Department of Medical Education, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
J Dermatol. 2021 Nov;48(11):1754-1762. doi: 10.1111/1346-8138.16109. Epub 2021 Aug 30.
Women with abnormal uterine bleeding (AUB) have been reported to develop chronic spontaneous urticaria (CSU). Nevertheless, whether or not AUB women have an increased risk of CSU has not been examined in large-scale epidemiologic studies. This study aimed to investigate the risk of CSU among reproductive-aged women with AUB. A total of 79 595 patients and 79 107 propensity-score matched controls were recruited from Taiwan's National Health Insurance Research Database to conduct a nationwide cohort study. The Cox proportional-hazard regression model was applied to examine the adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for CSU in relation to AUB. We found that women with AUB had a higher risk for CSU (aHR = 1.83; 95% CI, 1.76-1.90) than women without AUB. Subgroup analyses revealed that AUB with an abnormal bleeding frequency (aHR = 1.70; 95% CI, 1.60-1.79), irregular bleeding (aHR = 1.80; 95% CI, 1.71-1.89), and intermenstrual bleeding (aHR = 1.65; 95% CI, 1.49-1.83) were associated with an increased risk of CSU compared with those without abnormalities. The Kaplan-Meier analysis revealed that the cumulative incidence of developing CSU was consistently higher in the AUB cohort than in the non-AUB cohort during the entire follow-up period (log-rank test, p < 0.001). In conclusion, reproductive-aged women with AUB were found to have a higher risk of developing CSU. This study emphasizes the importance of enquiring CSU patients about menstrual problems in clinical practice. Further consultation with obstetrician-gynecologists may be beneficial.
患有异常子宫出血（AUB）的女性据报道会发展为慢性自发性荨麻疹（CSU）。然而，大规模的流行病学研究尚未检查 AUB 女性患 CSU 的风险是否增加。本研究旨在调查 AUB 育龄妇女患 CSU 的风险。共从台湾全民健康保险研究数据库招募了 79595 例患者和 79107 例倾向评分匹配对照进行全国性队列研究。应用 Cox 比例风险回归模型检查 AUB 与 CSU 相关的调整后危险比（aHR）和 95%置信区间（CI）。我们发现，患有 AUB 的女性患 CSU 的风险更高（aHR=1.83；95%CI，1.76-1.90），而没有 AUB 的女性。亚组分析显示，AUB 伴异常出血频率（aHR=1.70；95%CI，1.60-1.79）、不规则出血（aHR=1.80；95%CI，1.71-1.89）和经间出血（aHR=1.65；95%CI，1.49-1.83）与 CSU 风险增加相关与无异常者相比。Kaplan-Meier 分析显示，在整个随访期间，AUB 队列发生 CSU 的累积发生率始终高于非 AUB 队列（对数秩检验，p<0.001）。总之，患有 AUB 的育龄妇女发生 CSU 的风险较高。本研究强调了在临床实践中向 CSU 患者询问月经问题的重要性。进一步咨询妇产科医生可能会有所帮助。
