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Metabolic Comorbidities in Pediatric Atopic Dermatitis: A Narrative Review
Edoardo De Simoni1, Giulio Rizzetto1, Elisa Molinelli1
1Clinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy.
Insights
Atopic dermatitis (AD) in children is linked to higher rates of metabolic issues like obesity and high blood pressure. Early evaluation and treatment of these comorbidities are crucial to prevent long-term cardiovascular risks.
Area of Science:
- Dermatology
- Pediatrics
- Metabolic Health
Background:
- Atopic dermatitis (AD) affects 10-20% of children, presenting as chronic, itchy skin inflammation.
- Children with AD exhibit a higher prevalence of metabolic comorbidities, including metabolic syndrome, obesity, and hypertension, compared to healthy peers.
- The link between AD and metabolic issues involves immune system deregulation and chronic inflammation.
Purpose of the Study:
- To highlight the underestimation of metabolic comorbidities in pediatric atopic dermatitis.
- To emphasize the association between AD, metabolic disorders, and long-term cardiovascular risks in children.
- To advocate for early evaluation and management of metabolic issues in children with AD.
Main Methods:
- Review of existing literature on atopic dermatitis and metabolic comorbidities in pediatric populations.
- Analysis of the immunological pathways linking AD, adipose tissue dysfunction, and inflammation.
- Examination of epidemiological data on the prevalence of metabolic syndrome, obesity, dyslipidemia, and hypertension in children with AD.
Main Results:
- Patients with AD, particularly children, show a significantly higher incidence of metabolic syndrome, overweight, obesity, dyslipidemia, and arterial hypertension.
- Hypertrophic adipose tissue in AD contributes to inflammation via adipokines, promoting a pro-inflammatory state and hypersensitivity.
- These metabolic disorders in pediatric AD are often overlooked but are associated with significant long-term sequelae and increased cardiovascular risk.
Conclusions:
- Metabolic comorbidities are frequently associated with atopic dermatitis in children and are often underestimated.
- Early identification and management of metabolic disorders in pediatric AD are essential for mitigating long-term health consequences, including cardiovascular events.
- Addressing metabolic health in conjunction with skin care is vital for improving the overall prognosis and reducing future cardiovascular morbidity in affected children.
Abstract:
Atopic dermatitis (AD) is an itchy dermatitis with multifactorial aetiology, chronic-recurrent course, and typical distribution of lesions according to the age, affecting the 10-20% of pediatric population. Patients with AD, including children, suffer from many metabolic comorbidities, including metabolic syndrome, being overweight, obesity, dyslipidaemia, and arterial hypertension, all of which had a prevalence that was demonstrated to be higher than in healthy patients. The association between AD and metabolic comorbidities is multifactorial and involves the deregulation of immune system. In fact, hypertrophic adipose tissue produces soluble adipokines involved in inflammation and immunity, which stimulate the production of pro-inflammatory cytokines, responsible for a chronic low-grade inflammatory state and a higher predisposition to hypersensitivity reactions. Especially in pediatric population with AD, these metabolic disorders are usually underestimated and are associated with long term sequelae and an increased risk of a cardiovascular event, which may also occur later in adult age. Therefore, metabolic comorbidities should be carefully evaluated and early treated in children with AD, to minimize the long-term risk of cardiovascular events.
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