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非伤寒沙门氏菌感染后特应性皮炎的时间依赖性发病风险。

Time-dependent risk of atopic dermatitis following nontyphoidal Salmonella infection.

机构信息

Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan.

Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 40201, Taiwan.

出版信息

Postgrad Med J. 2024 Aug 16;100(1187):649-656. doi: 10.1093/postmj/qgae041.

Abstract

BACKGROUND

The pathogenesis of atopic dermatitis (AD) remains unclear. Nontyphoidal Salmonella (NTS) infection might trigger immune-mediated reactions. We aimed to examine NTS and the risk of subsequent AD.

METHODS

From 2002 to 2015, eligible patients (aged 0-100 years) with NTS were identified. NTS and non-NTS groups were matched at a 1:10 ratio on age and sex. We utilized conditional multivariable Cox proportional hazard models to estimate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for AD development. Subgroup analyses were conducted based on age, sex, and severity of NTS infection. We utilized landmark analysis to explore the time-dependent hazard of AD following NTS.

RESULTS

In the NTS group (N = 6624), 403 developed AD. After full adjustment of demographics and comorbidities, the NTS group had a higher risk of AD than the reference group (aHR = 1.217, 95% CI = 1.096-1.352). Age-stratified analysis revealed that NTS group exhibited an elevated risk compared to the reference group, particularly among those aged 13-30 years (aHR = 1.25, 95% CI = 1.017-1.559), individuals aged 31-50 years (aHR = 1.388, 95% CI = 1.112-1.733), those aged 51-70 years (aHR = 1.301, 95% CI = 1.008-1.679), and individuals aged 71 years and over (aHR = 1.791, 95% CI = 1.260-2.545). Severe NTS was associated with a higher risk of AD than the reference group (aHR = 2.411, 95% CI = 1.577-3.685). Landmark analysis showed generally consistent findings.

CONCLUSIONS

Minimizing exposure to NTS infection may represent a prospective strategy for averting the onset and progression of atopic dermatitis.

摘要

背景

特应性皮炎(AD)的发病机制尚不清楚。非伤寒沙门氏菌(NTS)感染可能引发免疫介导的反应。本研究旨在探讨 NTS 与随后发生 AD 的风险。

方法

从 2002 年到 2015 年,确定了患有 NTS 的合格患者(年龄 0-100 岁)。NTS 和非 NTS 组按年龄和性别 1:10 比例匹配。我们利用条件多变量 Cox 比例风险模型来估计 AD 发展的调整后危险比(aHR)和 95%置信区间(CI)。根据年龄、性别和 NTS 感染严重程度进行亚组分析。我们利用 landmark 分析来探讨 NTS 后 AD 的时间依赖性危险。

结果

在 NTS 组(N=6624)中,有 403 人发生 AD。在充分调整人口统计学和合并症后,NTS 组发生 AD 的风险高于对照组(aHR=1.217,95%CI=1.096-1.352)。年龄分层分析显示,与对照组相比,NTS 组发生 AD 的风险增加,尤其是在 13-30 岁(aHR=1.25,95%CI=1.017-1.559)、31-50 岁(aHR=1.388,95%CI=1.112-1.733)、51-70 岁(aHR=1.301,95%CI=1.008-1.679)和 71 岁及以上(aHR=1.791,95%CI=1.260-2.545)的人群中。严重的 NTS 与 AD 风险高于对照组相关(aHR=2.411,95%CI=1.577-3.685)。landmark 分析显示了大致一致的结果。

结论

尽量减少 NTS 感染的暴露可能是预防特应性皮炎发病和进展的一种前瞻性策略。

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