Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, Hellerup, Denmark.
Allergy. 2018 Apr;73(4):923-931. doi: 10.1111/all.13360. Epub 2017 Dec 12.
The association between atopic dermatitis (AD) and cardio-metabolic risk factors is not yet established. Furthermore, no validated questionnaire-based method of identifying adults with AD is currently available.
To assess the cardio-metabolic risk in adults with a history of AD using 3 different questionnaire-based diagnostic criteria.
We utilized data from a general population study including questionnaire data and objective measurements of 9656 Danish adults. To identify adults with a history of AD, we used a question regarding physician-diagnosed AD and 2 versions of the UK Working Party Diagnostic Criteria. Associations between AD status and cardio-metabolic endpoints were estimated using survey weighted logistic and linear regression analysis.
We identified 462 (4.8%) adults with self-reported physician-diagnosed AD, whereas 903 (9.4%) and 226 (2.3%) had AD according to the UK Working Party Criteria when at least 2 and 3of 4 minor criteria were fulfilled. The populations were not comparable in terms of occurrence of cardio-metabolic risk factors. For example, the prevalence of obesity was lower in participants with physician-diagnosed AD but overall higher in UK 2/4 and UK 3/4.
Due to the heterogeneity in the captured study populations in terms of the studied outcomes and absence of a gold standard, no conclusions regarding the cardio-metabolic risk in adults with AD in a general population could be made. This study serves as an example of the challenges that are often encountered in questionnaire-based epidemiologic studies and highlights the need of better definitions for this patient group.
特应性皮炎（AD）与心血管代谢危险因素之间的关联尚未确定。此外，目前尚无经过验证的基于问卷的方法来识别患有 AD 的成年人。
使用 3 种不同的基于问卷的诊断标准评估有 AD 病史的成年人的心血管代谢风险。
我们利用了一项包括问卷调查数据和 9656 名丹麦成年人的客观测量数据的一般人群研究的数据。为了确定有 AD 病史的成年人，我们使用了一个关于医生诊断的 AD 的问题和英国工作组诊断标准的两个版本。使用调查加权逻辑回归和线性回归分析来估计 AD 状态与心血管代谢终点之间的关联。
我们确定了 462 名（4.8%）自我报告有医生诊断的 AD 的成年人，而根据英国工作组标准，当至少满足 4 项次要标准中的 2 项和 3 项时，有 903 名（9.4%）和 226 名（2.3%）成年人患有 AD。这些人群在心血管代谢危险因素的发生方面无法进行比较。例如，在有医生诊断的 AD 的参与者中，肥胖的患病率较低，但在 UK 2/4 和 UK 3/4 中总体较高。
由于在研究人群方面，所研究的结果存在异质性，且缺乏金标准，因此无法就一般人群中患有 AD 的成年人的心血管代谢风险得出任何结论。本研究说明了基于问卷的流行病学研究中经常遇到的挑战，并强调了为这一患者群体制定更好定义的必要性。
