Abstract
Both atopic diseases and systemic lupus erythematosus (SLE) are immune disorders that may lead to physical complications or multi-system comorbidities. This population-based case-control study was designed to evaluate the risk of SLE associated with atopic diseases. Using a national insurance claims dataset in Taiwan, we identified 1673 patients newly diagnosed with SLE and 6692 randomly selected controls frequency matched for gender, age and index date. The odds ratios (OR) for SLE were calculated for associations with allergic rhinitis, allergic conjunctivitis, atopic dermatitis and asthma. The SLE patients were predominantly female (82.5%) with a mean age of 40.1 (SD = 18.2). The patients with SLE had a higher rate of atopic dermatitis (6.81% vs. 3.06%), and asthma (10.6% vs. 7.64%) was approximately 2 times more common in the patients with lupus than in those without. The patients with atopic disease (atopic dermatitis, allergic rhinitis, allergic conjunctivitis and asthma) were at a significant risk for SLE. The overall risk for SLE increased as the number of atopic diseases increased from 1.46 to 2.29, compared with—individuals without the diseases (p < 0.0001). In conclusion, this population-based case-control study demonstrates a significant relationship between atopic diseases and the risk of SLE, especially for females. Atopic dermatitis plays a stronger role than other types of atopic disease in association with SLE.
Highlights
Atopic diseases (AD) are common chronic conditions in the general population
The current results demonstrate strong and independent associations between systemic lupus erythematosus (SLE) and atopic diseases, adding substantial evidence of the reported relationship
The correlations were independent of various factors that are known to have an impact on the presence of SLE; here, we demonstrated the associations correlated with the numbers of atopic diseases even though the severity of the disorders was not available from the LHID database
Summary
Atopic diseases (AD) are common chronic conditions in the general population. They are provoked by allergens and usually manifest as recurring, non-infectious, inflammatory conditions that begin in childhood. AD, such as atopic dermatitis, allergic conjunctivitis, allergic rhinitis and asthma, are associated with a hyperreactivity towards environmental antigens and food allergens. The associations between SLE and AD have previously been shown to be statistically correlated [3,4,5] Both AD and SLE are immune diseases involving gene-environment interactions [1,4]. The correlations between AD and SLE have been investigated from bench to bedside to clarify the immune-gene interactions, even though very few studies have demonstrated the epidemiological association between AD and SLE [8]. Using insurance data we conducted a case-control study to investigate the risk of SLE associated with AD, including allergic rhinitis, allergic conjunctivitis, atopic dermatitis and asthma
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