School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Department of Pharmacy, Chung Shan Medical University Hospital, Taichung, Taiwan.
Front Immunol. 2023 Aug 18;14:1171804. doi: 10.3389/fimmu.2023.1171804. eCollection 2023.
In previous studies, it was reported that non-alcoholic fatty liver disease (NAFLD) incidence and prevalence increased in children with atopic dermatitis. Nevertheless, the actual association between the two diseases has not been fully proven in large-scale studies, and real-world evidence is missing. The objective of this nationwide, longitudinal cohort study was to evaluate the association between NAFLD and atopic dermatitis.
The National Health Insurance Research Database in Taiwan was utilized in this study. Patients with records of NAFLD diagnosis were recruited as the experimental group, and patients having less than three outpatient visits or one inpatient visiting record due to NAFLD were excluded from the study design. Non-NAFLD controls were matched based on a 1:4 propensity score matching. Potential confounders including age, gender, comorbidity, and medical utilization status were considered as covariates. The risk of future atopic dermatitis would be evaluated based on multivariate Cox proportional hazard regression.
Compared with people without NAFLD, a decreased risk of atopic dermatitis in NALFD patients had been observed (aHR = 0.93, 95% CI 0.87-0.98). The trend was especially presented in young NAFLD patients. In patients younger than 40 years old, a 20% decreased risk of atopic dermatitis was reported (aHR = 0.80, 95% CI 0.70-0.92).
People with NAFLD were not associated with an increased risk of atopic dermatitis. Conversely, a 0.93-fold risk was noted in NAFLD patients, compared with NAFLD-free controls. Future studies are warranted to evaluate further the mechanism regarding the interplay between the inflammatory mechanisms of NAFLD and atopic dermatitis.
在之前的研究中，有报道称特应性皮炎患儿的非酒精性脂肪性肝病（NAFLD）发病率和患病率增加。然而，这两种疾病之间的实际关联尚未在大规模研究中得到充分证明，并且缺乏真实世界的证据。本项全国性、纵向队列研究旨在评估 NAFLD 与特应性皮炎之间的关系。
本研究使用了台湾的全民健康保险研究数据库。将有 NAFLD 诊断记录的患者纳入实验组，并且排除了因 NAFLD 就诊次数少于 3 次或 1 次住院的患者。非 NAFLD 对照组则基于 1:4 的倾向评分匹配。将年龄、性别、合并症和医疗利用状况等潜在混杂因素作为协变量。基于多变量 Cox 比例风险回归来评估未来发生特应性皮炎的风险。
与无 NAFLD 的人相比，NAFLD 患者发生特应性皮炎的风险降低（aHR = 0.93，95%CI 0.87-0.98）。这种趋势在年轻的 NAFLD 患者中尤为明显。在年龄小于 40 岁的患者中，特应性皮炎的风险降低了 20%（aHR = 0.80，95%CI 0.70-0.92）。
NAFLD 患者与特应性皮炎的风险增加无关。相反，与无 NAFLD 对照组相比，NAFLD 患者的风险降低了 0.93 倍。需要进一步的研究来评估 NAFLD 和特应性皮炎之间的炎症机制相互作用的机制。
