Comorbidity network of chronic, non-communicable inflammatory diseases

慢性非传染性炎症性疾病（CID）造成了重大的医疗负担。这是由于其发病率高，缺乏治愈性治疗选择和高合并症。关于后者，诊断有给定CID的患者，例如，银屑病、类风湿性关节炎或乳糜泻，具有发生心血管和代谢合并症的增加的风险。值得注意的是，发展额外CID的风险也增加了。然而，对于大多数CID来说，这种发展为额外CID的假定风险是一个充满争议的问题。这些差异可能源于队列中的差异，因为大多数研究中未涉及性别、年龄和/或种族特异性风险。关于罕见或罕见的CID，关于炎性合并症的报道最多也就很少。对CID患者炎性共病的了解将改善疾病管理，因为共病CID的筛查和早期治疗可能会改善治疗结果。此外，共同出现的CID可能指向共同的致病途径，从而使未来的见解疾病的发病机制。在过去，由于大型数据库和/或前瞻性患者登记的可用性有限，因此对CID的炎症合并症的研究受到阻碍。我们最近获得了TriNetX的访问权限，该数据库包含超过1.2亿份电子医疗记录（EMR）。这些EMR包括人口统计学、诊断、药物和实验室检查结果的纵向数据。因此，我们现在处于解决CID炎症合并症的独特地位。为此，我们将对比诊断为每种CID的患者发生50种选定CID中任何一种的风险与入选研究时未诊断为任何CID的倾向匹配对照。与项目相关的初步工作确定了样本量，并通过对选定的CID之一（即乳糜泻）进行分析来评估该方法。在这里，我们证实了已经确定的风险，以及确定的新的风险有关的免疫合并症的腹腔疾病。将通过使用TriNetX内的其他网络对获得的数据进行验证。我们的分析还将包括确定性别、年龄和种族特异性的CID炎性合并症风险。完成后，我们将建立一个慢性非传染性炎症性疾病的共病/风险网络。这将有助于临床护理，并提供对潜在的共同致病途径的见解。

Chronic, non-communicable inflammatory diseases (CIDs) impose a major medical burden. This is due to their high prevalence, the lack of curative treatment options and a high comorbidity. Regarding the latter, patients diagnosed with a given CID, e.g., psoriasis, rheumatoid arthritis, or celiac disease, have an increased risk to develop cardiovascular and metabolic comorbidity. Notably, the risk to develop an additional CID is also increased. This presumed risk for the development of additional CIDs is, however, a matter of lively controversy for most CIDs. These discrepancies may stem from differences in the cohorts, as sex-, age- and/or race-specific risks have not been addressed in most studies. Regarding rare or orphan CIDs, reports on the inflammatory comorbidity are sparse at best. Insights into the inflammatory comorbidity of CID patients would improve disease management because screening for and early treatment of comorbid CID would potentially better treatment outcomes. Furthermore, co-occurrence of CIDs potentially points towards shared pathogenic pathways, thus allowing future insights into disease pathogenesis. Addressing the inflammatory comorbidity of CIDs has, in the past, been hampered by limited availability to large databases and/or prospective patient registries. We recently obtained access to TriNetX, a database including over 120 million electronic medical records (EMRs). These EMRs include longitudinal data on demographics, diagnoses, medications, and laboratory findings. Therefore, we are now in the unique position to address the inflammatory comorbidity of CIDs. For this, we will contrast the risk to develop any one of 50 selected CIDs in patients diagnosed with each one of the CIDs to propensity matched controls that had not been diagnosed with any CID upon inclusion into the study. Project-related preliminary work determined the sample size and evaluated the approach by running the analysis for one of the selected CIDs, namely celiac disease. Here, we confirmed already established risks, as well as identified novel risks regarding the immunological comorbidity of celiac disease. Validation of the obtained data will be done by use of additional networks within TriNetX. Our analysis will also include determination of the sex-, age and race-specific risks for the inflammatory comorbidity of CIDs. At completion, we will have generated a comorbidity/risk network of chronic, non-communicable inflammatory diseases. This will be useful for clinical care as well as provide insights into potentially shared pathogenic pathways.