Weight-for-length, early weight-gain velocity and atopic dermatitis in infancy and at two years of age: a cohort study

Teresa Løvold Berents, Karin Cecilie Lødrup Carlsen, Petter Mowinckel, Håvard Ove Skjerven, Leif Bjarte Rolfsjord, Live Solveig Nordhagen, Bente Kvenshagen, Jon Olav Gjengstø Hunderi, Maria Bradley, Per Medbøe Thorsby, Kai-Håkon Carlsen, Petter Gjersvik, Teresa Løvold Berents, Karin Cecilie Lødrup Carlsen, Petter Mowinckel, Håvard Ove Skjerven, Leif Bjarte Rolfsjord, Live Solveig Nordhagen, Bente Kvenshagen, Jon Olav Gjengstø Hunderi, Maria Bradley, Per Medbøe Thorsby, Kai-Håkon Carlsen, Petter Gjersvik

Abstract

Background: Overweight and atopic dermatitis (AD) are major health problems in most industrialised countries, but the relationship between overweight and AD in infants and young children is unclear. We investigated if weight-for-length at birth, in infancy and at two years, as well as early weight-gain velocity, are associated with the development of AD in early life.

Methods: Cohort study of infants (n = 642), all living in south-east Norway, hospitalized with acute bronchiolitis (n = 404) or recruited from the general population (n = 238), examined at mean age 5.1 months (enrolment) and at a two-year follow-up visit (n = 499; 78%) at mean age 24.6 months. Exposures were weight-for-length (g/cm) at birth, enrolment and two-year follow-up, and early weight-gain velocity (gram/month from birth to enrolment). Excessive weight-for-length was defined as weight-for-length >95th percentile of WHO child-growth standards. Data on weight-for-length at the three time points were obtained for 435, 428 and 473 children. AD was diagnosed according to the Hanifin & Rajka criteria or from a history of physician-diagnosed AD. We performed multivariate analyses with weight-for-length at birth, at enrolment and at the two-year follow-up visit and with early weight gain velocity for the endpoint AD at each visit.

Results: In adjusted analyses, excessive weight-for-length at enrolment was associated with concurrent AD (OR 3.03; 95% CI 1.23-7.50) and with AD at two years (OR 2.40; 1.11-5.17). In infants without AD, weight-for-length at enrolment increased the risk of AD at two years, with OR being 1.02 (95% CI 1.00-1.04) per increased gram/cm. AD at two years was not associated with concurrent excessive weight-for-length, nor was AD at any time associated with weight-for-length at birth or with early weight-gain velocity.

Conclusions: The results suggest that overweight in infancy may contribute to the development of AD in early life, highlighting the need for child health-care professionals to address potential overweight and atopic disease when advising infants' caregivers.

Trial registration: ClinicalTrials.gov number, NCT00817466 , EudraCT number, 2009-012667-34.

Keywords: Atopic dermatitis; Infancy; Overweight; Weight-for-length.

Figures

Fig. 1
Fig. 1
Flow chart of study cohort with 404 children hospitalized for acute bronchiolitis and 238 children recruited from the general population. The two-year follow-up visit was attended by 294 children from the bronchiolitis group (73%) and 205 (85%) of the children recruited from the general population

