Obesity is linked to disease severity in moderate to severe atopic dermatitis—Data from the prospective observational <scp>TREATgermany</scp> registry
Stephan Traidl, Moritz M. Hollstein, Nadine Kroeger, Sascha Fischer, Annice Heratizadeh, Luise Heinrich, Barbara Kind, Doreen Siegels, Susanne Abraham, Thomas Schäfer, Matthias Augustin, Inken Harder, Andreas Pinter, Knut Schäkel, Andreas Wollenberg, Konstantin Ertner, Jutta Ramaker‐Brunke, Anne B. Bong, Sven Quist, Hannah Gorriahn‐Maiterth, Florian Schenck, Michael Sticherling, Isaak Effendy, Beate Schwarz, Christiane Handrick, Andrea Asmussen, Stephan Weidinger, Jochen Schmitt, Thomas Werfel, The TREATgermany Study Group
Abstract
BACKGROUND: There are conflicting data on a potential association between obesity and atopic dermatitis (AD). The purpose of this study was to investigate the relationship between obesity and AD disease severity. METHODS: ) were excluded from the analysis. Physician- and patient-reported disease severity scores as well as additional phenotypic characteristics were evaluated for association with BMI. Generalized linear mixed models and multinomial logit models, respectively, were applied to investigate the association of BMI, age, sex and current systemic AD treatment with disease severity. RESULTS: ). Obesity was associated with lower educational background and smoking. Otherwise, obese and non-obese AD patients had similar baseline characteristics. Increased BMI was associated with higher oSCORAD (adjusted β: 1.24, 95% CI: 1.05-1.46, p = 0.013) and Patient-oriented eczema measure (POEM) (adjusted β: 1.09, 95% CI: 1.01-1.17, p = 0.038). However, the absolute difference in the overall oSCORAD was small between obese and non-obese AD patients (Δ oSCORAD = 2.5). Allergic comorbidity was comparable between all three groups, with the exception of asthma which was more pronounced in obese patients (p < 0.001). DISCUSSION: In this large and well-characterized AD patient cohort, obesity is significantly associated with physician- and patient-assessed measures of AD disease severity. However, the corresponding effect sizes were low and of questionable clinical relevance. The overall prevalence of obesity among the German AD patients was lower than in studies on other AD cohorts from different countries, which confirms previous research on the German population and suggests regional differences in the interdependence of AD and obesity prevalence.