Nutritional Status and Bone Metabolism in Children With Atopic Dermatitis

Abstract

Rationale: Atopic dermatitis (AD) is an inflammatory allergic skin disease that often requires topical glucocorticoid therapy (GC). To determine the impact of AD on nutritional status and bone parameters in children with moderate/severe AD compared to control group. Methods: Forty-nine children with AD (4-12 years) and 48 healthy controls were evaluated regarding nutritional status (height/age z-score, weight/age z-score and BMI z-score), disease activity and severity, topical GC use, and bone parameters. Bone mineral content (BMC), bone mineral density and z-score were measured at lumbar spine and total femur by DXA. Laboratory parameters analyzed were calcium, alkaline phosphatase, CTX, 25OHD and cortisol. Results: Children with AD compared to control group presented with lower height for age z-score (P=0.007), lower BMC at lumbar spine [16.5(6.4) vs. 19.8(8.3)g, P=0.027] and total femur [12.2(4.0) vs. 14.2(5.0)g, P=0.029]. Bone resorption marker (CTX) was lower in children with AD compared to healthy controls [1.36(0.59) vs. 1.67(0.79)ng/mL, P=0.026] and a tendency of lower bone formation marker (alkaline phosphatase) was also observed [228(75.3) vs. 255(70.7)ng/mL, P=0.074]. Children with AD presented inferior levels of serum cortisol in comparison to healthy group [9.06(4.8) vs. 10.57(4.9), P=0.061]. Conclusions: Lower lumbar and total femur BMC and lower bone turnover found in children with AD is probably due to a chronic GC use.