Association between social economic status and atopic dermatitis in Korean adult: an analysis of the Fifth Korea National Health and Nutrition Examination Survey (2010-2012)

Beom Joon Kim; Jin-A Jung; Ju Suk Lee

doi:10.4168/aard.2015.3.2.128

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Kim, Jung, and Lee: Association between social economic status and atopic dermatitis in Korean adult: an analysis of the Fifth Korea National Health and Nutrition Examination Survey (2010-2012)

Original Article

Allergy, Asthma & Respiratory Disease 2015; 3(2): 128-133.

Published online: 24 March 2015

DOI: https://doi.org/10.4168/aard.2015.3.2.128

Association between social economic status and atopic dermatitis in Korean adult: an analysis of the Fifth Korea National Health and Nutrition Examination Survey (2010-2012)

Beom Joon Kim¹, Jin-A Jung², Ju Suk Lee³

¹Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea.

²Department of Pediatrics, Dong-A University School of Medicine, Busan, Korea.

³Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.

Correspondence to: Ju Suk Lee. Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 158 Paryong-ro, Masanhoewon-gu, Changwon 630-723, Korea. Tel: +82-55-290-6045, Fax: +82-55-290-6044, ljs8952194@lycos.co.kr

Received 21 July 2014 Revised 2 October 2014 Accepted 4 October 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/).

Abstract

Purpose

Atopic dermatitis is one of the most common allergic diseases, and its prevalence has been increasing in recent decades. Social economic status is a well-known risk factor for allergic disease. This study was performed to investigate the relationship between social economic status and atopic dermatitis in Korean adults.

Methods

Data were acquired from 18,066 men and women aged older than 19 years who participated in the Fifth Korea National Health and Nutrition Examination Surveys (KNHANES), which was conducted from 2010 to 2012. The presence of atopic dermatitis was based on self-reported physician diagnosis of atopic dermatitis in the Health Interview Surveys.

Results

The prevalence of atopic dermatitis was 2.3%, which decreased with age. In univariate analysis, adults with atopic dermatitis were younger, well-educated, had higher monthly family income, had more household members, and lived in the urban area (P<0.05), whereas sex, residential type, or smoking status was not associated with the presence of atopic dermatitis. The prevalence of hypertension, diabetes mellitus, and obesity were lower in atopic dermatitis subjects, while asthma was higher (P<0.05). Binary logistic regression analysis showed that younger age and the presence of asthma were associated with higher prevalence of atopic dermatitis (P<0.01).

Conclusion

The results of this study suggest that younger age and the prevalence of asthma may be important risk factors for the prevalence of atopic dermatitis in Korean adults. These results warrant future studies to explore mechanisms underlying the association between social economic status and atopic dermatitis.

Keywords: Atopic dermatitis, Education, Economics, Income

Figures and Tables

Table 1

Demographic characteristics of subjects (n=18,066)

Characteristic	No. (%)
Sex
Male	7,632 (42.2)
Female	10,434 (57.8)
Age (yr)
19-30	2,359 (13.1)
31-40	3,448 (19.1)
41-50	3,156 (17.5)
51-60	3,434 (19.0)
61-70	3,082 (17.1)
> 70	2,587 (14.3)
Education, n = 17,860
< Middle school	4,606 (25.8)
Middle school	1,948 (10.9)
High school	5,939 (33.3)
> High school	5,367 (30.0)
Monthly family income (quartile), n = 17,856
1	3,538 (19.8)
2	4,597 (25.7)
3	4,841 (27.1)
4	4,880 (27.3)
No. of household members
1	1,368 (7.6)
2	4,741 (26.2)
3	4,461 (24.7)
4	5,040 (27.9)
≥5	2,456 (13.6)
Residential type
Apartment	8,361 (46.3)
House	9,705 (53.7)
Residence area
Urban	14,315 (79.2)
Rural	3,751 (20.8)
Smoking status
Current	3,673 (20.3)
Ex-smoker	3,632 (20.1)
None	10,761 (59.6)
Hypertension
Yes	4,117 (22.8)
No	13,949 (77.2)
Diabetes mellitus
Yes	1,506 (8.3)
No	16,560 (91.7)
Body mass index (kg/m²), n = 17,961
< 23	8,074 (45.0)
23-25	4,187 (23.3)
> 25	5,700 (31.7)

Table 2

Atopic dermatitis prevalence among adults in Korea, The Fifth Korea National Health and Nutrition Examination Survey (2010-2012)

