Body mass index (BMI) may causally affect the development of atopic dermatitis (AD), with some evidence suggesting that a higher BMI is associated with a greater risk for AD. This is according to study results published in the Journal of Allergy and Clinical Immunology.

The researchers of the study performed a meta-analysis of 33 studies that examined the relationship between increased BMI or obesity and AD. In a pooled cohort of 51,008 adults, the odds ratio (OR) for AD in people who were overweight was 1.05 (95% CI, 0.94-1.19). The OR for AD in individuals who were overweight in a pooled cohort of 506,202 children was 1.08 (95% CI, 1.00-1.16). The investigators noted that the ORs for AD in individuals with obesity were 1.19 (95% CI, 0.95-1.49) in 1,400,679 adults and 1.20 (95% CI, 1.11-1.30) in 796,514 children.

In an analysis of 2 large population-based studies, the OR for AD in individuals whose BMI was 25 to 30 kg/m2 was 1.02 (95% CI, 1.00-1.04) per 1 kg/m2 higher BMI vs control individuals (P =.07). The researchers also performed a Mendelian randomization analysis of data from these studies and data from published genome-wide association studies for BMI and AD (n=742,611). There was a small causal relationship between higher BMI and increasing AD risk (OR, 1.02; 95% CI, 1.00-1.04; P =.03). This finding suggested that for each 1 kg/m2 increase in BMI, there was an approximately 2% increased risk for AD.

Limitations of this analysis included the high likelihood of AD misclassification and the lack of assessment into the temporal relationship between BMI and AD risk.


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The investigators of this analysis wrote that their findings offer “support for the investigation of obesity management strategies and/or targeting of the adipocyte-keratinocyte cross-talk as therapeutic opportunities for AD.”

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Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

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Reference

Budu-Aggrey A, Watkins SH, Brumpton B, et al. Assessment of a causal relationship between body mass index and atopic dermatitis [published online May 17, 2020]. J Allergy Clin Immunol. doi: 10.1016/j.jaci.2020.04.050