Department of Dermatology, Alpert Medical School of Brown University, Providence, RI, U.S.A.
Department of Epidemiology, Brown University School of Public Health, Providence, RI, U.S.A.
Br J Dermatol. 2017 Oct;177(4):1043-1051. doi: 10.1111/bjd.15727. Epub 2017 Sep 10.
Atopic dermatitis (AD) has been associated with cardiovascular risk factors and diseases, but epidemiological studies to date have found conflicting results.
To determine the associations of AD with hypertension, type 2 diabetes (T2D), myocardial infarction (MI) and stroke.
We conducted a cross-sectional analysis of baseline data from the Canadian Partnership for Tomorrow Project, which includes Canadian residents aged 30-74 years living in British Columbia, Alberta, Ontario, Quebec and the Atlantic Provinces. We excluded participants with incomplete data on AD, hypertension, T2D, MI or stroke, who had type 1 or gestational diabetes or who developed any of the outcomes at an age prior to a diagnosis of AD. This left 259 119 participants in our analysis. We used logistic regression to calculate age- and sex-, and multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) between AD and subsequent hypertension, T2D, MI and stroke.
AD was reported by 21 379 (8·4%) participants. In total, 52 787 cases of hypertension, 12 739 cases of T2D, 4390 cases of MI and 2235 cases of stroke were reported by participants at enrolment. In the multivariable-adjusted model, AD was associated with decreased odds of hypertension (OR 0·87, 95% CI 0·83-0·90), T2D (OR 0·78, 95% CI 0·71-0·84), MI (OR 0·87, 95% CI 0·75-1·00) and stroke (OR 0·79, 95% CI 0·66-0·95).
We did not find evidence of a positive association between AD and subsequent hypertension, T2D, MI or stroke; AD was inversely associated with these outcomes in our study. Given our findings and the conflicting literature, AD is likely not a major risk factor for cardiovascular disease.
特应性皮炎(AD)与心血管危险因素和疾病有关,但迄今为止的流行病学研究结果存在矛盾。
确定 AD 与高血压、2 型糖尿病(T2D)、心肌梗死(MI)和中风的关联。
我们对加拿大明天伙伴关系项目的基线数据进行了横断面分析,该项目包括不列颠哥伦比亚省、艾伯塔省、安大略省、魁北克省和大西洋省份的 30-74 岁加拿大居民。我们排除了 AD、高血压、T2D、MI 或中风数据不完整的参与者,排除了患有 1 型或妊娠糖尿病的参与者,以及在 AD 诊断之前任何一种疾病的年龄就发病的参与者。这使得我们的分析中共有 259119 名参与者。我们使用逻辑回归计算 AD 与随后的高血压、T2D、MI 和中风之间的年龄和性别调整以及多变量调整后的比值比(OR)和 95%置信区间(CI)。
21379(8.4%)名参与者报告了 AD。在参与者入组时,共有 52787 例高血压、12739 例 T2D、4390 例 MI 和 2235 例中风。在多变量调整模型中,AD 与高血压(OR 0.87,95%CI 0.83-0.90)、T2D(OR 0.78,95%CI 0.71-0.84)、MI(OR 0.87,95%CI 0.75-1.00)和中风(OR 0.79,95%CI 0.66-0.95)的可能性降低相关。
我们没有发现 AD 与随后的高血压、T2D、MI 或中风之间存在正相关的证据;在我们的研究中,AD 与这些结果呈负相关。考虑到我们的发现和相互矛盾的文献,AD 不太可能是心血管疾病的主要危险因素。