Association of atopic dermatitis with being overweight and obese: A systematic review and metaanalysis

• Published in: Journal of the American Academy of Dermatology Vol. 72; no. 4; pp. 606 - 616.e4
• Main Authors: Zhang, April, MD, Silverberg, Jonathan I., MD, PhD, MPH
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-04-2015
• Subjects: adiposity; Adult; Age Factors; atopic dermatitis; Body Mass Index; Child; Cohort Studies; Continental Population Groups; Cross-Sectional Studies; Dermatitis, Atopic - epidemiology; Dermatology; eczema; Eczema - epidemiology; Female; Global Health; Humans; Male; metaanalysis; obesity; Obesity - epidemiology; Observational Studies as Topic; Odds Ratio; overweight; Overweight - epidemiology; prevalence; Publication Bias; adiposity; metaanalysis; AD; OR; body mass index; CI; atopic dermatitis; odds ratio; prevalence; eczema; confidence interval; overweight; obesity; BMI
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2014.12.013

Background Previous studies found conflicting results about whether atopic dermatitis (AD) is associated with overweight/obesity. Objective We sought to examine the relationship between AD and overweight/obesity by performing a systematic review and metaanalysis. Methods Observational studies of the relationship between AD and overweight/obesity were selected from PubMed, Embase, and the Cochrane Library. The quality of evidence was assessed using the Newcastle–Ottawa Scale. Fixed and random effects metaanalyses were performed to estimate pooled odds ratios (ORs). Sensitivity analyses were performed that compared results by location of study, study quality, and between studies in children and adults. Results In total, 30 studies were included for review. Patients who were overweight (Cochrane-Mantel-Haenszel [CMH] OR, 1.27 [95% confidence interval {CI}: 1.19-1.36]; random effects OR, 1.23 [95% CI: 1.11-1.41]), obese (CMH OR, 1.68 [95% CI: 1.54-1.84]; random effects OR, 1.47 [95% CI: 1.21-1.79]), or overweight/obese (CMH OR, 1.42 [95% CI: 1.34-1.50]; random effects OR, 1.31 [95% CI: 1.16-1.48]) had higher odds of AD than normal weight patients. In sensitivity analyses, children who were overweight (random effects OR, 1.24 [95% CI: 1.08-1.43]), obese (random effects OR, 1.44 [95% CI: 1.12-1.86]), or overweight/obese (random effects OR, 1.32 [95% CI: 1.15-1.51]) and adults who were obese (random effects OR, 1.56 [95% CI: 1.24-1.95]) or overweight/obese (random effects OR, 1.29 [95% CI: 1.05-1.59]) had higher odds of AD. The association remained significant in North America and Asia but not Europe. Limitations Most studies were cross-sectional. Conclusions Overweight/obesity in North America and Asia is associated with an increased prevalence of AD.