Prevalence of atopic dermatitis and its associated factors for elementary school children in Gyeonggi-do province

Eunji Kim; Soohyun Ri; Sung Chul Seo; Ji Tae Choung; Young Yoo

doi:10.4168/aard.2016.4.5.346

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Kim, Ri, Seo, Choung, and Yoo: Prevalence of atopic dermatitis and its associated factors for elementary school children in Gyeonggi-do province

Original Article

Allergy, Asthma & Respiratory Disease 2016; 4(5): 346-353.

Published online: 30 September 2016

DOI: https://doi.org/10.4168/aard.2016.4.5.346

Prevalence of atopic dermatitis and its associated factors for elementary school children in Gyeonggi-do province

Eunji Kim¹, Soohyun Ri¹, Sung Chul Seo², Ji Tae Choung^1,², Young Yoo^1,^2,³

¹Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.

²Environmental Health Center, Korea University Anam Hospital, Ansan, Korea.

³Allergy Immunology Center, Korea University, Seoul, Korea.

Correspondence to: Young Yoo, Department of Pediatrics, Korea University Anam Hospital, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Korea. Tel: +82-2-920-5090, Fax: +82-2-922-7476, yoolina@korea.ac.kr

Received 24 December 2015 Revised 4 March 2016 Accepted 6 March 2016

(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/4.0/).

Abstract

Purpose

This study aimed to investigate the prevalence of atopic dermatitis (AD) and associated factors for AD in a total of 2,077 children from 5 elementary schools in Gyeonggi-do province.

Methods

AD was defined when parents answered "Yes" to a question in the on International Study of Asthma and Allergies in Childhood questionnaire "Has your child ever has itchy rashes with xax and wane pattern for at least 6 months?" in October 2012. SCORing Atopic Dermatitis index, skin prick testing and blood testing, were evaluated.

Results

The prevalence of AD was 25.9% among 2,077 elementary school children in Gyeonggi-do province. Proportions of obesity (8.0% vs. 4.5%, P=0.004) and breast-feeding over 6 months (46.6% vs. 41.3%, P=0.035) were significantly higher in children with AD than those without. No significant differences were found in terms of sex, age, body mass index, history of breast-feeding ever and mode of delivery beween AD and non-AD children. obesity (adjusted odds ration [aOR], 1.80; 95% confidence interval [CI], 1.13–2.75; P=0.006) and breast-feeding over 6 months (aOR, 1.35; 95% CI, 1.03–1.77; P=0.029) were found as significant associated factors for AD. When stratified by sex, obesity in boys (aOR, 2.67; 95% CI, 1.53–4.66; P=0.001) and breast-feeding history in girls (aOR, 1.47; 95% CI, 1.03–2.11; P=0.034) were independently considered significant associated factors for AD. We found more boys (66.7%, P=0.028) than girls among the severe AD cases. Male sex was considered an associated factor of having severe AD (aOR, 2.23; 95% CI, 1.01–4.73; P=0.048).

Conclusion

The prevalence of AD was 25.9% in elementary school children in Gyeonggi-do. province obesity and breast-feeding over 6 months were found as associated factors of having AD. Male sex was considered an associated factor for severe AD.

Keywords: Atopic dermatitis, Child

Figures and Tables

Fig. 1

(A) The most common sensitized allergen group was house dust mites, followed by pollen, animal dander, fungus, and food allergens and (B) the sensitization rates to the common allergens in the severe atopic dermatitis (AD) group were not significantly different from those in the mild-to-moderate AD group. Der. p., Dermatophagoides pteronyssinus; Der. f., Dermatophagoides farinae.

Table 1

The clinical characteristics of study subjects

Characteristic	AD (n = 538)	Non-AD (n = 1,539)	Total (n = 2,077)	P-value
Age (yr)	9.8 ± 1.8	9.8 ± 1.7	9.8 ± 1.7	0.766
Boys	285/538 (53.0)	754/1,539 (49.0)	1,039/2,077 (50.0)	0.112
Body mass index (kg/m²)	18.2 ± 3.1	18.0 ± 2.9	18.0 ± 3.0	0.219
Obesity	38/476 (8.0)	62/1,378 (4.5)	100/1,854 (5.4)	0.004
Overweight	53/476 (11.1)	153/1,378 (11.1)	206/1,854 (11.1)	0.999
Birth weight (g)	3,270.0 ± 432.3	3,222.1 ± 451.7	3,234.5 ± 447.1	0.034
Cesarean section	217/537 (40.4)	638/1,535 (41.6)	855/2,072 (41.3)	0.640
Breast milk feeding	408/537 (76.0)	1,116/1,535 (72.7)	1,524/2,072 (73.6)	0.139
Breast milk feeding over 6 months	249/534 (46.6)	631/1,527 (41.3)	880/2,061 (42.7)	0.035

Values are presented as mean±standard deviation or number (%).

