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Original Investigation
November 17, 2021

Association Between Atopic Dermatitis and Height, Body Mass Index, and Weight in Children

Author Affiliations
  • 1Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 2The Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St Michael’s Hospital, Toronto, Ontario, Canada
  • 3Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  • 4Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  • 5Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
  • 6Department of Pediatrics, St Michael’s Hospital, Toronto, Ontario, Canada
  • 7Division of Dermatology, Department of Medicine and Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
JAMA Dermatol. Published online November 17, 2021. doi:10.1001/jamadermatol.2021.4529
Key Points

Question  What are the associations between atopic dermatitis and height, body mass index (BMI), and weight in children?

Findings  In this cohort study of 10 611 children (1834 with atopic dermatitis), atopic dermatitis was associated with somewhat shorter stature and higher BMI among young children, but these associations attenuated by age 14 years and 5.5 years, respectively. Atopic dermatitis was associated with somewhat decreased weight, and this association did not change with age.

Meaning  Associations between atopic dermatitis and decreased height and increased BMI in early childhood may be transient, with correction by adolescence; somewhat decreased weight may persist with age.

Abstract

Importance  Atopic dermatitis may be associated with short stature and obesity in children, but most previous studies have been either small or cross-sectional.

Objective  To evaluate the association between atopic dermatitis and height, body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), and weight throughout childhood.

Design, Setting, and Participants  TARGet Kids! (The Applied Research Group for Kids) is an ongoing prospective longitudinal cohort study that collects data at routine physician visits throughout childhood. In this cohort, children aged 5 or younger were followed up into adolescence at regular physician visits at general pediatric and family practices in Toronto, Canada, from June 2008 to February 2021.

Exposure  Parental report of atopic dermatitis.

Main Outcomes and Measures  Primary outcomes were length-for-age and BMI-for-age z scores. The secondary outcome was weight-for-age z score. Linear mixed effects models were used to estimate associations between atopic dermatitis and each outcome. In secondary analyses, interaction terms were included between atopic dermatitis and age.

Results  A total of 10 611 children were included in the analysis, with mean (SD) baseline age of 23 (20) months; 5070 (47.8%) participants were female. Participants were followed for a median (range) of 28.5 (0.0-158.0) months. A total of 1834 (17.3%) children had atopic dermatitis during follow-up. Atopic dermatitis was associated with lower length-for-age z score (−0.13; 95% CI, −0.17 to −0.09; P < .001), higher BMI z score (0.05; 95% CI, 0.01 to 0.09; P = .008), and lower weight-for-age z score (−0.07; 95% CI, −0.10 to −0.04; P < .001) compared with children without atopic dermatitis. The associations between atopic dermatitis and height and BMI changed with age, diminishing by age 14 years and 5.5 years, respectively. Based on World Health Organization growth tables, children with atopic dermatitis were on average 0.5 cm shorter with 0.2 more BMI units at age 2 years and 0.6 cm shorter with no difference in BMI at age 5 years than children without atopic dermatitis after adjusting for covariates. There was no evidence of interaction between atopic dermatitis and age with respect to weight.

Conclusions and Relevance  In this cohort study, atopic dermatitis was associated with shorter stature, higher BMI, and lower weight in early childhood, but these associations were small and, for height and BMI, attenuated with age and resolved by adolescence.

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