Cohort studies on 71 outcomes among people with atopic eczema in UK primary care data

被引:0
作者
Matthewman, Julian [1 ]
Schultze, Anna [1 ]
Strongman, Helen [1 ]
Bhaskaran, Krishnan [1 ]
Roberts, Amanda [2 ]
Denaxas, Spiros [3 ,4 ,5 ]
Mansfield, Kathryn E. [1 ]
Langan, Sinead M. [1 ]
机构
[1] London Sch Hyg & Trop Med, London, England
[2] Independent Patient Partner, London, England
[3] UCL, Inst Hlth Informat, London, England
[4] UCLH, BRC, NIHR, London, England
[5] HDR UK, BHF Data Sci Ctr, London, England
基金
英国惠康基金; 美国国家卫生研究院;
关键词
CAUSAL INFERENCE; NATIONAL-HEALTH; DERMATITIS; BURDEN; RISK;
D O I
10.1038/s41467-024-54035-1
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Atopic eczema may be related to multiple subsequent adverse health outcomes. Here, we provide evidence to judge and compare associations between eczema and a comprehensive set of outcomes. We conducted 71 cohort studies (age, sex, general practice-matched) using Clinical Practice Research Datalink Aurum primary care records (1997-2023), comparing up to 3.6 million people with eczema to 16.8 million without. Eczema was associated with subsequent diagnosis of outcomes with adjusted hazard ratios (99% confidence intervals) from Cox regression of up to 4.02(3.95-4.10) for food allergy (rate difference [RD] per 1,000 person-years of 1.5). Besides strong associations with atopic and allergic conditions (e.g., asthma 1.87[1.39-1.82], RD5.4) and skin infections (e.g., molluscum contagiosum 1.81[1.64-1.96], RD1.8), the strongest associations were with Hodgkin's lymphoma (1.85[1.66-2.06], RD0.02), Alopecia Areata (1.77[1.71-1.83], RD0.2), Crohn's disease (1.62[1.54-1.69], RD0.1), Urticaria (1.58[1.57-1.60], RD1.9), Coeliac disease (1.42[1.37-1.47], RD0.1), Ulcerative colitis (1.40[1.34-1.46], RD0.1), Autoimmune liver disease (1.32[1.21-1.43], RD0.01), and Irritable bowel syndrome (1.31[1.29-1.32], RD0.7). Sensitivity analyses revealed the impact of consultation bias or choice of cohort age cut-off on findings. Comparatively large HRs in severe eczema were seen for some liver, gastrointestinal and cardiovascular conditions, osteoporosis, and fractures. Most cancers and neurological conditions were not associated with eczema.
引用
收藏
页数:11
相关论文
共 31 条
  • [21] VanderWeele T.J., Mathur M.B., Chen Y., Outcome-wide longitudinal designs for causal inference: a new template for empirical studies, Stat. Sci, 35, (2020)
  • [22] de Lusignan S., Et al., Patterns and trends in eczema management in UK primary care (2009–2018): A population‐based cohort study, Clin. Exp. Allergy, 51, pp. 483-494, (2021)
  • [23] McDonald L., Schultze A., Carroll R., Ramagopalan S.V., Performing studies using the UK Clinical Practice Research Datalink: to link or not to link?, Eur. J. Epidemiol, 33, pp. 601-605, (2018)
  • [24] Clinical Practice Research Datalink. Small Area Level Data Based on Patient Postcode., 14, (2022)
  • [25] Brunner P.M., Et al., Increasing comorbidities suggest that atopic Dermatitis is a systemic disorder, J. Investig. Dermatol, 137, pp. 18-25, (2017)
  • [26] Abuabara K., Et al., Development and validation of an algorithm to accurately identify atopic eczema patients in primary care electronic health records from the UK, J. Investig. Dermatol, 137, pp. 1655-1662, (2017)
  • [27] Vandenbroucke J., Pearce N., Point: Incident exposures, prevalent exposures, and causal inference: does limiting studies to persons who are followed from first exposure onward damage epidemiology?, Am. J. Epidemiol, 182, pp. 826-833, (2015)
  • [28] Magyari A., Et al., Adult atopic eczema and the risk of dementia: A population-based cohort study, J. Am. Acad. Dermatol, 87, pp. 314-322, (2022)
  • [29] Langan S.M., Abuabara K., Henrickson S.E., Hoffstad O., Margolis D.J., Increased risk of cutaneous and systemic infections in atopic dermatitis—a cohort study, J. Investig. Dermatol, 137, pp. 1375-1377, (2017)
  • [30] Kuan V., Et al., A chronological map of 308 physical and mental health conditions from 4 million individuals in the English National Health Service, Lancet Digit. Health, 1, pp. e63-e77, (2019)