Ma Emily Z, Parthasarathy Varsha, Lee Kevin K, Shahsavari Shahin, Gage Davies, Akiska Yagiz, Callwood-Jackson Gabrielle, Mysore Manu, Kwatra Shawn G
Department of Dermatology, University of Maryland School of Medicine, 419 West Redwood Street, Baltimore, MD, 21201, USA.
Maryland Itch Center, University of Maryland School of Medicine, Baltimore, MD, USA.
Arch Dermatol Res. 2024 Dec 7;317(1):87. doi: 10.1007/s00403-024-03566-0.
Patients with prurigo nodularis (PN) present with pruritus which may lead to sleep disturbances and systemic comorbidities. The objective of our study was to determine the risk of sleep disorders in PN and its association with systemic inflammation and adverse cardiovascular outcomes. We conducted a retrospective population-level cohort using a global health records database to analyze the development of sleep disorders, C-reactive protein (CRP) levels, and risk of cardiovascular disease and mortality in PN compared to controls. PN patients had increased risk of general sleep disorders (RR 1.47, 95%CI 1.42-1.52, obstructive sleep apnea (1.61, 1.54-1.69), insomnia (1.37, 1.29-1.45), hypersomnia (1.47, 1.32-1.64), and restless legs syndrome (1.45, 1.28-1.65). Additionally, PN with sleep disorders had higher CRP levels than PN without sleep disorders (16.2 mg/L vs. 10.6 mg/L). PN patients with sleep disorders were more likely to develop cardiovascular comorbidities, including type 2 diabetes mellitus (RR 2.45, 95%CI 2.25-2.66), metabolic syndrome (4.16, 3.31-5.22), myocardial infarction (2.87, 2.52-3.22), venous thromboembolism (2.93, 2.55-3.39), and greater mortality (HR 1.47, 95%CI 1.34-1.62) compared to PN patients without sleep disorders. Our findings suggest that PN patients are at greater risk of developing various sleep disorders that are associated with adverse cardiovascular outcomes.
结节性痒疹（PN）患者存在瘙痒症状，这可能导致睡眠障碍和全身性合并症。我们研究的目的是确定PN患者发生睡眠障碍的风险及其与全身炎症和不良心血管结局的关联。我们使用全球健康记录数据库进行了一项回顾性人群队列研究，以分析PN患者与对照组相比睡眠障碍的发生情况、C反应蛋白（CRP）水平以及心血管疾病和死亡风险。PN患者发生一般睡眠障碍的风险增加（相对风险1.47，95%置信区间1.42 - 1.52），阻塞性睡眠呼吸暂停（1.61，1.54 - 1.69）、失眠（1.37，1.29 - 1.45）、嗜睡症（1.47，1.32 - 1.64）和不宁腿综合征（1.45，1.28 - 1.65）。此外，有睡眠障碍的PN患者CRP水平高于无睡眠障碍的PN患者（16.2mg/L对10.6mg/L）。与无睡眠障碍的PN患者相比，有睡眠障碍的PN患者更易发生心血管合并症，包括2型糖尿病（相对风险2.45，95%置信区间2.25 - 2.66）、代谢综合征（4.16，3.31 - 5.22）、心肌梗死（2.87，2.52 - 3.22）、静脉血栓栓塞（2.93，2.55 - 3.39），且死亡率更高（风险比1.47，95%置信区间1.34 - 1.62）。我们的研究结果表明，PN患者发生各种与不良心血管结局相关的睡眠障碍的风险更高。
