PURPOSE OF THE STUDY.
To determine whether there is an association between atopic dermatitis (AD) and being overweight/obese.
The 30 studies included in this systemic review and meta-analysis included 900 358 patients from 13 countries, including 878 354 children and 22 004 adults.
The investigators used PubMed, Embase, and the Cochrane Library to search for studies with primary epidemiologic data covering the relationship between AD and obesity/overweight. Reviewers independently extracted data from 30 studies. Studies were cross-sectional with respect to AD prevalence and retrospective or prospective. Years ranged from 2001 to 2014.
Of the total population studied, 28 498 (6.8%) of normal weight patients, 6648 (7.2%) of overweight patients, and 5173 (8.8%) of obese patients had a previous or current history of AD/eczema. AD/eczema prevalence was higher in studies with health care diagnosis (11.2%) compared with self-diagnosis (7.2%). Using fixed effects pooled analysis, patients who were overweight (Cochrane-Mantelo-Haenszel [CMH] odds ratio [OR], 1.27; 95% confidence interval [CI]: 1.19–1.36), obese (CMH OR 1.68; 95% CI: 1.34–1.5), or overweight/obese (CMH OR 1.42; 95% CI: 1.34–1.5) had significantly higher odds of AD than normal weight individuals. In random effects models, overweight patients (CMH OR 1.23; 95% CI: 1.11–1.4), obese (CMH OR 1.47; 95% CI: 1.21–1.79), and overweight/obese (CMH OR 1.31; 95% CI: 1.16–1.48) all had significant increased odds of AD. Overweight children (OR 1.24; 95% CI: 1.08–1.43), obese (OR 1.44; 95% CI: 1.12–1.86), or overweight/obese (OR 1.32; 95% CI: 1.15–1.51) had higher odds of AD. The association between AD and overweight/obesity was significant in North America and Asia but not Europe.
Being overweight/obese is associated with an increased prevalence of AD.
Studies have reported conflicting results regarding an association between being overweight or obese and AD, but this meta-analysis demonstrates a positive association. Given that the majority of available studies were cross-sectional, the authors were unable to determine the temporal relationship. Future studies using more rigorous clinical criteria for diagnosing AD and longitudinal studies are needed. The authors discuss proposed mechanisms including changes to the epidermal barrier caused by obesity and altered cutaneous and systemic inflammation. Sharing that there is an association between AD and overweight/obesity may be worthwhile in counseling families dealing with these chronic conditions.
- Copyright © 2015 by the American Academy of Pediatrics