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Influence of constipation on atopic dermatitis: A nationwide population-based cohort study in Taiwan
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  • Yen Chu Huang,
  • Meng Che Wu,
  • Yu-Hsun Wang,
  • James Cheng-Chung Wei
Yen Chu Huang
Taichung Veterans General Hospital
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Meng Che Wu
Taichung Veterans General Hospital
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Yu-Hsun Wang
Chung Shan Medical University Hospital
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James Cheng-Chung Wei
Chung Shan Medical University
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Abstract

Background Atopic dermatitis (AD) is the chronic inflammatory disorder that affects both in childhood and adulthood. Mounting evidence indicates that gut dysbiosis contributes to AD via the gut-skin axis. Constipation can result in alteration of the gut microflora. The clinical impact of constipation on AD has not been researched. Therefore, we aim to assess the risk of AD in constipated patients by the population-based cohort study. Methods We collected 87015 constipated people and 87015 people without constipation between 1999 and 2013 from the Taiwanese National Health Insurance Research Database. Propensity score analysis was administrated to match age, gender, comorbidities, and medications at a ratio of 1:1. Multiple Cox regression analysis was utilized to evaluate the adjusted hazard ratio of AD. In addition, sensitivity tests and a stratified analysis were conducted. Results The incidence of AD was 4.7 per 1,000 person-years in the constipation group, which was higher than the rate of 2.2 per 1,000 person-years observed in the non-constipation group. After adjustment for age, gender, comorbidities, corticosteroids, and antihistamine, constipated people had a 2.11-fold greater risk of AD compared to those without constipation (adjusted hazard ratio [aHR]: 2.11 (95% C.I. 1.98-2.24). Moreover, constipated people had a higher likelihood of AD, regardless of gender, comorbidities, as well as the usage of corticosteroids, and antihistamines. Conclusion Constipation is associated with a significantly risk factor of AD. Clinicians should be careful of the possibility of AD in constipated people. Further study is warranted to investigate the possible pathological mechanisms of this relationship.

Peer review status:ACCEPTED

22 Jun 2020Submitted to International Journal of Clinical Practice
24 Jun 2020Submission Checks Completed
24 Jun 2020Assigned to Editor
24 Jun 2020Reviewer(s) Assigned
09 Jul 2020Review(s) Completed, Editorial Evaluation Pending
09 Aug 20201st Revision Received
11 Aug 2020Submission Checks Completed
11 Aug 2020Assigned to Editor
11 Aug 2020Reviewer(s) Assigned
17 Aug 2020Review(s) Completed, Editorial Evaluation Pending
21 Aug 2020Editorial Decision: Accept