Comorbidity of Atopic Disorders with Autism Spectrum Disorder and Attention Deficit/Hyperactivity Disorder
Comorbidity of Atopic Disorders with Autism Spectrum Disorder and Attention Deficit/Hyperactivity Disorder
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特应性疾病与自闭症谱系障碍及注意缺陷/多动障碍的共病情况
DOI：
10.1016/j.jpeds.2015.12.063
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发表时间：
2016-04-01
影响因子：
5.1
通讯作者：
Chen, Chuan-Yu
中科院分区：
文献类型：
--
作者：
Liao, Tzu-Chu;Lien, Yi-Ting;Chen, Chuan-Yu
目的 评估生命早期过敏表现与整个儿童时期新诊断的自闭症谱系障碍 (ASD) 和注意力缺陷/多动障碍 (ADHD) 之间的关系。 研究设计 我们收集了一个基于人群的纵向队列，其中包括 2000 年至 2010 年期间参加台湾国民健康保险计划的儿童。我们首先确定了 387 262 名在 2 岁之前被诊断出特应性皮炎 (AD) 的儿童，并与未患 AD 的儿童进行 1:1 个体化匹配。采用 Cox 回归分析来估计过敏表现对 ASD 和 ADHD 的早发和累积影响。结果估计，接触 AD 的儿童中有 0.5% 被诊断为 ASD，3.7% 被诊断为 ADHD，显着高于未接触 AD 的同龄人分别为 0.4% 和 2.9%。 2 岁之前患有 AD 会使 ASD 的风险比 (HR) 增加 10%，ADHD 的风险比 (HR) 增加 16%；这种增加在早发或更严重的 AD 患者中尤为显着。对于患有持续性 AD 和儿童时期新出现的特应性呼吸道疾病的儿童，HR 尤其较高（例如，对于 ASD，调整后的 HR 分别为 1.75 和 2.13；P
Objective To assess the relationship between allergic manifestations in early life and the occurrence of newly diagnosed autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) throughout childhood.Study design We collected a population-based longitudinal cohort comprising children enrolled in Taiwan's National Health Insurance Program during 2000-2010. We first identified 387 262 children who had a diagnosis of atopic dermatitis (AD) before age 2 years, with 1:1 individualized matching to children without AD. Cox regression analyses were performed to estimate the early-onset and cumulative effects of allergic manifestations on ASD and ADHD.Results An estimated 0.5% of AD-exposed children received a diagnosis of ASD, and 3.7% were diagnosed with ADHD, significantly higher than the respective rates of 0.4% and 2.9% found in their nonexposed peers. Having AD before age 2 years was associated with an increased hazard ratio (HR) for ASD by 10% and that for ADHD by 16%; such increases were particularly prominent among those with earlier-onset or more severe AD. HRs were especially higher for children with persistent AD and emerging atopic respiratory diseases in childhood (eg, for ASD, adjusted HR, 1.75 and 2.13, respectively; P