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J Invest Dermatol. 2018 Nov 8. pii: S0022-202X(18)32798-2. doi: 10.1016/j.jid.2018.10.029. [Epub ahead of print]

Racial/ethnic differences in incidence and persistence of childhood atopic dermatitis.

Author information

1
Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
2
Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Department of Dermatology and Allergy, Herlev-Gentofte University Hospital, Hellerup, Denmark.
3
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
4
Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
5
Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
6
Department of Dermatology and Allergy, Herlev-Gentofte University Hospital, Hellerup, Denmark.
7
Division of Pediatric Pulmonology, Department of Pediatrics, Golisano Children's Hospital at Strong, University of Rochester Medical Center, Rochester, NY.
8
Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA. Electronic address: masgari@partners.org.

Abstract

Although previous studies have explored racial/ethnic differences in incident atopic dermatitis (AD) in childhood, few studies have examined risk factors associated with AD persistence. As such, we sought to examine differences in incidence and persistence of childhood AD by race/ethnicity accounting for socio-demographic characteristics and perinatal vitamin D levels. Using data from Project Viva, a prospective pre-birth cohort in eastern Massachusetts, we studied 1,437 mother-child pairs with known AD status to examine the associations of race/ethnicity with maternally-reported child AD. We used multivariable logistic regression, adjusting for socio-demographic factors and maternal plasma vitamin D, to estimate adjusted odds ratios (aOR) of AD incidence at early childhood and persistence at mid-childhood. Compared to non-Hispanic whites, non-Hispanic blacks (aOR 2.71, 95% CI: 1.75, 4.19) and other non-Hispanics (aOR 1.80, 95% CI: 1.16, 2.80) were more likely to have incident AD. Non-Hispanic blacks (aOR 6.26, 95% CI: 2.32, 16.88) and Hispanics (aOR 6.42, 95% CI: 1.93, 21.41) with early childhood AD were more likely to have persistent AD. In conclusion, compared to non-Hispanic whites, AD incidence and persistence is higher among certain non-white racial/ethnic subgroups. Further research is warranted to identify environmental, socioeconomic, and genetic factors that may be responsible for the observed differences.

KEYWORDS:

atopic dermatitis; race and ethnicity; vitamin D

PMID:
30414911
DOI:
10.1016/j.jid.2018.10.029

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