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