All the included 3 case-control studies with a total of 423,893 subjects provided data regarding the association of rosacea with CD.[46–48] As shown in Figure 3A, the meta-analysis demonstrated marginally increased odds of prevalent CD in patients with rosacea (pooled OR 1.30, 95% CI 0.99–1.69). We identified substantial statistical heterogeneity across the three studies (I2 = 74%).
Two included cohort studies with a total of 4,458,002 subjects supplied usable data on the HR estimates of CD and UC in patients with rosacea.[44,45] As displayed in Figure 4A, the meta-analysis of cohort studies demonstrated a significantly increased risk of incident CD in rosacea patients (pooled HR 1.58, 95% CI 1.14–2.20). Moreover, as shown in Figure 4B, the meta-analysis of cohort studies demonstrated a significantly increased risk of incident UC in rosacea patients (pooled HR 1.18, 95% CI 1.01–1.37). No statistical heterogeneity was detected across these studies for both CD and UC (I2 = 30% and 0%, respectively).
The only Asian study included 268,068 subjects and showed significantly increased HR of incident IBD in rosacea (HR 1.94, 95% CI 1.04–3.63). We contacted the authors for respective data on CD and UC; however, they decided not to conduct further calculations because of a very limited number of events (16 and 37 incident cases of IBD in the rosacea and reference cohorts, respectively).
The present study has several limitations. First, we originally planned to assess publication bias, but the limited number of included studies prevented us from drawing a funnel plot. However, the total sample size was large and the risk of bias of included studies was generally low. Second, the included studies were primarily from Western countries, especially the US and UK. The only Asian study provided data on the association of rosacea with IBD but lacked respective data of CD and UC for meta-analysis. More studies for rosacea patients in different ethnic groups are needed. Third, we did not find studies that examined the association between rosacea of different severity or phenotypes and IBD. Whether the strength of association differs among patients of different rosacea severity or phenotypes remains unclear.
Ching-Chi Chi orcid: 0000-0001-5699-0283.
Fang-Ying Wang orcid:0000-0002-8189-4944.
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