Association of atopic dermatitis with allergic, autoimmune, and cardiovascular comorbidities in US adults

Jonathan I. Silverberg, Joel M. Gelfand, David J. Margolis, Mark Boguniewicz, Luz Fonacier, Mitchell H. Grayson, Eric Simpson, Peck Y. Ong, Zelma C. Chiesa Fuxench

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)604-612.e3
JournalAnnals of Allergy, Asthma and Immunology
Volume121
Issue number5
DOIs
StatePublished - Nov 1 2018

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Atopic Dermatitis
Comorbidity
Odds Ratio
Confidence Intervals
Food Hypersensitivity
Anxiety
Structural Models
Depression
Autoimmune Diseases
Heart Diseases
Obesity
Hypertension
Seasonal Allergic Rhinitis
Hematologic Diseases
Eczema
Dermatology
Internet
Asthma
Logistic Models
Quality of Life

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pulmonary and Respiratory Medicine

Cite this

Silverberg, J. I., Gelfand, J. M., Margolis, D. J., Boguniewicz, M., Fonacier, L., Grayson, M. H., ... Chiesa Fuxench, Z. C. (2018). Association of atopic dermatitis with allergic, autoimmune, and cardiovascular comorbidities in US adults. Annals of Allergy, Asthma and Immunology, 121(5), 604-612.e3. https://doi.org/10.1016/j.anai.2018.07.042

Association of atopic dermatitis with allergic, autoimmune, and cardiovascular comorbidities in US adults. / Silverberg, Jonathan I.; Gelfand, Joel M.; Margolis, David J.; Boguniewicz, Mark; Fonacier, Luz; Grayson, Mitchell H.; Simpson, Eric; Ong, Peck Y.; Chiesa Fuxench, Zelma C.

In: Annals of Allergy, Asthma and Immunology, Vol. 121, No. 5, 01.11.2018, p. 604-612.e3.

Research output: Contribution to journalArticle

Silverberg, JI, Gelfand, JM, Margolis, DJ, Boguniewicz, M, Fonacier, L, Grayson, MH, Simpson, E, Ong, PY & Chiesa Fuxench, ZC 2018, 'Association of atopic dermatitis with allergic, autoimmune, and cardiovascular comorbidities in US adults', Annals of Allergy, Asthma and Immunology, vol. 121, no. 5, pp. 604-612.e3. https://doi.org/10.1016/j.anai.2018.07.042
Silverberg, Jonathan I. ; Gelfand, Joel M. ; Margolis, David J. ; Boguniewicz, Mark ; Fonacier, Luz ; Grayson, Mitchell H. ; Simpson, Eric ; Ong, Peck Y. ; Chiesa Fuxench, Zelma C. / Association of atopic dermatitis with allergic, autoimmune, and cardiovascular comorbidities in US adults. In: Annals of Allergy, Asthma and Immunology. 2018 ; Vol. 121, No. 5. pp. 604-612.e3.
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abstract = "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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AU - Fonacier, Luz

AU - Grayson, Mitchell H.

AU - Simpson, Eric

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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.

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