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特应性皮炎患者发生 1 型糖尿病的风险:一项全国性基于人群的队列研究。

Risk of Type 1 Diabetes Mellitus in Patients with Atopic Dermatitis: A Nationwide Population-Based Cohort Study.

机构信息

Department of Medical Education, Chang-Gung Memorial Hospital, Taoyuan, Taiwan.

School of Traditional Chinese Medicine, Chang-Gung University, Taoyuan, Taiwan.

出版信息

Dermatology. 2024;240(2):254-261. doi: 10.1159/000535848. Epub 2023 Dec 20.

Abstract

INTRODUCTION

Atopic dermatitis (AD) is a disease frequently occurring in children. The immune response is characterized by T-helper (Th)-2-dependent inflammation. Type 1 diabetes mellitus (T1DM) is an autoimmune disease that destroys pancreatic islet beta cells. In contrast, it is mainly mediated by a Th-1-dependent response. An inverted association has been hypothesized between T1DM and AD since Th1 and Th2 responses are mutually inhibitory.

METHODS

Data was retrieved from a nationwide healthcare database in Taiwan. A logistic regression model was used to evaluate the association of T1DM in patients with AD within a year. A Cox proportional hazards analysis was used to evaluate the subsequent risk of developing T1DM 1 year after AD diagnosis.

RESULTS

We identified 396,461 patients with AD and 1,585,844 age- and sex-matched controls. During the first year of follow-up, after adjusting variates, the association between T1DM and AD showed no statistical differences (odds ratio: 1.40; 95% confidence interval [CI]: 0.83-2.38, p = 0.207). After excluding those T1DM cases within 1 year of AD diagnosis and those with a follow-up duration of less than 1 year, AD did not significantly increase the risk of T1DM (hazard ratio [HR]: 1.02; 95% CI, 0.83-1.25, p = 0.843).

CONCLUSIONS

Our study revealed that there was no significant association between AD and T1DM in the first year after AD diagnosis, and there was no increased risk of T1DM in AD patients in the average 5-year follow-up in our study.

摘要

简介

特应性皮炎(AD)是一种常见于儿童的疾病。免疫反应的特征是 T 辅助(Th)-2 依赖性炎症。1 型糖尿病(T1DM)是一种自身免疫性疾病,会破坏胰岛β细胞。相比之下,它主要由 Th1 依赖性反应介导。由于 Th1 和 Th2 反应相互抑制,因此假设 T1DM 和 AD 之间存在反向关联。

方法

我们从台湾的一个全国性医疗保健数据库中检索数据。使用逻辑回归模型评估一年内 AD 患者并发 T1DM 的相关性。使用 Cox 比例风险分析评估 AD 诊断后 1 年内发生 T1DM 的后续风险。

结果

我们确定了 396461 例 AD 患者和 1585844 名年龄和性别匹配的对照。在随访的第一年,调整了变量后,T1DM 与 AD 之间的关联没有统计学差异(优势比:1.40;95%置信区间[CI]:0.83-2.38,p=0.207)。排除 AD 诊断后 1 年内发生的 T1DM 病例和随访时间少于 1 年的病例后,AD 并不会显著增加 T1DM 的发病风险(风险比[HR]:1.02;95%CI,0.83-1.25,p=0.843)。

结论

我们的研究表明,AD 诊断后第一年 AD 与 T1DM 之间无显著相关性,在平均 5 年随访中 AD 患者发生 T1DM 的风险也没有增加。

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