Metabolic Comorbidities in Pediatric Atopic Dermatitis: A Narrative Review
Edoardo De Simoni,
Giulio Rizzetto,
Elisa Molinelli,
Guendalina Lucarini,
Monica Mattioli-Belmonte,
Irene Capodaglio,
Gianna Ferretti,
Tiziana Bacchetti,
Annamaria Offidani,
Oriana Simonetti
Affiliations
Edoardo De Simoni
Clinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy
Giulio Rizzetto
Clinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy
Elisa Molinelli
Clinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy
Guendalina Lucarini
Department of Clinical and Molecular Sciences-Histology, Polytechnic University of Marche, 60020 Ancona, Italy
Monica Mattioli-Belmonte
Department of Clinical and Molecular Sciences-Histology, Polytechnic University of Marche, 60020 Ancona, Italy
Irene Capodaglio
Hospital Cardiology and UTIC, Ospedali Riuniti di Ancona, 60126 Ancona, Italy
Gianna Ferretti
Research Center of Health Education and Health Promotion, Department of Clinical Experimental Science and Odontostomatology-Biochemistry, 60126 Ancona, Italy
Tiziana Bacchetti
Department of Life and Environmental Sciences-Biochemistry, Polytechnic University of Marche, 60126 Ancona, Italy
Annamaria Offidani
Clinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy
Oriana Simonetti
Clinic of Dermatology, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60126 Ancona, Italy
Atopic dermatitis (AD) is an itchy dermatitis with multifactorial aetiology, chronic-recurrent course, and typical distribution of lesions according to the age, affecting the 10–20% of pediatric population. Patients with AD, including children, suffer from many metabolic comorbidities, including metabolic syndrome, being overweight, obesity, dyslipidaemia, and arterial hypertension, all of which had a prevalence that was demonstrated to be higher than in healthy patients. The association between AD and metabolic comorbidities is multifactorial and involves the deregulation of immune system. In fact, hypertrophic adipose tissue produces soluble adipokines involved in inflammation and immunity, which stimulate the production of pro-inflammatory cytokines, responsible for a chronic low-grade inflammatory state and a higher predisposition to hypersensitivity reactions. Especially in pediatric population with AD, these metabolic disorders are usually underestimated and are associated with long term sequelae and an increased risk of a cardiovascular event, which may also occur later in adult age. Therefore, metabolic comorbidities should be carefully evaluated and early treated in children with AD, to minimize the long-term risk of cardiovascular events.
