Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.
Pediatr Allergy Immunol. 2018 May;29(3):260-266. doi: 10.1111/pai.12853. Epub 2018 Jan 31.
Atopic dermatitis (AD) is associated with systemic inflammation and may have a similar pathogenesis as obstructive sleep apnea (OSA). However, to date, studies on the association between AD and OSA are limited.
This study evaluated the association between OSA and AD in children in a large-scale, population-based cohort.
A total of approximately 120 736 children (<18 years) with newly diagnosed AD and 120 736 age- and sex-matched patients without AD from 2000 to 2007 were identified from Taiwan's National Health Insurance Research Database from 2000 to 2007. The Kaplan-Meier test was used for measuring the cumulative incidence of OSA in each cohort. Cox proportional hazard regression models were used for evaluating the risk of OSA in patients with or without AD between the two cohorts.
The Kaplan-Meier analysis revealed that the cumulative incidence curves of OSA were significantly higher in patients with AD than in those without AD (log-rank test, P < .001). After adjusting for age, sex, urbanization level, and comorbidities, patients with AD had a higher risk of OSA than those without AD (adjusted hazard ratio = 1.86, 95% confidence interval = 1.43-2.42). Compared with patients without AD, patients with AD exhibited a higher risk of developing OSA, irrespective of underlying comorbidities.
This nationwide, population-based cohort study revealed an increased risk of OSA in children with AD. Therefore, comprehensive evaluation and aggressive risk reduction for OSA are recommended in these patients.
特应性皮炎（AD）与全身炎症有关，其发病机制可能与阻塞性睡眠呼吸暂停（OSA）相似。然而，迄今为止，有关 AD 与 OSA 之间关联的研究有限。
本研究在一项大规模的基于人群的队列中评估了儿童 OSA 与 AD 之间的关联。
从 2000 年至 2007 年，从台湾全民健康保险研究数据库中确定了约 120736 名患有新诊断的 AD 且年龄和性别相匹配的儿童（<18 岁）和 120736 名无 AD 的年龄和性别相匹配的患者。使用 Kaplan-Meier 检验来衡量每个队列中 OSA 的累积发生率。使用 Cox 比例风险回归模型来评估两个队列中有无 AD 的患者患 OSA 的风险。
Kaplan-Meier 分析显示，AD 患者的 OSA 累积发生率曲线明显高于无 AD 患者（对数秩检验，P<.001）。在校正年龄、性别、城市化水平和合并症后，AD 患者患 OSA 的风险高于无 AD 患者（调整后的危险比=1.86，95%置信区间=1.43-2.42）。与无 AD 的患者相比，患有 AD 的患者发生 OSA 的风险更高，与潜在的合并症无关。
这项基于全国人群的队列研究显示，AD 儿童患 OSA 的风险增加。因此，建议对这些患者进行全面评估和积极降低 OSA 的风险。
