New research indicates that a higher body mass index (BMI) in early childhood is associated with an increased risk of developing immune-mediated skin diseases (IMSDs) such as atopic dermatitis (AD), alopecia areata (AA), and psoriasis.
The research team looked at data on over 2 million children in South Korea via the Korean National Health Insurance Service. According to the study data, there were significant associations between elevated BMI percentiles and the risk of IMSDs. Children classified as overweight (BMI 85th–94th percentile) or obese (BMI ≥ 95th percentile) were at higher risk of developing AD and psoriasis compared to their peers with normal weight (BMI 5th–84th percentile). Children classified as obese had a 12% increased risk of AD, a 15% increased risk of AA, and a 24% increased risk of psoriasis.
Lower BMI percentile earlier in life was associated with a lower likelihood of developing these conditions. Underweight children (BMI < 5th percentile) had a 21% lower risk of AA and a 6% lower risk of AD compared to their normal-weight counterparts. The retrospective nature of the study was cited as a limitation.
"Childhood obesity was associated with an increased risk of pediatric IMSDs, including AA, AD, and psoriasis," the authors wrote in the paper. "In addition, weight gain was correlated with an increased AD risk, whereas weight loss was correlated with a decreased AD risk. Implementing purposeful interventions, including nutritional strategies, to decrease body weight may aid in reducing the risk of developing IMSDs in children."
In an accompanying editorial by Dr. Arturo Borzutzky, of the Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile in Paraguay, wrote of the results:
"This study by Kim et al., 2024 adds important epidemiological evidence of a causal association of obesity on AD risk, particularly by showing for the first time that transitioning from normal weight to weight excess during early childhood heightens the risk of developing AD. This knowledge not only sheds light on the underlying biology of the disease but also informs the development of primary and secondary prevention measures focused on overweight/obesity treatment and on targeted therapeutic interventions aimed at mitigating the impact of obesity on AD outcomes."
Source: Kim S, et al. Journal of Investigational Dermatology. 2024;144(9):1975-1984. Doi:10.1016/j.jid.2024.01.037
Borzutzky A. Journal of Investigational Dermatology. 2024;144(9):1909-1911. Doi: 10.1016/j.jid.2024.02.035