Gwak Yeon-Su, Kim Seo-Yeon, Woo Chae-Eon, Shin Kihyuk, Son Eunjeong, Kim Jin-Woo, Kim Sung-Jin, Song Tae-Jin, Park Hae Ryoun, Kim Kihun, Ko Dai Sik, Kim Yun Hak
School of Medicine, Pusan National University, Yangsan, Republic of Korea.
Department of Dermatology, College of Medicine, Pusan National University, Busan, Korea; Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea; Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Busan, Korea.
Acta Derm Venereol. 2025 Jan 3;105:adv41321. doi: 10.2340/actadv.v105.41321.
Recent cohort studies suggest a potential association between atopic dermatitis and dementia, though the evidence remains conflicting. This study aims to elucidate the association between atopic dermatitis and dementia employing systematic review, meta-analysis, and Mendelian randomization (MR). A comprehensive search was performed to select eligible cohort studies using Medline, Embase, Scopus, ScienceDirect, and the Web of Science database. In MR analysis, genomic data from the Genome Wide Association Study (GWAS) (864,982 European individuals) for atopic dermatitis cases and dementia cases were obtained from the MRBase. Statistical analyses included the inverse-variance weighted (IVW) method, sensitivity tests, and MR-PRESSO for outliers. The adjustment accounted for various factors, including sex, age, smoking status, and other medical comorbidities, along with several additional variables. In the systematic review and meta-analysis, 5 longitudinal cohort studies (12,576,235 participants) indicated a significant association between atopic dermatitis and all-cause dementia (adjusted hazard ratio: 1.15, 95% CI: 1.07-1.23). Subgroup analyses revealed an adjusted hazard ratio of 1.18 (95% CI: 1.08-1.27) for Alzheimer's disease in patients with atopic dermatitis, and an adjusted hazard ratio of 1.37 (95% CI: 1.21-1.55) for all-cause dementia in patients with moderate-to-severe atopic dermatitis. However, MR analysis showed no significant causal link between atopic dermatitis and dementia, Alzheimer's disease, vascular dementia, or cognitive performance. While the meta-analysis revealed a significant association, MR analysis did not substantiate a significant causal link. Future research should consider demographic variables and medication influences in unravelling the intricate atopic dermatitis-dementia interplay.
近期的队列研究表明特应性皮炎与痴呆症之间可能存在关联，尽管证据仍存在冲突。本研究旨在通过系统评价、荟萃分析和孟德尔随机化（MR）来阐明特应性皮炎与痴呆症之间的关联。我们进行了全面检索，以使用Medline、Embase、Scopus、ScienceDirect和Web of Science数据库选择符合条件的队列研究。在MR分析中，来自全基因组关联研究（GWAS）（864,982名欧洲个体）的特应性皮炎病例和痴呆症病例的基因组数据从MRBase获得。统计分析包括逆方差加权（IVW）方法、敏感性测试以及针对异常值的MR-PRESSO。调整考虑了各种因素，包括性别、年龄、吸烟状况和其他合并症，以及几个其他变量。在系统评价和荟萃分析中，5项纵向队列研究（12,576,235名参与者）表明特应性皮炎与全因痴呆症之间存在显著关联（调整后的风险比：1.15，95%置信区间：1.07-1.23）。亚组分析显示，特应性皮炎患者患阿尔茨海默病的调整后风险比为1.18（95%置信区间：1.08-1.27），中度至重度特应性皮炎患者患全因痴呆症的调整后风险比为1.37（95%置信区间：1.21-1.55）。然而，MR分析显示特应性皮炎与痴呆症、阿尔茨海默病、血管性痴呆或认知表现之间没有显著的因果联系。虽然荟萃分析显示存在显著关联，但MR分析并未证实存在显著的因果联系。未来的研究在阐明复杂的特应性皮炎-痴呆症相互作用时应考虑人口统计学变量和药物影响。
