Risk for pediatric atopic dermatitis rises with weight gain, drops with weight loss
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Key takeaways:
- Children who gained weight were 1.15 times more likely to develop AD vs. those who maintained normal weight.
- Children who lost weight and achieved normal weight were 0.87 times more likely to develop AD.
Gaining weight can raise the risk for atopic dermatitis and possibly other immune-mediated skin diseases in children, whereas losing weight can reduce this risk, according to a study.
“Previously, many studies have looked at the link between childhood obesity and immune-related skin diseases like AD and psoriasis,” Seong Rae Kim, MD, Seong-Joon Koh, MD, PhD and Hyunsun Park, MD, PhD, co-lead investigators of the study and faculty members at Seoul National University College of Medicine, told Healio in a statement. “However, most of these studies only looked at data from one point in time, compared groups with and without the condition and had small sample sizes.”
According to the authors, very few studies have followed childhood development over a long period of time, meaning it has not been determined whether having obesity or overweight causes these diseases or vice versa.
To address these gaps, the authors decided to conduct a large, longitudinal study using a national database in Korea that included information on infants and children (n = 2,161,900) from 2009 to 2020.
According to the authors, the study followed the children over a long period of time and established a defined temporal sequence, which sets this study apart.
“Of course, this approach still may not directly or completely show cause and effect, but it is precisely why our study is particularly novel compared to previous research,” the authors explained.
Results showed that children with obesity or overweight were more likely to develop atopic dermatitis, psoriasis and alopecia areata vs. children with normal weight. According to the authors, atopic dermatitis demonstrated this trend the most.
Children who initially had normal weight and subsequently transitioned to having overweight were 1.15 times (95% CI, 1.11-1.2) more at risk for developing AD vs. those who maintained normal weight.
On the other hand, children who shifted from having overweight to normal weight experienced a lower AD risk vs. those who continued to have overweight (adjusted HR = 0.87; 95% CI, 0.81-0.94).
According to the authors, there are many factors attributed to obesity that could cause this disease response.
“Obesity may contribute to the development of immune-mediated skin diseases because being overweight can lead to the release of certain chemicals, like adipokines, from fat tissue that cause inflammation,” the authors said. “These chemicals attract immune cells that release substances like [tumor necrosis factor]-alpha and [interleukin]-6, which are linked to these skin conditions.”
Additionally, the authors posit that obesity can affect a patient’s skin protective barrier due to inflammation. Multiple hormones may also be implicated in the development of these auto-immune diseases. For example, leptin, a hormone produced by fat cells, influences appetite, body weight and inflammation. It has also been shown to promote the activity of certain immune cells that contribute to psoriasis and AD.
“In summary, the study suggests that being overweight or obese in early childhood can increase the risk of developing skin conditions related to the immune system,” the authors told Healio. “Gaining weight can raise the risk of atopic dermatitis, while losing weight can reduce this risk.”
“Maintaining a healthy weight might help lower the chances of getting these skin conditions,” the authors added. “Implementing purposeful interventions, including nutritional strategies, to decrease body weight may aid in reducing the risk of developing immune-mediated skin diseases in children.”
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Kim SR, et al. J Invest Dermatol. 2024;doi:10.1016/j.jid.2024.01.037.
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