Atopic Dermatitis and Markers of Early Cardiovascular Risk in Children and Adolescents.

The prevalence of active atopic dermatitis varied by age and ranged from 13.10% to 21.58% at ages 3 through 18 years.

• Among participants with AD, 3.52% to 6.85% reported moderate or severe disease at each age.
• The subcohort included 9281 children, of whom 4669 (50.31%) were male.
• Participation at each age ranged from 1001 participants (10.79%) at age 3 years to 6352 (68.44%) at age 7 years.
• Data were collected from 1991 to 2017 from the Avon Longitudinal Study of Parents and Children.

Multivariable linear regression models did not reveal associations between active atopic dermatitis and most cardiovascular risk factors.

• The primary outcome was cardiometabolic risk scores calculated at ages 15, 17, and 24 years.
• Secondary outcomes included body mass index, blood pressure, and lipid profiles measured up to 12 times between ages 3 and 24 years.
• Only 2 associations between AD and low-density lipoprotein cholesterol levels were found with P < .05.
• The two LDL cholesterol associations differed in directionality: mean difference of -0.33 (95% CI, -0.58 to -0.07) SDs at age 3 years versus 0.14 (95% CI, 0.03-0.24) SDs at age 10 years.

There was no consistent evidence for dose-response effects on cardiovascular risk factors by atopic dermatitis severity.

• Among participants with AD, moderate or severe disease was reported by 3.52% to 6.85% at each age.
• Analyses examined patterns of more active and severe AD across childhood and adolescence.
• No dose-response relationship was identified across the range of disease severity measured.

There were no associations between patterns of more active and severe atopic dermatitis across childhood and subclinical atherosclerosis.

• Subclinical atherosclerosis was assessed using ultrasonography measures at ages 17 and 24 years.
• This outcome was examined in relation to patterns of AD activity and severity across childhood and adolescence.
• No statistically significant associations were found between AD and ultrasonographic markers of subclinical atherosclerosis at either time point.

Systematic screening of all children with atopic dermatitis is unlikely to improve identification of early cardiovascular risk.

• This conclusion was based on null findings across a comprehensive set of cardiovascular risk markers including cardiometabolic risk scores, BMI, blood pressure, lipid profiles, and subclinical atherosclerosis.
• The study accounted for heterogeneity in disease activity and severity across childhood, which prior studies had not addressed.
• The longitudinal cohort followed participants from birth into early adulthood (up to age 24 years).
• The population-based design used data from the Avon Longitudinal Study of Parents and Children in the United Kingdom.