Cardiovascular and metabolic outcomes associated with moderate-to-severe atopic dermatitis: A systematic review and meta-analysis

IF 3.9 2区医学 Q2 ALLERGY

World Allergy Organization Journal Pub Date : 2025-03-01 DOI:10.1016/j.waojou.2025.101035

Suvijak Untaaveesup MD , Thipsukon Amnartpanich MD , Noraworn Jirattikanwong MD , Anchaya Boonsom MD , Treedanuch Treemethawee MD , Pornteera Srichana MD , Chettha Yimkijboriharn MD , Phichayut Phinyo MD, PhD , Wannada Laisuan MD , Torpong Thongngarm MD

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Abstract

Background

Chronic systemic inflammation in individuals with moderate-to-severe atopic dermatitis (AD) potentially predisposes them to metabolic and cardiovascular diseases. Nevertheless, evidence with regard to such association is limited.

Objective

To assess the association between metabolic and cardiovascular outcomes and moderate-to-severe AD.

Methods

A systematic search was performed through PubMed, Scopus, EMBASE, and Cochrane for population-based studies that addressed the effects of moderate-to-severe AD on metabolic and cardiovascular outcomes compared with the general population from inception to August 31, 2023. Meta-analysis was performed using the random effects model. The pooled odds ratio (OR) and certainty of evidence for each outcome were reported.

Results

We included 11 studies, 4 retrospective cohorts, 1 prospective cohort, 4 cross-sectional, and 2 case-control studies involving 405,170 moderate-to-severe AD patients compared to 4,591,478 unaffected controls. Moderate-to-severe AD was associated with a higher risk of myocardial infarction with an OR (95% CI) of 1.33 (1.07, 1.65), angina 1.33 (1.06, 1.66), heart failure 1.56 (1.28, 1.90), stroke 1.45 (1.21, 1.74), hypertension 1.38 (1.18, 1.63), dyslipidemia 1.27 (1.15, 1.41), and metabolic syndrome 1.24 (1.05, 1.42) with very low certainty of evidence. No significantly increased risk of cardiovascular death with an odds ratio (95% CI) of 1.81 (0.96, 3.44) and diabetes of 1.24 (0.91, 1.68) was observed. High heterogeneity was observed in most studies for all of the outcomes.

Conclusion

Our meta-analysis demonstrated a modest but significant association between moderate-to-severe AD and increased susceptibility to metabolic and cardiovascular diseases. Initial assessment of cardiovascular and metabolic risk for patients with moderate-to-severe AD should be considered to enable early management strategies.

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与中度至重度特应性皮炎相关的心血管和代谢结果：一项系统综述和荟萃分析

背景：中度至重度特应性皮炎（AD）患者的慢性全身性炎症可能使他们易患代谢和心血管疾病。然而，关于这种关联的证据是有限的。目的评估代谢和心血管结局与中重度AD之间的关系。方法通过PubMed， Scopus， EMBASE和Cochrane进行系统检索，以人群为基础的研究，研究中度至重度AD对代谢和心血管结局的影响，并与普通人群进行比较，从开始到2023年8月31日。采用随机效应模型进行meta分析。报告了每个结果的合并优势比（OR）和证据确定性。我们纳入了11项研究，4项回顾性队列，1项前瞻性队列，4项横断面研究和2项病例对照研究，涉及405,170名中重度AD患者和4,591,478名未受影响的对照组。中度至重度AD与较高的心肌梗死风险相关，OR （95% CI）为1.33(1.07,1.65)，心绞痛1.33(1.06,1.66)，心力衰竭1.56(1.28,1.90)，卒中1.45(1.21,1.74)，高血压1.38(1.18,1.63)，血脂异常1.27(1.15,1.41)，代谢综合征1.24(1.05,1.42)，证据确定性非常低。心血管死亡风险无显著增加，比值比（95% CI）为1.81(0.96,3.44)，糖尿病风险为1.24（0.91,1.68）。在大多数研究中观察到所有结果的高度异质性。我们的荟萃分析显示，中度至重度AD与代谢和心血管疾病易感性增加之间存在适度但显著的关联。应考虑对中重度AD患者的心血管和代谢风险进行初步评估，以便制定早期管理策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Allergy Organization Journal Immunology and Microbiology-Immunology

CiteScore

9.10

自引率

5.90%

发文量

审稿时长

9 weeks

期刊介绍： The official pubication of the World Allergy Organization, the World Allergy Organization Journal (WAOjournal) publishes original mechanistic, translational, and clinical research on the topics of allergy, asthma, anaphylaxis, and clincial immunology, as well as reviews, guidelines, and position papers that contribute to the improvement of patient care. WAOjournal publishes research on the growth of allergy prevalence within the scope of single countries, country comparisons, and practical global issues and regulations, or threats to the allergy specialty. The Journal invites the submissions of all authors interested in publishing on current global problems in allergy, asthma, anaphylaxis, and immunology. Of particular interest are the immunological consequences of climate change and the subsequent systematic transformations in food habits and their consequences for the allergy/immunology discipline.