Endocrine Abstracts

JOINT1457

Background: The evidence on the association between atopic dermatitis (AD) and linear growth in children in current literature is inconsistent. Some studies have suggested that the presence of AD may negatively impact height, while other studies have not reported similar associations. This systematic review aims to evaluate the association between AD and linear growth in children, and determine factors that may be potentially associated with compromised linear growth in children with AD.

Methods: A PRISMA-compliant systematic review was conducted. Databases included in the review were PubMed, Embase, Scopus and Cochrane. The search timeline was from database inception to June 2024. Inclusion criteria includes articles that reported a quantitative relationship between AD and linear growth in children (<18 years old). The quality of included articles was assessed using the Joanna Briggs Institute Critical Appraisal Tools, while quality of evidence in these studies was evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. A meta-analysis was not performed due to significant clinical and methodological heterogeneity between the studies that met inclusion criteria.

Results: Fourteen studies which comprises 50,146 patients with AD were included. Seven studies reported either a “strong positive” or “positive” association between AD and reduced height standard deviation score (SDS) in children; the remaining 7 studies reported no association between AD and height. Only 3 of the 14 studies had moderate quality of evidence, all of which had reported an association between AD and poorer height SDS; while the remaining 11 studies scored low in quality of evidence. Three studies reported the impact of AD on height to be transient, mimicking constitutional growth delay. In addition, severity of AD, timing of onset of AD, sleep disruption and extent of nutritional restrictions are important risk factors for linear growth impairment in patients with AD. Topical steroid use did not appear to be associated with shorter stature in patients with AD.

Conclusions: The evidence at present reporting on the association between childhood AD and poor linear growth is weak and inconsistent. However, patients with more severe AD, earlier disease onset, poorer sleep quality and higher nutritional restrictions appear more susceptible to linear growth impairment. Therefore, management of patients with AD should not only be focused on treatment and control of the disease, but also on optimizing growth, nutrition, sleep and quality of life.