New research reveals that obese children are more susceptible to developing common immune-mediated skin conditions, including atopic dermatitis, psoriasis, and alopecia areata.
A large-scale study conducted in South Korea has uncovered a significant association between childhood obesity and the development of immune-mediated skin diseases (IMSDs). The research, published in the September 2024 issue of the Journal of Investigative Dermatology, suggests that maintaining a healthy weight during childhood could potentially reduce the risk of these conditions.
The study, led by researchers from Seoul National University College of Medicine, analysed data from 2,161,900 Korean children over an 11-year period from 2009 to 2020. This comprehensive dataset allowed the team to investigate the relationship between obesity, dynamic changes in body weight, and the subsequent development of IMSDs.
Dr Seong Rae Kim, co-lead investigator from the Department of Dermatology at Seoul National University College of Medicine, explained the rationale behind the study: “Previously, many studies have looked at the link between childhood obesity and IMSDs. However, most of these studies only looked at data from one point in time or compared groups with and without the condition (i.e., obesity or overweight), and they had small sample sizes.”
Dr Kim further noted that very few studies had followed children over an extended period to observe how body weight affects the development of these skin conditions. This gap in longitudinal research meant that the causal relationship between obesity and IMSDs, particularly atopic dermatitis and psoriasis, remained unclear.
Key findings
The research revealed that obese children were more likely to develop common IMSDs compared to their normal-weight peers. Among the three most prevalent IMSDs studied – alopecia areata, atopic dermatitis, and psoriasis – atopic dermatitis showed the most pronounced trend.
Interestingly, the study also examined the impact of weight changes on IMSD risk. Children who transitioned from a normal weight to an overweight status demonstrated a higher risk of developing atopic dermatitis compared to those who maintained a normal weight. Conversely, children who lost weight, moving from an overweight to a normal status, exhibited a lower risk of developing atopic dermatitis than those who remained overweight.
Implications for prevention and management
Dr Seong-Joon Koh, co-lead investigator from the Department of Internal Medicine and Liver Research Institute at Seoul National University College of Medicine, emphasised the practical implications of these findings: “Our findings support the importance of promoting weight maintenance among children who are already within the normal weight range because it may help reduce the risk of developing atopic dermatitis.”
Dr Koh further advocated for preventive measures, stating: “Prevention of excessive weight gain and purposeful weight loss, including adopting healthy diet strategies in children with obesity to prevent atopic dermatitis, particularly before school age, should be promoted.”
The gut-skin axis hypothesis
The research team’s interest extends beyond the direct relationship between obesity and IMSDs. Dr Hyunsun Park, co-lead investigator from multiple departments at Seoul National University, including the Laboratory of Intestinal Mucosa and Skin Immunology, highlighted their broader research focus: “Our research team is very interested in the skin-gut axis. We think that various factors, including diet, obesity, or other lifestyles can affect gut environment and contribute to the development of IMSDs.”
Dr Park views this study as a crucial step towards deciphering the relationship between environmental factors and immune-mediated skin conditions. The team’s ongoing efforts aim to piece together the puzzle of how diet, obesity, and lifestyle factors may influence the gut environment and, subsequently, the development of IMSDs.
Public health implications
The findings of this study are particularly relevant given the global rise in childhood obesity rates. As childhood obesity continues to present a significant public health challenge, understanding its relationship with IMSDs becomes increasingly important.
The research underscores the potential for weight management strategies to play a role in reducing the incidence of IMSDs, particularly atopic dermatitis, in children. By promoting healthy weight maintenance and addressing obesity in young populations, healthcare providers may be able to mitigate the risk of these challenging skin conditions.
Reference:
- Kim, S. R., Koh, S. J., Park, H. et. al. (2024). Childhood Obesity, Weight Change, and Pediatric Immune-Mediated Skin Diseases. Journal of Investigative Dermatology, 144(9).
https://doi.org/10.1016/j.jid.2024.01.037
