The Association With Cardiovascular Disease and Type 2 Diabetes in Adults With Atopic Dermatitis

A Systematic Review and Meta-analysis

J.P. Thyssen; A.-S. Halling-Overgaard; Y.M.F. Andersen; G. Gislason; L. Skov; A. Egeberg

Disclosures

The British Journal of Dermatology. 2018;178(6):1272-1279. 

In This Article

Abstract and Introduction

Abstract

Background: Recent studies examining the association between atopic dermatitis (AD) and cardiovascular disease (CVD) and type 2 diabetes have shown inconsistent results.

Objectives: To carry out a systematic review and meta–analysis that examines the association with cardiovascular disease and type 2 diabetes in adults with AD.

Methods: We compared the risk of CVD and diabetes for adult patients with and without AD by searching the PubMed, Embase and Web of Science databases. Data extraction was carried out by two independent reviewers. We found a total of 2855 citations, of which 53 were considered relevant based on title and abstract. Overall, 16 publications were included in the qualitative analysis, of which 13 were also included in a quantitative meta–analysis of crude data.

Results: No association was observed between AD and unspecified but suspected type 2 diabetes [pooled odds ratio (OR) 1·11; 95% confidence interval (CI) 0·87–1·42], hypertension (pooled OR 1·16; 95% CI 0·98–1·37), stroke (pooled OR 1·15; 95% CI 0·95–1·39) or myocardial infarction (pooled OR 1·14; 95% CI 0·83–1·56), but a positive association was observed with angina pectoris (OR 1·73; 95% CI 1·27–2·37). Meta–analysis of adjusted data gave similar results.

Conclusions: While adults with AD in some populations have an increased prevalence of cardiovascular risk factors, such as obesity and smoking, it is unlikely that AD represents an independent and clinically relevant risk factor for cardiometabolic disease.

Introduction

Atopic dermatitis (AD) is a chronic and relapsing paediatric inflammatory skin disease, which may persist into adulthood.[1] Established adult AD comorbidities include atopic, psychiatric and autoimmune diseases.[2] The presence of systemic low–grade inflammation has been put forward as a potential explanation for the observed increased cardiovascular disease (CVD) risk in patients with psoriasis.[3] Along similar lines, recent studies have examined the AD–associated risk of CVD and diabetes,[4–10] but results have been conflicting. We performed a systematic review and meta–analysis in order to examine the possible association of AD with diabetes and CVD.

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