Table 2.
Association of bullous pemphigoid with metabolic, cardiovascular and kidney diseases and their medication.
| Author | Year | Location | Study design | Reference cohort | N (case/control) |
Metabolic comorbidities and their medication in individuals with BP |
OR/HR | 95% CI | p |
|---|---|---|---|---|---|---|---|---|---|
| Marzano A.V., et al. (33) | 2012 | Italy | Case-control | age-, body mass index- and sex-matched controls | 15/28 | Lower 25-OHD-levels | n.a. | n.a. | 0.01 |
| Sarre M.E., et al. (34) | 2016 | France | Case-control | n.a. | 31/59 | Hypovitaminosis D | 3.7 | n.a. | 0.046 |
| Karabay E. A., et al. (35) | 2017 | Turkey | Cohort-study | n.a. | 62/217 |
Patients with BP with higher incidence of
- Hypertension - Diabetes - Coronary artery disease |
n.a. n.a. n.a. |
n.a. n.a. n.a. |
<0.01 <0.01 0.001 |
| Ren Z., et al. (27) | 2017 | USA | Register study of hospitalized adult patients in the USA |
n.a. | 2,108 BP primary diagnosis 11,234 BP secondary diagnosis 72,108,077 total hospital discharges |
Myocarditis
Diabetes Obesity Congestive heart failure Pulmonary circulation disorders Hypertension |
6.29
1.57 1.56 1.43 1.38 0.98 |
1.57-25.1
1.35-1.82 1.44-1.70 1.35-1.52 1.22-1.58 0.93-1.02 |
0.02
0.003 0.003 0.003 0.003 0.003 |
| Kwa M. C., et al. (36) | 2017 | USA | Register study of hospitalized adult patients in the USA |
n.a. | 13,342/ 72,651,487 |
Congestive heart failure
Pulmonary circulation disorder Hypertension Peripheral vascular disease Type 2 Diabetes Coronary artery disease |
2.58
1.92 1.80 1.68 1.45 1.17 |
2.42-2.74
1.69-2.19 1.71-1.90 1.54-1.83 1.24-1.69 1.10-1.24 |
<0.001
<0.001 <0.001 <0.001 <0.001 <0.001 |
| Sim B., et al. (26) | 2017 | Singapore | Case-control | Age- and sex-matched controls | 105/315 |
Hypertension
Diabetes Ischemic heart disease Hyperlipidemia Kidney disease |
2.37
1.23 1.12 0.24 0.44 |
1.18-4.77
0.78-1.96 0.68-1.82 0.1-0.49 0.2-0.99 |
0.015
0.375 0.66 0.001 0.049 |
| Jeon H.W., et al. (7) | 2018 | Korea | Cohort study | Age- and sex-matched general population of Korea | 103/n.a. |
Standardized mortality ratio
- 70-79 years - >80 years - total Prevalence of Diabetes Arterial hypertension Chronic kidney disease |
2.35 2.18 1.83 1.64 0.63 0.56 |
1.52-3.47 1.31-3.42 1.34-2.46 1.06-2.55 0.42-0.95 0.30-1.08 |
<0.05 <0.05 <0.05 0.026 0.036 0.109 |
| Varpuluoma O., et al. (37) | 2018 | Finnland | Register study | Age-, sex and year of diagnosis matched controls | 3,397/12,941 | Increased risk for BP after adjustment for diabetes and several neurologic disorders - DPP-4-inhibitors - Metformin |
2.19 1.05 |
1.55-3.11 0.88-1.24 |
<0.05 >0.05 |
| Varpuluoma O., et al. (38) | 2018 | Finnland | Register case-control study | Age-, sex and year of diagnosis matched controls | 3,397/12,941 | - Diabetes prevalence of 19.6% in BP patients - No association of anti-diabetic medication and BP (excluding DPP4-inhibitos, metformin and insulin) |
n.a. | n.a. | >0.05 |
| Kalińska-Bienias A., et al. (28) | 2019 | Poland | Case-control | Age- and sex-matched controls | 218/168 | Arterial hypertension | 2.17 | 1.35-3.49 | <0.001 |
| Chovatiya R., et al. (39) | 2020 | USA | Register study | n.a. | 8,864/ 198,102,435 |
Osteoporosis
Pathological fractures |
1.55
1.52 |
1.39-1.73
1.22-1.88 |
<0.0001
0.0002 |
| Lee S., et al. (40) | 2021 | USA | Case-control | Age- and sex-matched controls | 91/546 |
End-stage renal disease
Diabetes mellitus Chronic kidney disease Hypertension |
3.82
2.59 2.29 2.03 |
2.45-11.1
1.60-4.19 1.19-4.40 1.24-3.32 |
0.0235
0.0011 0.0473 0.0235 |
| Wu C.Y., et al. (41) | 2021 | Taiwan | Cohort-study of diabetic patients with and without DPP4-i treatment | Matched by age, sex, duration of diabetes, insulin usage, and propensity score-matching of comorbidities | 124,619 DPP4-I/ 124,619 Non-DPP4-I |
Increased risk for BP by
- Renal disease - DPP4-Inhibitor treatment - Metformin |
2.32 2.15 1.93 |
n.a. 1.18-3.91 n.a. |
<0.001 0.01 0.006 |
| Sánchez-García V., et al. (2) | 2022 | Spain | Retrospective observational study | Compared to pemphigus patients | 5,424/1,950 | Higher prevalence in BP compared to pemphigus - Arterial hypertension - Kidney disease - Heart failure - Chronic obstructive pulmonary disease - Diabetes - Osteoporosis |
n.a. n.a. n.a. n.a. n.a. n.a. |
n.a. n.a. n.a. n.a. n.a. n.a. |
0.004 <0.001 <0.001 <0.001 <0.001 0.003 |
| Martin E., et al. (13) | 2022 | Germany | Case-control | Age- and sex-matched controls | 300/583 |
Renal impairment
Anemia Diabetes mellitus |
2.21
2.12 1.41 |
1.64-2.99
1.53-2.95 1.03-1.93 |
<0.0005
<0.0005 0.029 |
| Titou H., et al. (31) | 2022 | Morocco | Case-control | Age- and sex-matched controls | 81/162 | No significant association of BP with - Hypertension - Type 2 diabetes - Dyslipidemia |
n.a. n.a. n.a. |
n.a. n.a. n.a. |
0.891 0.062 0.643 |
| Shen W.C., et al. (42) | 2022 | Taiwan | Cohort study | Age- and sex- matched controls | 252/1,008 | Cardiovascular mortality | 4.8 | 3.07-7.59 | <0.05 |
| Zhang B. et al. (43) | 2022 | China | Case-control | Age- and sex-matched controls | 162/162 |
Diabetes
Obesity Hypertension |
1.87
1.80 0.75 |
1.02-3.39
1.02-3.18 0.44-1.12 |
0.001
<0.001 0.200 |
Data in bold indicate statistically significant results.
BP, bullous pemphigoid; OR, odds ratio; HR, hazard ratio; CI, confidence interval; n.a, not available.