Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea.
Department of Pediatrics, Kyung Hee University Medical Center, Seoul, Republic of Korea.
Front Immunol. 2023 Dec 5;14:1165586. doi: 10.3389/fimmu.2023.1165586. eCollection 2023.
infection is common in the general population and may be followed by immune dysfunction, but links with subsequent autoimmune disease remain inconclusive.
To estimate the association of infection with the risk of subsequent autoimmune disease.
This retrospective cohort study examined the medical records of South Korean children from 01/01/2002 to 31/12/2017. The exposed cohort was identified as patients hospitalized for infection. Each exposed patient was matched with unexposed controls based on birth year and sex at a 1:10 ratio using incidence density sampling calculations. The outcome was subsequent diagnosis of autoimmune disease, and hazard ratios (HRs) were estimated with control for confounders. Further estimation was performed using hospital-based databases which were converted to a common data model (CDM) to allow comparisons of the different databases.
The exposed cohort consisted of 49,937 children and the matched unexposed of 499,370 children. The median age at diagnosis of infection was 4 years (interquartile range, 2.5-6.5 years). During a mean follow-up time of 9.0 ± 3.8 years, the incidence rate of autoimmune diseases was 66.5 per 10,000 person-years (95% CI: 64.3-68.8) in the exposed cohort and 52.3 per 10,000 person-years (95% CI: 51.7-52.9) in the unexposed cohort, corresponding to an absolute rate of difference of 14.3 per 10,000 person-years (95% CI: 11.9-16.6). Children in the exposed cohort had an increased risk of autoimmune disease (HR: 1.26; 95% CI: 1.21-1.31), and this association was similar in the separate analysis of hospital databases (HR: 1.25; 95% CI 1.06-1.49).
infection requiring hospitalization may be associated with an increase in subsequent diagnoses of autoimmune diseases.
感染在普通人群中很常见，并且可能随之导致免疫功能障碍，但与随后发生的自身免疫性疾病之间的联系仍不确定。
评估 感染与随后发生自身免疫性疾病的风险之间的关联。
本回顾性队列研究分析了 2002 年 1 月 1 日至 2017 年 12 月 31 日期间韩国儿童的医疗记录。将感染住院的患者确定为暴露队列。使用发生率密度抽样计算，按照出生年份和性别以 1:10 的比例，为每个暴露患者匹配未暴露对照。结局为随后诊断为自身免疫性疾病，使用协变量控制估计风险比（HRs）。进一步使用基于医院的数据库进行估计，这些数据库被转换为通用数据模型（CDM），以允许比较不同数据库。
暴露队列包含 49937 名儿童，匹配的未暴露队列包含 499370 名儿童。感染诊断的中位年龄为 4 岁（四分位距，2.5-6.5 岁）。在平均 9.0±3.8 年的随访期间，暴露队列的自身免疫性疾病发生率为 66.5/10000 人年（95%CI：64.3-68.8），未暴露队列为 52.3/10000 人年（95%CI：51.7-52.9），绝对差异率为 14.3/10000 人年（95%CI：11.9-16.6）。暴露队列的儿童发生自身免疫性疾病的风险增加（HR：1.26；95%CI：1.21-1.31），这一关联在医院数据库的单独分析中也相似（HR：1.25；95%CI 1.06-1.49）。
需要住院治疗的 感染可能与随后诊断出的自身免疫性疾病的增加有关。
