Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Northwestern Medicine Multidisciplinary Eczema Center, Chicago, Illinois.
J Am Acad Dermatol. 2019 Feb;80(2):382-389. doi: 10.1016/j.jaad.2018.09.025. Epub 2018 Oct 1.
Little is known about the risk and predictors of autoimmune diseases in children and adults.
To determine the prevalence, predictors, and excess costs of autoimmune disease in atopic dermatitis (AD) patients.
Cross-sectional study of the 2002-2012 National Inpatient Sample, which includes a ∼20% sample of all US hospitalizations (n = 87,053,155 adults and children).
The prevalence of autoimmune disease was higher in adults with AD (7.9%, 95% confidence interval [95% CI] 7.3-8.5%) than without AD (5.7%, 95% CI 5.7%-5.8%) and higher in children with AD (2.0%, 95% CI 1.7%-2.3%) than without AD (1.0%, 95% CI 0.9%-1.1%). In multivariable logistic regression models controlling for sociodemographics, adult (adjusted odds ratio 1.45, 95% CI 1.32-1.58) and pediatric (adjusted odds ratio 2.08, 95% CI 1.73-2.50) AD were associated with any autoimmune disorder. In particular, AD was associated with 18 of 32 autoimmune disorders examined in adults and 13 of 24 examined in children, including disorders of the skin, endocrine, gastrointestinal, hematologic, and musculoskeletal systems. AD patients hospitalized with any autoimmune disorder had a higher cost of inpatient care, with $2.5-$50 million excess annual costs.
Adults and children with AD had increased cutaneous and extracutaneous autoimmune disorders, which were associated with a considerable cost burden.
对于儿童和成人的自身免疫性疾病的风险和预测因素知之甚少。
确定特应性皮炎（AD）患者中自身免疫性疾病的患病率、预测因素和超额费用。
对 2002 年至 2012 年全国住院患者样本进行横断面研究，该样本包括美国约 20%的住院患者（n=87053155 名成人和儿童）。
AD 成人（7.9%，95%置信区间[95%CI] 7.3%-8.5%）的自身免疫性疾病患病率高于无 AD 的成人（5.7%，95%CI 5.7%-5.8%），AD 儿童（2.0%，95%CI 1.7%-2.3%）的自身免疫性疾病患病率高于无 AD 的儿童（1.0%，95%CI 0.9%-1.1%）。在控制社会人口统计学因素的多变量逻辑回归模型中，成人（调整优势比 1.45，95%CI 1.32-1.58）和儿科（调整优势比 2.08，95%CI 1.73-2.50）AD 与任何自身免疫性疾病相关。特别是，AD 与成人中检查的 32 种自身免疫性疾病中的 18 种和儿童中检查的 24 种自身免疫性疾病中的 13 种相关，包括皮肤、内分泌、胃肠道、血液和肌肉骨骼系统的疾病。患有任何自身免疫性疾病的 AD 住院患者的住院治疗费用更高，每年有 2500 万至 5000 万美元的超额费用。
患有 AD 的成人和儿童患自身免疫性皮肤病和非皮肤病的风险增加，这与相当大的费用负担有关。
