Comorbidity of Atopic Disorders with Autism Spectrum Disorder and Attention Deficit/Hyperactivity Disorder

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• 作者：Tzu-Chu Liao ; MSc¹ ; Yi-Ting Lien ; MSc¹ ; ² ; Sabrina Wang ; PhD³ ; Song-Lih Huang ; MD ; ScD¹ ; Chuan-Yu Chen ; PhD¹ ; ² ; ^{chuanychen@ym.edu.tw" class="auth_mail" title="E-mail the corresponding author}
• 关键词：AD ; Atopic dermatitis ; ADHD ; Attention deficit/hyperactivity disorder ; aHR ; Adjusted HR ; ASD ; Autism spectrum disorder ; HR ; Hazard ratio ; ICD-9-CM ; International Classification of Diseases ; Ninth Revision ; Clinical Modification ; NAD ; Nonatopic dermatitis ; NHIRD ; National Health Insurance Research Database ; RD ; Respiratory disease
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：171
• 期：Complete
• 页码：248-255
• 全文大小：373 K

文摘

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 < .001).

Conclusion

The observed increased risks of ASD and ADHD associated with AD in infancy suggest that a disordered immunologic response may exert effects on neurodevelopment and have implications for research into etiology and treatment strategies.