title: Obstructive sleep apnea and the risk of atopic dermatitis: a population-based case control study.
abstract: BACKGROUND
  Obstructive sleep apnea (OSA) is associated with systemic inflammation and induces various comorbid medical diseases. To date, no study has explored the relationship between OSA and atopic dermatitis (AD), an inflammatory and autoimmune skin disorder. This study investigated the longitudinal risk for AD in patients with OSA.
  
  
  METHODS
  A random sample of 1,000,000 individuals from Taiwan's National Health Insurance database was collected. From this sample, 1222 patients with newly-diagnosed OSA between 2000 and 2005 were identified and compared with a matched cohort of 18330 patients without OSA. All patients were tracked for 5.5 years from the index date in order to identify which patients subsequently developed AD.
  
  
  RESULTS
  During the 5.5-year follow-up period, the incidence rates of AD in the OSA cohort and comparison groups were 9.81 and 6.21 per 1000 person-years, respectively. After adjustment for age, gender, diabetes, hypertension, coronary heart disease, obesity, allergy, allergic rhinitis, asthma, monthly income, and geographic location, patients with OSA were 1.5-times more likely to develop AD than patients without OSA (95% CI = 1.15-1.95, p = 0.0025). The hazard risk for AD was greater in male OSA patients and young OSA patients (0-18 and 19-34 years), adjusted HRs being 1.53 (95% CI = 1.14-2.06, p = 0.005), 4.01(95% CI = 1.57-10.26, p = 0.0038) and 1.75(95% CI = 1.00-3.04, p = 0.0483), respectively. The log-rank test indicated that OSA patients <35-years-old had significantly higher cumulative incidence rates of AD than those patient of the same age in the comparison group (p = 0.0001).
  
  
  CONCLUSIONS
  Patients with OSA, especially male patients and younger patients, are at an increased risk for AD later in life.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan ; Center of General Education, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
authors.forename: Kai-Jen
authors.initials: KJ
authors.lastname: Tien
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Chien-Wen
authors.initials: CW
authors.lastname: Chou
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Shang-Yu
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Nai-Cheng
authors.initials: NC
authors.lastname: Yeh
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Chwen-Yi
authors.initials: CY
authors.lastname: Yang
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Feng-Chieh
authors.initials: FC
authors.lastname: Yen
authors.affiliation: Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Jhi-Joung
authors.initials: JJ
authors.lastname: Wang
authors.affiliation: Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan ; Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
authors.forename: Shih-Feng
authors.initials: SF
authors.lastname: Weng
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003876:Dermatitis, Atopic / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012306:Risk; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology