Division of Pediatric Gastroenterology, Children's Medical Center, Taichung Veterans General Hospital, Taichung City, Taiwan.
Department of Medical Research, Chung Shan Medical University Hospital, Taichung City, Taiwan.
Int J Clin Pract. 2021 Mar;75(3):e13691. doi: 10.1111/ijcp.13691. Epub 2020 Sep 21.
Atopic dermatitis (AD) is the chronic inflammatory disorder that affects both in childhood and adulthood. Mounting evidence indicates that gut dysbiosis contributes to AD via the gut-skin axis. Constipation can result in alteration of the gut microflora. The clinical impact of constipation on AD has not been researched. Therefore, we aim to assess the risk of AD in constipated patients by the population-based cohort study.
We collected 85 554 constipated people and 85 554 people without constipation between 1999 and 2013 from the Taiwanese National Health Insurance Research Database. Propensity score analysis was administrated to match age, gender, comorbidities and medications at a ratio of 1:1. Multiple Cox regression analysis was utilised to evaluate the adjusted hazard ratio of AD. In addition, sensitivity tests and a stratified analysis were conducted.
The incidence of AD was 4.9 per 1000 person-years in the constipation group, which was higher than the rate of 2.1 per 1000 person-years observed in the non-constipation group. After adjustment for age, gender, comorbidities, corticosteroids, antihistamine and antibiotics, constipated people had a 2.31-fold greater risk of AD compared with those without constipation (adjusted hazard ratio [aHR]: 2.31 (95% CI 2.17-2.46). Moreover, constipated people had a higher likelihood of AD, regardless of gender, comorbidities, as well as the usage of corticosteroids, antihistamines and antibiotics.
Constipation is associated with a significantly risk factor of AD. Clinicians should be careful of the possibility of AD in constipated people. Further study is warranted to investigate the possible pathological mechanisms of this relationship.
特应性皮炎（AD）是一种慢性炎症性疾病，可发生于儿童期和成年期。越来越多的证据表明，肠道菌群失调通过肠-皮轴导致 AD。便秘可导致肠道微生物群的改变。便秘对 AD 的临床影响尚未得到研究。因此，我们旨在通过基于人群的队列研究评估便秘患者患 AD 的风险。
我们从 1999 年至 2013 年收集了 85554 名便秘患者和 85554 名非便秘患者的台湾全民健康保险研究数据库。采用倾向评分分析按年龄、性别、合并症和药物的比例为 1:1 进行匹配。利用多 Cox 回归分析评估 AD 的调整后危险比。此外，还进行了敏感性测试和分层分析。
便秘组 AD 的发病率为每 1000 人年 4.9 例，高于非便秘组的每 1000 人年 2.1 例。调整年龄、性别、合并症、皮质类固醇、抗组胺药和抗生素后，与非便秘患者相比，便秘患者患 AD 的风险增加了 2.31 倍（调整后的危险比[aHR]：2.31（95%CI 2.17-2.46））。此外，无论性别、合并症以及皮质类固醇、抗组胺药和抗生素的使用情况如何，便秘患者患 AD 的可能性都更高。
便秘是 AD 的一个显著危险因素。临床医生应注意便秘患者患 AD 的可能性。需要进一步研究以探讨这种关系的可能病理机制。
