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一项关于白癜风的全国性、多中心病例对照研究(MEDEC-V),以确定其发病率及相关因素。

A Nationwide, Multicentric Case-Control Study on Vitiligo (MEDEC-V) to Elicit the Magnitude and Correlates.

作者信息

Sarma Nilendu, Chakraborty Sayantani, Poojary Shital, Shashi Kumar B M, Gupta Lalit Kumar, Budamakuntla Leelavathy, Kumrah Leishiwon, Das Suchibrata, Ovhal Ajay Govindrao, Mandal Nirmal Kumar, Mukherjee Shuvankar, Anoop T V, Thakur Binod Kumar, Eswari L, Samson Joan Felicita, Patel Krina Bharat, Rajagopalan Rajesh, Gupta Sanjeev, Kaur Tejinder

机构信息

Department of Dermatology, Dr B C Roy Post Graduate Institute of Pediatric Science, Kolkata, West Bengal, India.

Department of RG Kar Medical College, Kolkata, West Bengal, India.

出版信息

Indian J Dermatol. 2020 Nov-Dec;65(6):473-482. doi: 10.4103/ijd.IJD_822_19.

Abstract

BACKGROUND

Vitiligo is an acquired, idiopathic, and common depigmentation disorder. The values of various epidemiologic parameters are often doubtful due to the methodological weaknesses of the studies.

AIMS

To elicit the magnitude of various epidemiological parameters and important correlates of vitiligo.

MATERIALS AND METHODS

Every vitiligo patient attending the outpatient department of medical colleges spread over most of the Indian states were examined over a period of 1 year. Various epidemiological and clinical variables were examined and compared with age and sex-matched controls (registered in the Clinical Trial Registry of India CTRI/2017/06/008854).

RESULTS

A total of 4,43,275 patients were assessed in 30 medical colleges from 21 Indian states. Institutional prevalence of vitiligo was 0.89% (0.86% in males and 0.93% in females, < 0.001). The mean age at presentation and mean age at onset were 30.12 ± 17.97 years and 25.14 ± 7.48 years, respectively. Head-neck was the most common primary site ( = 1648, 41.6%) and most commonly affected site ( = 2186, 55.17%). Most cases had nonsegmental vitiligo ( = 2690, 67.89%). The disease started before 20 years of age in more than 46% of cases. About 77% of all cases had signs of instability during the last 1 year. The family history, consanguinity, hypothyroid disorders, and depressed mood were significantly ( < 0.001) higher among the cases. First, second, and third-degree family members were affected in 269 (60.04%), 111 (24.78%), and 68 (15.18%) cases, respectively. Work-related exposure to chemicals was significantly higher among cases ( < 0.008). Obesity was less common among vitiligo cases [ < 0.001, odds ratio (OR) 0.78, 95% confidence interval (CI): 0.71-0.86].

CONCLUSION

This is one of the largest studies done on vitiligo in India. The prevalence of vitiligo was found to be 0.89% among hospital attendees. Prevalence of vitiligo was higher among females than in males and prevalence of family history, consanguinity, hypothyroid disorders were higher in vitiligo than among controls.

摘要

背景

白癜风是一种后天性、特发性的常见色素脱失性疾病。由于研究方法的缺陷,各种流行病学参数的值往往存疑。

目的

明确白癜风各种流行病学参数的规模及其重要相关因素。

材料与方法

在1年的时间里,对印度大部分邦医学院门诊部的每一位白癜风患者进行了检查。检查了各种流行病学和临床变量,并与年龄和性别匹配的对照组(登记于印度临床试验注册中心CTRI/2017/06/008854)进行比较。

结果

来自印度21个邦的30所医学院共评估了443275例患者。白癜风的机构患病率为0.89%(男性为0.86%,女性为0.93%,P<0.001)。就诊时的平均年龄和发病时的平均年龄分别为30.12±17.97岁和25.14±7.48岁。头颈部是最常见的首发部位(n = 1648,41.6%)和最常受累部位(n = 2186,55.17%)。大多数病例为非节段性白癜风(n = 2690,67.89%)。超过46%的病例在20岁之前发病。在过去1年中,约77%的病例有病情不稳定的迹象。病例组中家族史、近亲结婚、甲状腺功能减退症和情绪低落的发生率显著更高(P<0.001)。一级、二级和三级家庭成员受累的病例分别为269例(60.04%)、111例(24.78%)和68例(15.18%)。病例组中与工作相关的化学物质暴露显著更高(P<0.008)。白癜风患者中肥胖不太常见[P<0.001,比值比(OR)0.78,95%置信区间(CI):0.71 - 0.86]。

结论

这是印度针对白癜风开展的最大规模研究之一。在医院就诊者中,白癜风的患病率为0.89%。女性白癜风患病率高于男性,白癜风患者家族史近亲结婚、甲状腺功能减退症的患病率高于对照组。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae16/7810087/699938320660/IJD-65-473-g001.jpg

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