Is Atopic Dermatitis Associated With Increased Bone Metabolism Abnormalities?

Atopic dermatitis (AD) may increase the risk for low bone mineral density (BMD), osteopenia, osteoporosis, and fractures related to these conditions, study findings published in Annals of Translational Medicine suggests.

The study was a systematic review and meta-analysis of 10 studies published through 2019 that reported the association of AD and abnormal bone metabolism. Specifically, researchers in these studies examined the association of AD and BMD, osteopenia, osteoporosis, and fractures related to these conditions. Related fractures comprised the defined primary outcome of the meta-analysis. Additional secondary outcomes included BMD, osteoporosis, and osteopenia.

A total of 4 studies examined the association between AD and BMD in children. In 3 studies, researchers found a link between AD and an increased risk for low BMD in children and adolescents. In contrast, another study reported a similar BMD in AD and control groups.

There were 3 studies that evaluated the risk for fracture in relation to AD and were included in the final primary analysis. The pooled cohort included 562,405 patients among 3,171,268 participants. Adults with AD in the cohort had a significantly increased fracture risk (odds ratio [OR], 1.13; 95% CI, 1.05–1.22; P =.001).

Researchers found AD was also associated with an increased osteoporosis risk in the meta-analysis of 3 studies that specifically examined the association between AD and osteoporosis (OR, 1.95; 95% CI, 1.18–3.23; P =.009). The presence of AD was also associated with an increased risk for osteopenia (OR, 1.90; 95% CI, 1.51–2.38; P <.001) and low BMD at the femur and spine.

Limitations of this meta-analysis included its retrospective nature as well as the lack of high-quality studies available for analysis.

Given the limitations, the investigators suggest “both clinical studies and basic research are warranted” to better “clarify the association between AD and abnormal bone metabolism,” which may improve “better prevention and treatment of bone loss in patients with AD.”

Reference

Wu D, Wu XD, Zhou X, Huang W, Luo C, Liu Y. Bone mineral density, osteopenia, osteoporosis, and fracture risk in patients with atopic dermatitis: a systematic review and meta-analysis. Ann Transl Med. 2021;9(1):40. doi:10.21037/atm-20-4708