Cardiovascular comorbidities in patients with rosacea: A nationwide case-control study from Taiwan.

BACKGROUND: Rosacea is a chronic inflammatory skin disease. Inflammation plays a prominent role in atherosclerosis and its complications. OBJECTIVE: We sought to investigate the associations of rosacea with cardiovascular disease risk factors and cardiovascular diseases from a nationwide population-based database. METHODS: A total of 33,553 patients with rosacea and 67,106 age- and gender-matched control subjects were identified from the National Health Insurance Research Database in Taiwan from 1997 to 2010. Multivariate logistic regressions were performed to compare the odds of comorbidities between the 2 groups. RESULTS: Dyslipidemia (odds ratio 1.41; 95% confidence interval 1.36-1.46), coronary artery disease (odds ratio 1.35, 95% confidence interval 1.29-1.41), and hypertension (odds ratio 1.17, 95% confidence interval 1.12-1.21) were significantly associated with rosacea. Coronary artery disease remained independently associated with rosacea after adjustment for hypertension, diabetes mellitus, and dyslipidemia. Male patients with rosacea had higher risks for all comorbidities than female patients with rosacea. LIMITATIONS: The National Health Insurance Research Database does not contain information regarding rosacea subtypes or disease severity, or laboratory data. CONCLUSION: Patients with rosacea are more likely to have dyslipidemia and hypertension. They are also at increased risk of coronary artery disease after adjustment for cardiovascular disease risk factors.

Autoimmune disease comorbidities in patients with atopic dermatitis: a nationwide case-control study in Taiwan.

BACKGROUND AND OBJECTIVES: Atopic dermatitis (AD) is a chronic relapsing dermatitis of unknown etiology. It is thought that abnormal regulation of Th1 and Th2 is not only the major cause of AD, but also the vital pathogenesis of many autoimmune diseases. To date, no large-scale studies have been performed on the relationship between AD and autoimmune disease. By conducting a nationwide population-based study with case-controls in Taiwan, we sought to clarify the association of AD with other autoimmune diseases to obtain a better understanding of its pathogenesis. METHODS: Data were obtained from the National Health Insurance Research Database (NHIRD) of Taiwan from 1997 to 2010. In total, 41950 patients with AD and 167800 age- and gender-matched controls were enrolled. RESULTS: Patients with AD tended to have a high risk of associated lupus erythematosus (LE) (OR: 1.94, 95% CI: 1.48-2.54). The risk of LE was higher in female AD patients (OR: 2.05, 95% CI: 1.53-2.76) than in male AD patients (OR: 1.48, 95% CI: 0.76-2.85). Juvenile patients younger than 18 yrs with AD had higher risk of LE (OR: 3.02, 95% CI: 1.30-7.03) than adult patients with AD (OR: 1.68, 95% CI: 1.26-2.24). CONCLUSIONS: Our study confirmed the association between AD and LE. Early survey for LE in juvenile patients with AD is recommended.

Comorbid autoimmune diseases in patients with sarcoidosis: A nationwide case-control study in Taiwan.

The association between sarcoidosis and autoimmune comorbidities has been reported, however, it has seldom been confirmed by a large nationwide study. Our study aimed to clarify the association between sarcoidosis and autoimmune comorbidities in the Taiwanese. A total of 1237 patients with sarcoidosis and 4948 age- and sex-matched control subjects were selected from the National Health Insurance Research Database of Taiwan from 1997 to 2010. Multiple logistic regressions were performed to calculate the odds of comorbidities between the two groups. The prevalence of sarcoidosis was 2.17/100 000 individuals in Taiwan. Sarcoidosis patients tended to run a higher risk of autoimmune comorbidities than the control group (17.6% vs 9.4%, P < 0.05). Autoimmune thyroid disease (adjusted odd ratio [aOR], 1.32; 95% confidence interval [CI], 1.05-1.64), Sjögren's syndrome (aOR, 11.6; 95% CI, 4.36-31.0) and ankylosing spondylitis (aOR, 3.80; 95% CI, 2.42-5.97) were significantly associated with sarcoidosis. The sex-stratified analyses were carried out to demonstrate a significant association of sarcoidosis with ankylosing spondylitis in both sexes, but with autoimmune thyroid disease in male patients and with Sjögren's syndrome female patients, respectively. Besides, the diagnosis of the autoimmune comorbidities strongly associated with sarcoidosis tended to be established after that of sarcoidosis. This study demonstrated that patients with sarcoidosis tended to have autoimmune thyroid disease, Sjögren's syndrome and ankylosing spondylitis, and the diagnosis of sarcoidosis usually preceded that of associated comorbidities. Clinicians should be alert to autoimmune comorbidities in patients with sarcoidosis.