Region	Total subjects	Atopic dermatitis, n (%)
Seoul	3,780	126 (3.3)
Busan	1,079	18 (1.7)
Daegu	901	11 (1.2)
Incheon	1,064	26 (2.4)
Gwangju	519	9 (1.7)
Daejeon	558	13 (2.3)
Ulsan	444	11 (2.5)
Gyeunggi	3,910	101 (2.6)
Gangwon	551	18 (3.3)
Chungbuk	540	10 (1.9)
Chungnam	754	10 (1.3)
Jeonbuk	730	10 (1.4)
Jeonnam	741	6 (0.8)
Gyeungbuk	1,086	18 (1.7)
Gyeungnam	1,021	20 (2.0)
Jeju	388	2 (0.5)

Table 3

Demographic characteristics according to the presence of atopic dermatitis (n=18,066)

Characteristic	Atopic dermatitis	Nonatopic dermatitis	P-value
Sex			0.25
Male	161 (39.4)	7,471 (42.3)
Female	248 (60.6)	10,186 (57.7)
Age (yr)			< 0.01
19-30	178 (43.5)	2,181 (12.4)
31-40	85 (20.8)	3,363 (19.0)
41-50	41 (10.0)	3,115 (17.6)
51-60	44 (10.8)	3,390 (19.2)
61-70	38 (9.3)	3,044 (17.2)
> 70	23 (5.6)	2,564 (14.5)
Education, n = 17,860			< 0.01
< Middle school	43 (10.5)	4,563 (26.1)
Middle school	24 (5.9)	1,924 (11.0)
High school	186 (45.6)	5,753 (33.0)
> High school	155 (38.0)	5,212 (29.9)
Monthly family income (quartile), n = 17,856			< 0.01
1	47 (11.7)	3,491 (20.0)
2	104 (25.8)	4,493 (25.7)
3	126 (31.3)	4,715 (27.0)
4	126 (31.3)	4,754 (27.2)
No. of household members			< 0.01
1	31 (7.6)	1,337 (7.6)
2	64 (15.6)	4,677 (26.5)
3	112 (27.4)	4,349 (24.6)
4	142 (34.7)	4,898 (27.7)
≥5	60 (14.7)	2,396 (13.6)
Residential type			0.29
Apartment	8,161 (46.2)	200 (48.9)
House	9,496 (53.8)	209 (51.1)
Residence area			< 0.01
Urban	346 (84.6)	13,969 (79.1)
Rural	63 (15.4)	3,688 (20.9)
Smoking status			0.36
Current	93 (22.7)	3,580 (20.3)
Ex-smoker	74 (18.1)	3,558 (20.1)
None	242 (59.2)	10,519 (59.6)

Values are presented as number (%).

Table 4

Comorbidity conditions in atopic dermatitis subjects (n=18,066)

Characteristic	Atopic dermatitis	Nonatopic dermatitis	P-value
Hypertension			< 0.01
Yes	45 (11.0)	4,072 (23.1)
No	364 (89.0)	13,585 (76.9)
Diabetes mellitus			< 0.01
Yes	16 (3.9)	1,490 (8.4)
No	393 (96.1)	16,167 (91.6)
Body mass index (kg/m²), n = 17,961			< 0.01
< 23	215 (53.1)	7,859 (44.8)
23-25	76 (18.8)	4,111 (23.4)
> 25	114 (28.1)	5,586 (31.8)
Asthma			< 0.01
Yes	27 (6.6)	560 (3.2)
No	382 (93.4)	17,097 (96.8)

Values are presented as number (%).

Table 5

Adjusted odd ratio (OR) and their 95% confidence interval (CI) for the prevalence of atopic dermatitis

Characteristic	Adjusted OR	95% CI	P-value
Age			< 0.01
19-30	6.049	3.335-10.972	< 0.01
31-40	1.967	1.059-3.655	0.03
41-50	1.073	0.568-2.028	0.83
51-60	1.203	0.673-2.152	0.53
61-70	1.243	0.714-2.166	0.44
> 70	Reference
Education			0.11
< Middle school	Reference
Middle school	1.215	0.710-2.078	0.48
High school	1.628	1.034-2.562	0.04
> High school	1.378	0.853-2.227	0.19
No. of household members			0.17
1	Reference
2	0.564	0.359-0.885	0.01
3	0.649	0.422-1.000	0.05
4	0.654	0.426-1.005	0.05
≥5	0.628	0.392-1.004	0.05
Monthly family income (quartile)			0.84
1	Reference
2	1.170	0.797-1.718	0.42
3	1.168	0.793-1.720	0.43
4	1.200	0.810-1.777	0.36
Residential type
Urban	0.981	0.736-1.308	0.90
Asthma
Yes	2.391	1.560-3.663	< 0.01
Hypertension
Yes	0.829	0.564-1.219	0.34
Diabetes mellitus
Yes	0.879	0.508-1.522	0.65
Body mass index (kg/m²)			0.72
< 23	Reference		0.72
23-25	0.894	0.679-1.177	0.42
> 25	0.999	0.778-1.259	0.93

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