title: Association between obesity and eczema prevalence, severity and poorer health in US adolescents.
abstract: BACKGROUND
  Identification of modifiable risk factors for the development of eczema is of major public health significance.
  
  
  OBJECTIVE
  This study aimed to determine the effects of obesity in adolescence on the prevalence, severity, and quality of life of patients with eczema.
  
  
  METHODS
  We used the 2007-2008 National Survey of Children's Health, including a nationally representative sample of 45,897 adolescents aged 10 to 17 years. Caregiver report of eczema, health status, height, weight, number of health conditions, use of health services, and sociodemographics were assessed.
  
  
  RESULTS
  The prevalences of overweight (20.3% vs 15.4%) and obesity (16.8% vs 15.4%) were increased in adolescents with eczema compared with adolescents without eczema (Rao-Scott χ, P < 0.0001). A body mass index for-age-percentile (BMIP) of 50 to 94 (logistic regression, odds ratio [OR], 1.61 [95% confidence interval (CI), 1.32-1.97]) and greater than or equal to 95 (1.46 [1.15-1.86]) was associated with higher odds of eczema compared with 5% to 49%. Moderate to severe eczema was higher with BMIP of 50 to 94 (41.2%; OR, 2.46 [95% CI, 1.73-3.51]) and greater than or equal to 95 (45.7%; 2.95 [1.73-3.51]) compared with 5 to 49 (22.2%). There was a significant interaction between race/ethnicity and BMIP in multivariate regression models of eczema severity, such that BMIP remained significant in Hispanics (OR, 3.24 [95% CI, 1.56-6.71]), non-Hispanic whites (3.64 [1.93-6.84]), Asians (57.17 [4.02-813.10]), Pacific Islanders/Alaskan Natives (90,336.3 [11,963.80-682,111.0]), and multiracial/other (3.99 [1.23-12.98]) but not in non-Hispanic blacks (1.88 [0.91-3.91]) and American Indians (2.12 [0.11-42.33]). Obese adolescents with eczema had higher odds of having only good (OR, 2.67 [95% CI, 1.56-4.56]) or fair (2.60 [1.35-5.03]) health compared with excellent overall health, had higher number of chronic health conditions (34.6% vs 18.0% with ≥2 conditions; P ≤ 0.003), and used more health services than most children of the same age compared with nonobese children (31.2% vs 21.5%; P = 0.01).
  
  
  CONCLUSIONS
  Obesity in adolescence is associated with increased eczema prevalence and severity, poorer overall health, and increased chronic health conditions and health care utilization.
authors.affiliation: From the Departments of *Dermatology, †Preventive Medicine, and ‡Medical Social Sciences, Northwestern University, Chicago, IL; §Department of Dermatology, St Luke's-Roosevelt Hospital Center, New York, NY; and ∥Department of Dermatology, Oregon Health and Sciences University, Portland, OR.
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Silverberg
authors.forename: Eric L
authors.initials: EL
authors.lastname: Simpson
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D015992:Body Mass Index; D002648:Child; D004485:Eczema / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006304:Health Status; D006306:Health Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data; D004930:Inuit / Q000706:statistics & numerical data; D008297:Male; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data; D009765:Obesity / Q000453:epidemiology* / Q000208:ethnology; D015995:Prevalence; D011788:Quality of Life; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology