Weng Yu-Ching, Juan Chao-Kuei, Ho Hsiu J, Chang Yi-Ling, Wu Chun-Ying, Chen Yi-Ju
Department of Dermatology, Taichung Veterans General Hospital, Taichung, Taiwan.
Faculty of Medicine and Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
J Dermatol. 2021 Feb;48(2):168-174. doi: 10.1111/1346-8138.15661. Epub 2020 Oct 30.
Coexistence of inflammatory bowel disease (IBD) in atopic dermatitis (AD) patients has been reported. The long-term risk of IBD in AD patients remains unclear. Our aim for the study is to examine the long-term risk of IBD in AD patients. This is a nationwide cohort study. From the National Health Insurance Research Database of Taiwan (1997-2013), a total of 36 400 AD patients were identified and matched with 364 000 reference subjects without AD by age, sex and number of hospital visits. Demographic characteristics and comorbidities were compared. Cox proportional hazards regression analysis was conducted to examine the risk of IBD. The 16-year cumulative incidences of IBD were 0.047% (95% confidence interval [CI], 0.040-0.054) and 0.047% (95% CI, 0.025-0.096) in non-AD and AD cohorts, respectively (P = 0.973). There were 17 cases of IBD (0.05%), including 10 ulcerative colitis and seven Crohn's disease, among AD patients compared with 169 IBD cases (0.05%) among controls (P > 0.999). Infections (adjusted hazard ratio [HR], 2.71; 95% CI, 1.96-3.95; P < 0.001) and age (adjusted HR, 1.03; 95% CI, 1.02-1.03; P < 0.001) were independently associated with IBD, after adjusting for major comorbidities and conducting multivariate analyses. AD was not associated with IBD development. In conclusion, AD is not independently associated with IBD development.
已有报道称特应性皮炎（AD）患者中存在炎症性肠病（IBD）。AD患者发生IBD的长期风险仍不明确。我们开展这项研究的目的是检测AD患者发生IBD的长期风险。这是一项全国性队列研究。从台湾地区国民健康保险研究数据库（1997 - 2013年）中，共识别出36400例AD患者，并按照年龄、性别和就诊次数与364000例无AD的对照对象进行匹配。比较了人口统计学特征和合并症情况。进行Cox比例风险回归分析以检测IBD风险。非AD队列和AD队列中IBD的16年累积发病率分别为0.047%（95%置信区间[CI]，0.040 - 0.054）和0.047%（95%CI，0.025 - 0.096）（P = 0.973）。AD患者中有17例IBD（0.05%）病例，包括10例溃疡性结肠炎和7例克罗恩病；对照对象中有169例IBD病例（0.05%）（P > 0.999）。在对主要合并症进行校正并进行多因素分析后，感染（校正风险比[HR]，2.71；95%CI，1.96 - 3.95；P < 0.001）和年龄（校正HR，1.03；95%CI，1.02 - 1.03；P < 0.001）与IBD独立相关。AD与IBD发生无关。总之，AD与IBD发生无独立相关性。
