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Atopic dermatitis is associated with an increased risk for rheumatoid arthritis and inflammatory bowel disease, and a decreased risk for type 1 diabetes

Official URL:https://doi.org/10.1016/j.jaci.2015.06.029
PubMed:View item in PubMed
Creators Name:Schmitt, J. and Schwarz, K. and Baurecht, H. and Hotze, M. and Foelster-Holst, R. and Rodriguez, E. and Lee, Y.A.E. and Franke, A. and Degenhardt, F. and Lieb, W. and Gieger, C. and Kabesch, M. and Noethen, M.M. and Irvine, A.D. and McLean, W.H.I. and Deckert, S. and Stephan, V. and Schwarz, P. and Aringer, M. and Novak, N. and Weidinger, S.
Journal Title:Journal of Allergy and Clinical Immunology
Journal Abbreviation:J Allergy Clin Immunol
Volume:137
Number:1
Page Range:130-136
Date:January 2016
Keywords:Atopic Dermatitis, Cohort Study, Epidemiology, Inflammatory Bowel Disease, Rheumatoid Arthritis, Type 1 Diabetes
Abstract:BACKGROUND: Atopic dermatitis (AD) is characterized by epidermal barrier failure and immune-mediated inflammation. Evidence on AD as a potential risk factor for inflammatory comorbidities is scarce. OBJECTIVES: We sought to test the hypothesis that prevalent AD is a risk factor for incident rheumatoid arthritis (RA) and inflammatory bowel disease (IBD; Crohn disease [CD], ulcerative colitis [UC]) and is inversely related to type 1 diabetes (T1D) and to investigate established RA, IBD, and T1D susceptibility loci in AD. METHODS: This cohort study used data from German National Health Insurance beneficiaries aged 40 years or younger (n = 655,815) from 2005 through 2011. Prevalent AD in the period 2005 to 2006 was defined as primary exposure, and incident RA, IBD, and T1D in the period 2007 to 2011 were defined as primary outcomes. Risk ratios were calculated with generalized linear models. Established RA, IBD, and T1D loci were explored in high-density genotyping data from 2,425 cases with AD and 5,449 controls. RESULTS: Patients with AD (n = 49,847) were at increased risk for incident RA (risk ratio [RR], 1.72; 95% CI, 1.25-2.37) and/or IBD (CD: RR, 1.34; 95% CI, 1.11-1.61; UC: RR, 1.25; 95% CI, 1.03-1.53). After adjusting for health care utilization, there was a nominally significant inverse effect on T1D risk (RR, 0.72; 95% CI, 0.53-0.998). There was no disproportionate occurrence of known RA, CD, UC, or T1D risk alleles in AD. CONCLUSIONS: AD is a risk factor for the development of RA and IBD. This excess comorbidity cannot be attributed to major known IBD and RA genetic risk factors.
ISSN:0091-6749
Publisher:Elsevier / Mosby (U.S.A.)
Item Type:Article

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