References

    1. Baird J, Fisher D, Lucas P, Kleijnen J, Roberts H, Law C. Being big or growing fast: systematic review of size and growth in infancy and later obesity. BMJ. 2005;331:929. doi: 10.1136/bmj.38586.411273.E0.
    1. Zhang A, Silverberg JI. Association of atopic dermatitis with being overweight and obese: a systematic review and metaanalysis. J Am Acad Dermatol. 2015;72:606–616. doi: 10.1016/j.jaad.2014.12.013.
    1. Weidinger S, Novak N. Atopic dermatitis. Lancet. 2016;387:1109–1122. doi: 10.1016/S0140-6736(15)00149-X.
    1. Nino M, Franzese A, Ruggiero Perrino N, Balato N. The effect of obesity on skin disease and epidermal permeability barrier status in children. Pediatr Dermatol. 2012;29:567–570. doi: 10.1111/j.1525-1470.2012.01738.x.
    1. Loffler H, Aramaki JU, Effendy I. The influence of body mass index on skin susceptibility to sodium lauryl sulphate. Skin Res Technol. 2002;8:19–22. doi: 10.1046/j.0909-752x.
    1. Hersoug LG, Linneberg A. The link between the epidemics of obesity and allergic diseases: does obesity induce decreased immune tolerance? Allergy. 2007;62:1205–1213. doi: 10.1111/j.1398-9995.2007.01506.x.
    1. Han JC, Lawlor DA, Kimm SY. Childhood obesity. Lancet. 2010;375:1737–1748. doi: 10.1016/S0140-6736(10)60171-7.
    1. Irvine AD, McLean WH, Leung DY. Filaggrin mutations associated with skin and allergic diseases. N Engl J Med. 2011;365:1315–1327. doi: 10.1056/NEJMra1011040.
    1. Skjerven HO, Hunderi JO, Brugmann-Pieper SK, Brun AC, Engen H, Eskedal L, et al. Racemic adrenaline and inhalation strategies in acute bronchiolitis. N Engl J Med. 2013;368:2286–2293. doi: 10.1056/NEJMoa1301839.
    1. Skjerven HO, Rolfsjord LB, Berents TL, Engen H, Dizdarevic E, Midgaard C, et al. Allergic diseases and the effect of inhaled epinephrine in children with acute bronchiolitis: follow-up from the randomised, controlled, double-blind, Bronchiolitis ALL trial. Lancet Respir Med. 2015;3:702–708. doi: 10.1016/S2213-2600(15)00319-7.
    1. Berents TL, Carlsen KC, Mowinckel P, Skjerven HO, Kvenshagen B, Rolfsjord LB, et al. Skin barrier function and Staphylococcus aureus colonization in vestibulum nasi and fauces in healthy infants and infants with eczema: a population-based cohort study. PLoS One. 2015;10:e0130145. doi: 10.1371/journal.pone.0130145.
    1. Berents TL, Lodrup Carlsen KC, Mowinckel P, Sandvik L, Skjerven HO, Rolfsjord LB, et al. Vitamin D levels and atopic eczema in infancy and early childhood in Norway: a cohort study. Br J Dermatol. 2016;175:95–101. doi: 10.1111/bjd.14537.
    1. Hanifin JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol. 1980;92:44–47.
    1. Kunz B, Oranje AP, Labreze L, Stalder JF, Ring J, Taieb A. Clinical validation and guidelines for the SCORAD index: consensus report of the European task force on atopic dermatitis. Dermatol. 1997;195:10–19. doi: 10.1159/000245677.
    1. WHO Multicentre Growth Reference Study Group . WHO child growth standards: length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: methods and development. Geneva: World Health Organization; 2006.
    1. Hosmer DW, Lemeshow S. Applied logistic regression. 2. New York: John Wiley & Sons; 2000.
    1. Hamilton LC. Regression with graphics: a second course in applied statistics. Pacific Grove, California, USA: Brooks/Cole Publishing Company; 1991.
    1. Little RJA. A test of missing completely at random for multivariate data with missing values. J Am Stat Assoc. 1988;83:1198–1202. doi: 10.1080/01621459.1988.10478722.
    1. Murray CS, Canoy D, Buchan I, Woodcock A, Simpson A, Custovic A. Body mass index in young children and allergic disease: gender differences in a longitudinal study. Clin Exp Allergy. 2011;41:78–85. doi: 10.1111/j.1365-2222.2010.03598.x.
    1. Byberg KK, Eide GE, Forman MR, Juliusson PB, Oymar K. Body mass index and physical activity in early childhood are associated with atopic sensitization, atopic dermatitis and asthma in later childhood. Clin Transl Allergy. 2016;6:33. doi: 10.1186/s13601-016-0124-9.
    1. Mai XM, Almqvist C, Nilsson L, Wickman M. Birth anthropometric measures, body mass index and allergic diseases in a birth cohort study (BAMSE) Arch Dis Child. 2007;92:881–886. doi: 10.1136/adc.2006.110692.
    1. Sevelsted A, Bisgaard H. Neonatal size in term children is associated with asthma at age 7, but not with atopic dermatitis or allergic sensitization. Allergy. 2012;67:670–675. doi: 10.1111/j.1398-9995.2012.02805.x.
    1. Olesen AB, Ellingsen AR, Olesen H, Juul S, Thestrup-Pedersen K. Atopic dermatitis and birth factors: historical follow up by record linkage. BMJ. 1997;314:1003–1008. doi: 10.1136/bmj.314.7086.1003.
    1. Egeberg A, Andersen YM, Gislason G, Skov L, Thyssen JP. Neonatal risk factors of atopic dermatitis in Denmark - results from a nationwide register based study. Pediatr Allergy Immunol. 2016;27:368–374. doi: 10.1111/pai.12560.
    1. Eneli IU, Karmaus WK, Davis S, Kuehr J. Airway hyperresponsiveness and body mass index: the child health and environment cohort study in Hesse. Germany Pediatr Pulmonol. 2006;41:530–537. doi: 10.1002/ppul.20391.
    1. Sidoroff V, Hyvarinen MK, Piippo-Savolainen E, Korppi M. Overweight does not increase asthma risk but may decrease allergy risk at school age after infantile bronchiolitis. Acta Paediatr. 2012;101:43–47. doi: 10.1111/j.1651-2227.2011.02439.x.
    1. Coelho M, Oliveira T, Fernandes R. Biochemistry of adipose tissue: an endocrine organ. Arch Med Sci. 2013;9:191–200. doi: 10.5114/aoms.2013.33181.
    1. Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240–1243. doi: 10.1136/bmj.320.7244.1240.
    1. Monasta L, Lobstein T, Cole TJ, Vignerova J, Cattaneo A. Defining overweight and obesity in pre-school children: IOTF reference or WHO standard? Obes Rev. 2011;12:295–300. doi: 10.1111/j.1467-789X.2010.00748.x.
    1. Juliusson PB, Roelants M, Hoppenbrouwers K, Hauspie R, Bjerknes R. Growth of Belgian and Norwegian children compared to the WHO growth standards: prevalence below −2 and above +2 SD and the effect of breastfeeding. Arch Dis Child. 2011;96:916–921. doi: 10.1136/adc.2009.166157.
    1. Thyssen JP, Kezic S. Causes of epidermal filaggrin reduction and their role in the pathogenesis of atopic dermatitis. J Allergy Clin Immunol. 2014;134:792–799. doi: 10.1016/j.jaci.2014.06.014.

Source: PubMed

Sponsorer og samarbeidspartnere

Medisinsk tilstand

Legemiddelintervensjoner

3
Abonnere