Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Md.
Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa.
J Allergy Clin Immunol Pract. 2023 Oct;11(10):3123-3132.e3. doi: 10.1016/j.jaip.2023.08.007. Epub 2023 Aug 10.
Atopic dermatitis (AD) may increase risk for atherothrombotic and cardiovascular (CV) disease.
Determine CV disease and venous thromboembolism risk among patients with AD.
Cohort study using electronic health data from U.K. general practices in 1994 to 2015. Children (<18 y) and adults (≥18 y) with AD were matched to patients without AD on age, same practice, and encounter date. Treatments and specialist referrals served as proxies of AD severity. Outcomes were incident myocardial infarction, cerebrovascular accident (CVA), diabetes, hypertension, dyslipidemia, deep vein thrombosis (DVT), and pulmonary embolism. Cox regression analysis was used to compare outcomes in AD versus non-AD patients.
Comparing 409,341 children with AD (93.2% mild, 5.5% moderate, and 1.3% severe) to 1,809,029 unaffected children, AD was associated with higher risk of DVT (hazard ratio [HR] 1.23; 95% confidence interval [95% CI] 1.02-1.48) and severe AD was associated with higher risk of CVA (HR 2.43; 95% CI 1.13-5.22) and diabetes (HR 1.46; 95% CI 1.06-2.01). Comparing 625,083 adults with AD (65.7% mild, 31.4% moderate, and 2.9% severe) to 2,678,888 unaffected adults, AD, especially when severe, was associated with higher risk of DVT (HR 1.14; 95% CI 1.11-1.18; and HR 1.64; 95% CI 1.49-1.82, respectively) and small but increased risks of CVA, diabetes, and dyslipidemia. Adults with severe AD had higher risk of myocardial infarction (HR 1.27; 95% CI 1.15-1.39), CVA (HR 1.21; 95% CI 1.13-1.30), diabetes (HR 1.15; 95% CI 1.09-1.22), dyslipidemia (HR 1.11; 95% CI 1.06-1.17), and pulmonary embolism (HR 1.39; 95% CI 1.21-1.60) compared with adults without AD.
Atopic dermatitis, particularly when severe, is associated with small but increased risks of CV risk factors and events and significantly increased risk of venous thromboembolism.
特应性皮炎（AD）可能增加动脉粥样硬化和心血管（CV）疾病的风险。
确定 AD 患者的 CV 疾病和静脉血栓栓塞风险。
使用英国普通实践中的电子健康数据进行队列研究，时间范围为 1994 年至 2015 年。将患有 AD 的儿童（<18 岁）和成年人（≥18 岁）与没有 AD 的患者按年龄、同一实践和就诊日期进行匹配。治疗和专科转诊作为 AD 严重程度的替代指标。结局是心肌梗死、卒中等心脑血管疾病、糖尿病、高血压、血脂异常、深静脉血栓形成（DVT）和肺栓塞。使用 Cox 回归分析比较 AD 患者和非 AD 患者的结局。
将 409341 例患有 AD（93.2%为轻度，5.5%为中度，1.3%为重度）的儿童与 1809029 名未受影响的儿童进行比较，AD 与 DVT（风险比 [HR] 1.23；95%置信区间 [95%CI] 1.02-1.48）的风险增加相关，严重 AD 与卒中等心脑血管疾病（HR 2.43；95%CI 1.13-5.22）和糖尿病（HR 1.46；95%CI 1.06-2.01）的风险增加相关。将 625083 例患有 AD（65.7%为轻度，31.4%为中度，2.9%为重度）的成年人与 2678888 名未受影响的成年人进行比较，AD，尤其是重度 AD，与 DVT（HR 1.14；95%CI 1.11-1.18；和 HR 1.64；95%CI 1.49-1.82，分别）和小但增加的卒中等心脑血管疾病、糖尿病和血脂异常风险相关。严重 AD 的成年人患心肌梗死（HR 1.27；95%CI 1.15-1.39）、卒中等心脑血管疾病（HR 1.21；95%CI 1.13-1.30）、糖尿病（HR 1.15；95%CI 1.09-1.22）、血脂异常（HR 1.11；95%CI 1.06-1.17）和肺栓塞（HR 1.39；95%CI 1.21-1.60）的风险均高于无 AD 的成年人。
特应性皮炎，尤其是严重的特应性皮炎，与 CV 危险因素和事件的小但增加的风险以及静脉血栓栓塞的显著增加风险相关。