Obesity: BMI≥95th percentile; overweight: 85th percentile≤BMI<95th percentile.

Table 2

Comparison of clinical characteristics and blood eosinophil markers between mild-to-moderate and severe atopic dermatitis subjects

Parameter	Mild-to-moderate AD (n = 180)	Severe AD (n = 36)	P-value
Age (yr)	9.5 ± 1.7	9.5 ± 1.6	0.928
Boys	84/180 (46.7)	24/36 (66.7)	0.028
BMI (kg/m²)	17.9 ± 2.8	18.3 ± 3.9	0.510
Obesity	8/157 (5.1)	3/32 (9.4)	0.401
Overweight	23/157 (14.6)	4/32 (12.5)	1.000
Birth weight (kg)	3.3 ± 0.4	3.4 ± 0.5	0.119
Cesarean section	78/179 (43.6)	15/35 (42.9)	0.938
Breast milk feeding	128/179 (71.5)	26/35 (74.3)	0.738
Breast milk feeding over 6 months	92/178 (51.7)	18/35 (51.4)	0.867
Hb (g/dL)	13.6 ± 0.7	13.7 ± 0.9	0.401
Log eosinophil	1.1 ± 0.9	1.5 ± 0.8	< 0.001
Log IgE (IU/mL)	4.3 ± 2.5	5.0 ± 2.7	0.130
Log ECP (ng/mL)	2.9 ± 1.7	3.4 ± 1.6	0.086

Values are presented as mean±standard deviation or number (%).

BMI, body mass index; ECP, eosinophil cationic protein.

Obesity: BMI≥95th percentile; overweight: 85th percentile≤BMI<95th percentile.

Table 3

Multivariate models for atopic dermatitis and severe atopic dermatitis

Variable	aOR^* for AD (95% CI)	P-value	aOR^* for severe-AD (95% CI)	P-value
Age	1.02 (0.96±1.09)	0.532	1.03 (0.81±1.30)	0.806
Boys	1.15 (0.93±1.43)	0.193	2.23 (1.01±4.73)	0.048
Obesity	1.80 (1.13±2.75)	0.006	1.62 (0.37±7.18)	0.523
Overweight	1.07 (0.76±1.49)	0.706	0.73 (0.23±2.35)	0.596
Birth weight	1.02 (1.00±1.05)	0.055	1.05 (0.96±1.16)	0.263
Cesarean section	0.96 (0.77±1.18)	0.656	0.97 (0.44±2.17)	0.947
Breast milk feeding	1.26 (0.99±1.61)	0.063	1.05 (0.47±2.84)	0.760
Breast milk feeding over 6 months	1.35 (1.03±1.77)	0.029	0.77 (0.29±2.01)	0.590

aOR, adjusted odds ratio; AD, atopic dermatitis; CI, confidence interval; BMI, body mass index.

Obesity: BMI≥95th percentile; overweight: 85th percentile≤BMI<95th percentile.

^*Adjusted for age, sex, obesity, birth weight, breast milk feeding history and delivery mode.

Table 4

Multivariate models for atopic dermatitis in boys and girls

Variable	Boys (n = 1,039)		Girls (n = 1,038)
Variable	aOR^* for AD (95% CI)	P-value	aOR^* for AD (95% CI)	P-value
Age	1.03 (0.94±1.12)	0.528	1.01 (0.93±1.11)	0.793
Obesity	2.67 (1.53±4.66)	0.001	1.06 (0.52±2.14)	0.877
Overweight	1.26 (0.81±1.97)	0.303	0.87 (0.52±1.47)	0.606
Birth weight	1.03 (1.00±1.06)	0.094	0.01 (0.98±1.05)	0.572
Cesarean section	1.09 (0.81±1.47)	0.582	0.83 (0.61±1.14)	0.248
Breast milk feeding	1.16 (0.82±1.62)	0.408	1.47 (1.03±2.11)	0.034
Breast milk feeding over 6 months	1.36 (0.95±1.96)	0.095	1.39 (0.94±2.04)	0.099

aOR, adjusted odds ratio; AD, atopic dermatitis; CI, confidence interval; BMI, body mass index.

Obesity: BMI≥95th percentile; overweight: 85th percentile≤BMI<95th percentile.

^*Adjusted for age, sex, obesity, birth weight, breast milk feeding history and delivery mode.

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ORCID iDs: Young Yoo
https://orcid.org/http://orcid.org/0000-0003-3354-6969
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