Pattern of growth and adiposity from infancy to adulthood in atopic dermatitis

Background: Impaired linear growth has been reported in children with atopic dermatitis (AD) but the pattern of growth in height and weight through childhood and adolescence has not been described. Objectives: To define the pattern of linear growth and adiposity in AD from early childhood through to adult life. Methods: Growth measurements of 70 male and 40 female patients with AD followed through childhood and adolescence were studied retrospectively and compared with the 1990 U.K. normal values. Height, weight and body mass index (BMI) were converted to standard deviation scores (SDS). Regression analysis examined whether the mean trend was different from zero. Results: While dermatitis was the predominant atopic problem in all 110 patients, 92 had a history of asthma which was mild in 85 of 92. Regression analyses showed that the trends in height, weight and BMI SDS for AD patients were significantly different from zero and also different between males and females. Both sexes were short and relatively overweight from early childhood, a trend that was more pronounced in males than females. At 5 years (school entry), the 50th centile BMI of male (but not female) patients was 0.44 kg m(-2) higher than the reference population but height and weight were lower. The age at adiposity rebound in AD males and females was 0.8 year and 0.7 year later than the U.K. population (6.2 years vs. 5.4 years and 6.2 years vs. 5.3 years, respectively). AD patients attained peak height velocity later than the 1990 U.K. population (males 16.0 years vs. 13.5 years, P = 0.0002; females 13.4 years vs. 11.0 years, P = 0.008). In addition, males had greater mean gain in height during late adolescence (12.2 vs. 8.8 cm, P = 0.03) and were shorter as young adults (170.9 vs. 177.6 cm, P = 0.0005). Conclusions: Our patients with AD were relatively overweight very early but had a later adiposity rebound, were short in childhood and had a delayed adolescent growth spurt. Serial growth measurements should be done on all children with troublesome AD and can be helpful in counselling about the growth prognosis.