Is Atopic Dermatitis Associated with Systemic Metabolic Disturbances? A Systematic Review

Atopic dermatitis (AD) is a chronic, complex, and immunologically mediated skin disease. Its exact cause remains complex, multifaceted and yet to be discovered but is likely related to a combination of immunological, genetic and environmental factors. A medical literature search of PubMed (1992-present), Google Schoolar and Embase was performed using appropriate terms without date limitations in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Nevertheless, chronic inflammation is believed to be a major player in the development of AD and a causative element in the development of metabolic syndrome (MetS). Metabolic syndrome is a cluster of common metabolic abnormalities including hypertension, insulin resistance, abdominal obesity, reduced high-density lipoprotein (HDL)-cholesterol levels and elevated triglyceride levels. High waist circumference is positively correlated with the risk of atopic dermatitis, but there is no significant correlation between adult-onset atopic dermatitis and hypertension. Some evidence suggests an association between AD and hypertension but only in patients with severe AD. On the other hand, the relationship between AD and hyperglycemia or AD and cholesterol levels seems inconclusive. The aim of this review is to present current knowledge on the association between atopic dermatitis and metabolic syndrome, including each of the components of metabolic syndrome.