TY - JOUR
T1 - Association of atopic dermatitis with allergic, autoimmune, and cardiovascular comorbidities in US adults
AU - Silverberg, Jonathan I.
AU - Gelfand, Joel M.
AU - Margolis, David J.
AU - Boguniewicz, Mark
AU - Fonacier, Luz
AU - Grayson, Mitchell H.
AU - Simpson, Eric L.
AU - Ong, Peck Y.
AU - Chiesa Fuxench, Zelma C.
N1 - Publisher Copyright:
© 2018 The Authors
PY - 2018/11
Y1 - 2018/11
N2 - Background: Atopic dermatitis (AD) has been associated with multiple comorbid extracutaneous and systemic disorders. The relation between AD severity and disease comorbidities is complex and not fully understood. Objective: To determine the complex relation between AD severity and comorbidities. Methods: A cross-sectional US population-based study of 8,217 adults who were participants in a nationally representative internet health panel was performed using a structured questionnaire. A diagnosis of AD was determined using modified United Kingdom Working Party Criteria for AD (n = 602). AD severity was assessed using Patient-Oriented Scoring AD, Patient-Oriented Eczema Measure, Dermatology Life Quality Index, and self-reported global AD severity. Logistic regression and structural equation models were used to explore associations of AD with self-reported allergic, cardiometabolic, anxiety and depression, and autoimmune disease. Results: In multivariable regression models controlling for sociodemographics, AD was associated with higher odds of asthma (adjusted odds ratio [OR] 2.09, 95% confidence interval [CI] 1.71–2.55), hay fever (OR 4.31, 95% CI 3.27–5.69), food allergy (OR 2.07, 95% CI 1.54–2.77), anxiety and depression (OR 2.34, 95% CI 1.91–2.87), autoimmune disease (OR 3.05, 95% CI 2.31–4.03), obesity (OR 1.37, 95% CI 1.13–1.67), diabetes (OR 1.52, 95% CI 1.16–1.99), high blood pressure (OR 1.46, 95% CI 1.18–1.80), and heart disease (OR 1.94, 95% CI 1.40–2.70) compared with controls (P <.01 for all). All these associations were significant in mild and/or moderate disease, with even stronger effects in severe AD. Results of structural equation models showed direct effects of moderate to severe AD on food allergy, anxiety and depression, and diabetes, direct and indirect effects on obesity, and indirect effects on high blood pressure and heart disease. Conclusion: There is a strong relation of AD severity to allergic, autoimmune, and cardiovascular comorbidities.
AB - Background: Atopic dermatitis (AD) has been associated with multiple comorbid extracutaneous and systemic disorders. The relation between AD severity and disease comorbidities is complex and not fully understood. Objective: To determine the complex relation between AD severity and comorbidities. Methods: A cross-sectional US population-based study of 8,217 adults who were participants in a nationally representative internet health panel was performed using a structured questionnaire. A diagnosis of AD was determined using modified United Kingdom Working Party Criteria for AD (n = 602). AD severity was assessed using Patient-Oriented Scoring AD, Patient-Oriented Eczema Measure, Dermatology Life Quality Index, and self-reported global AD severity. Logistic regression and structural equation models were used to explore associations of AD with self-reported allergic, cardiometabolic, anxiety and depression, and autoimmune disease. Results: In multivariable regression models controlling for sociodemographics, AD was associated with higher odds of asthma (adjusted odds ratio [OR] 2.09, 95% confidence interval [CI] 1.71–2.55), hay fever (OR 4.31, 95% CI 3.27–5.69), food allergy (OR 2.07, 95% CI 1.54–2.77), anxiety and depression (OR 2.34, 95% CI 1.91–2.87), autoimmune disease (OR 3.05, 95% CI 2.31–4.03), obesity (OR 1.37, 95% CI 1.13–1.67), diabetes (OR 1.52, 95% CI 1.16–1.99), high blood pressure (OR 1.46, 95% CI 1.18–1.80), and heart disease (OR 1.94, 95% CI 1.40–2.70) compared with controls (P <.01 for all). All these associations were significant in mild and/or moderate disease, with even stronger effects in severe AD. Results of structural equation models showed direct effects of moderate to severe AD on food allergy, anxiety and depression, and diabetes, direct and indirect effects on obesity, and indirect effects on high blood pressure and heart disease. Conclusion: There is a strong relation of AD severity to allergic, autoimmune, and cardiovascular comorbidities.
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U2 - 10.1016/j.anai.2018.07.042
DO - 10.1016/j.anai.2018.07.042
M3 - Article
C2 - 30092266
AN - SCOPUS:85054869330
SN - 1081-1206
VL - 121
SP - 604-612.e3
JO - Annals of Allergy, Asthma and Immunology
JF - Annals of Allergy, Asthma and Immunology
IS - 5
ER -