaad.2016.11.065. Epub 2017 Jan 7.

DOI:10.1016/j.jaad.2016.11.065

PMID:28073582

Abstract

BACKGROUND

A link between rosacea and inflammatory bowel disease (IBD) has been proposed with unknown mechanisms. Epidemiologic evidence of this association needs to be examined.

METHODS

In this nationwide cohort study, a total of 89,356 patients with rosacea and 178,712 matched patients without rosacea between 1997 and 2013 were identified in the Taiwanese National Health Insurance Research Database. Cumulative incidences of IBD were compared between these 2 cohorts. Frailty Cox proportional hazard model was used and subgroup analyses were conducted to examine the risk factors for IBD.

RESULTS

The 15-year cumulative incidences of IBD were 0.036% (95% confidence interval [CI] 0.00%-1.57%) and 0.019% (95% CI 0.00%-0.83%) in rosacea and nonrosacea cohorts, respectively (P = .05). Rosacea (adjusted hazard ratio 1.94, 95% CI 1.04-3.63, P = .04) and male gender (adjusted hazard ratio 3.52, 95% CI 2.03-6.11, P < .01) were independently associated with IBD, after adjustment for major comorbidities. Multivariate subgroup analyses revealed consistent results. The incidence rates of IBD decreased with increasing antibiotic use in patients with rosacea, but without statistical significance.

LIMITATION

Information related to lifestyle, diet, alcohol, and smoking was not included in the database.

CONCLUSION

Patients with rosacea may have an increased risk of IBD.

摘要

背景

有人提出酒渣鼻和炎症性肠病（IBD）之间存在关联，但具体机制尚不清楚。需要对这种关联的流行病学证据进行研究。

方法

在这项全国性队列研究中，我们在台湾全民健康保险研究数据库中，于 1997 年至 2013 年期间，共确定了 89356 例酒渣鼻患者和 178712 例匹配的无酒渣鼻患者。比较了这两组患者的 IBD 累积发生率。使用脆弱性 Cox 比例风险模型进行了亚组分析，以检查 IBD 的危险因素。

结果

酒渣鼻组和无酒渣鼻组的 15 年累积 IBD 发生率分别为 0.036%（95%置信区间 [CI] 0.00%-1.57%）和 0.019%（95% CI 0.00%-0.83%）（P =.05）。校正主要合并症后，酒渣鼻（调整后的危险比 1.94，95% CI 1.04-3.63，P =.04）和男性（调整后的危险比 3.52，95% CI 2.03-6.11，P<.01）与 IBD 独立相关。多变量亚组分析得出了一致的结果。在酒渣鼻患者中，随着抗生素使用量的增加，IBD 的发生率呈下降趋势，但无统计学意义。