Association of Atopic Dermatitis with Cardiovascular Risk Factors and Diseases

Abstract

Epidemiological studies suggested an association between atopic dermatitis (AD) and cardiovascular disease. Therefore, we investigate associations and potential underlying pathways of AD and cardiovascular disease in large cohort studies: the AOK PLUS cohort (n = 1.2 Mio), the GINIplus/LISAplus birth cohorts (n = 2,286), and the Cooperative Health Research in the Region of Augsburg (KORA) F4 cohort (n = 2,990). In addition, metabolomics in KORA F4 and established cardiovascular risk loci in genome-wide data on 10,788 AD cases and 30,047 controls were analyzed. Longitudinal analysis of patients with AD in AOK PLUS showed slightly increased risk for incident angina pectoris (adjusted risk ratio 1.17 [95% confidence interval 1.12-1.23]), hypertension (1.04 [1.02-1.06]), and peripheral arterial disease (1.15 [1.11-1.19]) but not for myocardial infarction (1.05 [0.99-1.12]) and stroke (1.02 [0.98-1.07]). In KORA F4 and GINIplus/LISAplus, AD was not associated with cardiovascular risk factors and no differences in metabolite levels were detected. There was no robust evidence for shared genetic risk variants of AD and cardiovascular disease. This study indicates only a marginally increased risk for angina pectoris, hypertension, and peripheral arterial disease and no increased risk for myocardial infarction or stroke in patients with AD. Relevant associations of AD with cardiovascular risk factors reported in US populations could not be confirmed. Likewise, patients with AD did not have increased genetic risk factors for cardiovascular disease.

Association between Atopic Dermatitis and the Metabolic Syndrome: A Systematic Review

“…A positive association between AD and hypertension was observed in 6 out of 11 studies [1,2,15,18,22,24], 3 studies [12,17,23] found an inverse association, and 2 studies [19,32] did not find any association. The study by Uehara et al [12] with physician's diagnosed AD and measured blood pressure found no association.…”

“…Longitudinal analysis by Standl et al [2] of adult German National Health Insurance beneficiaries (n = 1.2 million) with information on disease obtained by registered ICD-10 codes showed a slightly increased risk for hypertension (adjusted risk ratio 1.04; 95% CI 1.02-1.06). The severity of AD was assessed using treatment (no medication, exclusively topical medication, or systemic medication) as proxy.…”

“…Epidemiological [1,2] and clinical studies [3] have suggested an association between atopic dermatitis (AD) and cardiovascular disease (CVD). Metabolic syndrome is an important risk factor for CVD incidence and mortality, as well as all-cause mortality [4].…”

Atopic dermatitis and the metabolic syndrome: a cross‐sectional study of 116 816 patients

“…A recent study based on a large claims database from Germany found that the association between AD and cardiovascular disease was modest. In a more refined analysis, the cardiovascular risk profile architecture was comparable between patients with AD and controls . Nijsten claimed that the story of comorbidities in AD is just copycats of the scientific approach in the research for the association between psoriasis and comorbidities.…”

“…The Councilors of the International Eczema Council recently suggested that AD is linked to overrepresentation of several metabolic disorders . Nevertheless, this report provoked sharp criticism stating that this association is not observed in daily practice, as evidenced by several observational reports with contradictory findings . Given the controversial nature of current reports, the relations between AD and metabolic syndrome and further epidemiological studies are needed.…”