Modelling trajectories of parentally reported and physician-confirmed atopic dermatitis in a birth cohort study.
Author(s)
Type
Journal Article
Abstract
BACKGROUND: In a population-based birth cohort, we aimed to identify longitudinal trajectories of atopic dermatitis (AD) during childhood using data from different sources (validated questionnaires and healthcare records), investigate impact of different AD definitions on such trajectories and their relationships with various risk factors. METHODS: Of the 1184 children born into the study, 1083 had information on current AD on at least three follow-ups from birth to age 11 years and were included in the analysis for parentally-reported AD (PRAD). Data were transcribed from healthcare records of 916/1184 children, for the analysis of doctor-diagnosed AD (DDAD). We also derived composite definition (CDAD; at least 2 of 3 features: PRAD, DDAD, current use of AD treatment). Using latent class analysis (LCA), we determined longitudinal profiles of AD using the three definitions (PRAD, DDAD CDAD). FLG genotype was available for 803 Caucasian participants. RESULTS: For PRAD, LCA identified four AD classes ("No AD", "Persistent", "Early-onset remitting"" and "Late-onset"). For DDAD and CDAD, the optimal number of phenotypes was three ("No AD", "Persistent" and "Early-onset remitting"). Although AD classes at population level appeared similar in different models, a considerable proportion of children (n=485, 45%) moved between classes. The association with FLG genotype, atopic diseases, and early-life risk factors were inconsistent across different definitions, but the association with oral food challenge-confirmed peanut allergy was similar, with a 9 to 11-fold increase amongst children in the Persistent AD class. In a CDAD model, compared to Early-onset remitting class, those with Persistent AD were significantly more likely to have (at age 3 years) moderate/severe AD (OR=11.6, [95% CI 1.7-80.2]), polysensitisation (5.2, [1.3-21.2]), and current wheeze (4.8, [1.4-16.6]), and were less likely to be breastfed (0.2, [0.05-0.8]). CONCLUSIONS: Standardised composite definitions of AD may help define AD cases with more precision and identify more consistent long-term trajectories.
Date Issued
2022-02
Date Acceptance
2021-09-21
Citation
British Journal of Dermatology, 2022, 186 (2), pp.274-284
ISSN
0007-0963
Publisher
Wiley
Start Page
274
End Page
284
Journal / Book Title
British Journal of Dermatology
Volume
186
Issue
2
Copyright Statement
© 2021 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
License URL
Sponsor
Medical Research Council (MRC)
Medical Research Council (MRC)
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/34564850
Grant Number
MR/K002449/2
MR/S025340/1
Subjects
Science & Technology
Life Sciences & Biomedicine
Dermatology
PARTY DIAGNOSTIC-CRITERIA
ASTHMA
CHILDHOOD
PATTERNS
CHILDREN
DISEASE
ECZEMA
SENSITIZATION
METAANALYSIS
PREVALENCE
Dermatology & Venereal Diseases
1103 Clinical Sciences
1112 Oncology and Carcinogenesis
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2021-09-26