Children with Obesity Have Increased Risk of Atopic Dermatitis

Hyunsun Park, MD, PhD

Credit: Seoul National University

A new study found children with obesity have an increased risk of pediatric immune-mediated skin diseases, particularly atopic dermatitis. Conversely, weight loss can lower the risk.

“This is the noteworthy longitudinal investigation that has revealed the association between BMI changes and subsequent occurrences of 3 main pediatric [immune-mediated skin diseases]—[alopecia areata, atopic dermatitis, and psoriasis]—as well as the direct influence of BMI on [alopecia areata],” wrote co-lead investigators Hyunsun Park, MD, PhD, Seong Rae Kim, MD, and Seong-Joon Koh, MD, PhD, from Seoul National University College of Medicine.

In recent years, immune-mediated skin diseases, such as alopecia areata, atopic dermatitis, and psoriasis have become a public health concern among children. These conditions harm the quality of life regarding emotional, physical, social, and functional well-being.

Obesity rates have also surged in the previous years. Research has suggested excessive adipose tissues may trigger proinflammatory mechanisms that lead to the development of skin diseases, however, this topic still needed further investigations as this was speculation. In this study, investigators wanted to understand better how childhood obesity or weight gain interacted with the development of pediatric immune-mediated skin diseases.

“Our research team is very interested in the skin-gut access,” said co-lead investigator Hyunsun Park, MD, PhD, from the department of dermatology at Seoul National University College of Medicine in Seoul, Republic of Korea. “We think that various factors, including diet, obesity, or other lifestyles can affect gut environment and contribute to the development of IMSDs. We are trying to find the puzzle pieces to demonstrate how they are connected, and our current research is a step towards that understanding.”

Thus, investigators, also co-led by Seong Rae Kim, MD, and Seong-Joon Koh, MD, PhD, both from the Seoul National University College of Medicine, conducted a study to assess the associations between body mass index (BMI) or BMI changes and the development of 3 immune-mediated skin diseases: alopecia areata, atopic dermatitis, and psoriasis.

The team analyzed a longitudinal cohort of 2,161,900 Korean children from 2009 to 2020. The sample included 10,524,561 person-years in the alopecia areata cohort, 6,910,806 person-years in the atopic dermatitis, and 10,530,018 person-years in the psoriasis cohort. Overall, the cases of immune-mediated skin diseases were 4,878 for alopecia areata (51.1% male), 41,386 for atopic dermatitis (50.4%); and 2,191 for psoriasis (51.1).

The findings demonstrated children with obesity had a greater risk of pediatric immune-mediated skin diseases than those with a normal weight (P < .01). Children who had an increase in BMI with a weight gain from normal to overweight had a greater risk of atopic dermatitis (adjusted hazard ratio [aHR], 1.15; 95% confidence interval [CI], 1.11 – 1.20). Reversely, a decrease in BMI—and weight loss from overweight to normal weight, had a lower atopic dermatitis risk than children who were overweight and maintained their weight (aHR, 0.87; 95% CI, 0.81 – 0.94; P < .001).

“Our findings support the importance of promoting weight maintenance among children who are already within the normal weight range because it may help reduce the risk of developing atopic dermatitis,” Koh said in the press release. “In addition, prevention of excessive weight gain and purposeful weight loss, including adopting healthy diet strategies in children with obesity to prevent atopic dermatitis, particularly before school age, should be promoted. Implementing purposeful interventions, including nutritional strategies, to decrease body weight may aid in reducing the risk of developing [immune-mediated skin diseases] in children."

References

Kim, R, Koh, S, Park, H. Childhood Obesity, Weight Change, and Pediatric Immune-Mediated Skin Diseases. JID Journal of Invesitgative Dermatology. September 2024. DOI:https://doi.org/10.1016/j.jid.2024.01.037

Obese Children Are More Likely to Develop Skin Conditions Related To The Immune System. EurekAlert! August 21, 2024. https://www.eurekalert.org/news-releases/1054657. Accessed August 23, 2024.