Comorbidities of Atopic Dermatitis: using National Health Insurance data in Korea

SESSION 2 / New fields in AD: big data mining, AD in sub-Saharan Africa, neuroinflammation Jiyoung AHNNational Medical Center, Seoul, KoreaOregon Health and Science University, OR, USA Overview ObjectiveMethodsResults ➜ Ask questions to the author! Author retain copyright. Atopic March ➜ Inflammatory Skin March ➜ worldallergy.org education & programs Conflicting Results Cardiovascular Risk and Disease direct effectindirect effect Objective To analyze whether the risk of other diseases are different between AD patients and healthy controls using National Health Insurance Data in Korea. Methods Korean National Health Insurance Research Database Data from 2005 to 2016Healthy control (N1,331,969)AD patients (N285,468)Control group matched the age and sex of AD patientsAD groups: Non-AD groups ➜ ratio of 1:5 Survival Analysis (Multivariable Cox regression)ANOVA testUsing SAS, Version 9.4, SAS Institute, Cary, NC Operation Definition: AD Patients Atopic Dermatitis Code (main)Two AD-Related Test Validation study to accurately identify patients with atopic dermatitis in the National Health Insurance Data in Korea: GroupAD codeAD labSensitivitySpecificityPositive predictive valueNegative predictive valueA2-0.030.990.900.52B110.300.990.960.60C120.290.990.980.59D1⩾ 30.110.020.970.54Table 1. Sensitivity, specificity, positive predictive value, negative predictive value of each group Each group was investigated for accompanying Cardiovascular DiseaseCVD, which contains hypertension, type 2 diabetes, hyperlipidemia, angina, myocardial infarction, peripheral vascular disease, stroke I10, E11, E780~E785, I20, I21, I22, I23, I70, I71, I72, I73, I63, I64Inflammatory Bowel Disease (IBD)K50, K51Allergic Contact Dermatitis (ACD)L23, L25Skin CancerBCC, SCC, MM, AK, Bowen’s Dis.C443, C449, C000, C001, C441, C442, C443, C445, C446, C447, C449, C435, C436, C439, L570, D049PsoriasisL4 Results TOTALN%Total2 780 356100Male1 379 33649.6Female1 401 02050.4Under 10720 29825.910s1 071 28638.520s451 59516.230s257 4079.340s132 1984.850s77 6372.860s43 7811.6over 7026 1540.9 MODERATEN%Male29 04950.0Female29 09950.0Under 1013 48623.210s20 93936.020s12 70221.830s6 75811.640s2 5474.450s8361.460s4810.8over 703990.7 SEVEREN%Total1 140 898Male567 13149.7Female573 76750.3Under 10257 60722.610s411 50736.120s209 89918.430s124 89211.040s63 8075.650s38 0173.360s21 9281.9over 7013 1511.2 Trend Analysis in the Number of AD Patients by Year Frequency Analysis Multivariable Cox Regression Analysis Multivariable Cox Regression Analysis according to AD Severity Summary Increase in AD in KoreaIncrease in AD over 30 years of age indicated that the study of systemic diseases that witch occur mainly in adults, such as CVD, is crucial for AD research.Increase in severe AD should be noted. Because the increase in comorbidities increases according to the severity, more active treatment is required.Skin cancer, psoriasis, CVD, IBD, and ACD than non-AD patients although adjusted by sex, age, and metabolic disordersThe results of our study confirmed that AD is associated with CVD after adjusting for other variables, indicating that AD directly affects CVD and metabolic diseases Limitation Adjustments were made for age and sex, metabolic disorders, and other CVDs, but not for education level, physical activities, medication, obesity (body mass index), smoking, and alcohol intake.It is impossible to accurately determine the causal relationship over time due to the study design, and there may be cases where an incident occurs, which is a problem that most population based studies have in common. well-planned longitudinal prospective cohort study should be conducted to draw a more accurate conclusion. ➜ download as PDF Ask questions to Jiyoung AHN: Disclosure of conflict of interest: MOU Koean Atopic Dermatitis Association with National Health Insurance Sharing Service References OLIVEIRA, C. & TORRES, T. 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