Childhood Atopic Dermatitis Not Linked to Cardiovascular Risk in Early Adulthood

Children with atopic dermatitis (AD), even when severe or persistent, are not at increased risk for early markers of cardiovascular disease, according to a new study.¹ This challenges prior assumptions that chronic childhood inflammation from AD could elevate cardiometabolic risk in adulthood.

This longitudinal study from the United Kingdom is published in JAMA Network Open.

“The objectives of this study were to evaluate whether AD is associated with cardiovascular risk factors in children and to assess whether more active and severe AD across childhood is associated with cardiometabolic risk and subclinical atherosclerosis in early adulthood,” wrote the researchers of the study.

AD is a common chronic inflammatory skin disease that, although traditionally considered a childhood condition, affects approximately 5% to 10% of adults, with prevalence rising globally.² AD is well recognized for its link to other atopic conditions, such as asthma and allergic rhinitis, a progression known as the “atopic march.” Emerging evidence now suggests that AD may also be associated with nonallergic comorbidities, including cardiometabolic diseases.

The study analyzed data from a birth cohort that enrolled children born between 1991 and 1992. Participants included those alive at 1 year with at least 1 assessment of AD and at least 1 cardiovascular risk factor measured at any time point from childhood through early adulthood.¹ AD activity and severity were repeatedly assessed from ages 3 to 18 years, whereas cardiovascular outcomes—including cardiometabolic risk scores, body mass index, blood pressure, lipid profiles, and ultrasonographic measures of subclinical atherosclerosis—were collected up to 12 times between ages 3 and 24 years.

A total of 9281 participants were included in the analysis. Active AD prevalence varied by age, ranging from 13.1% at 3 years to 21.6% at 18 years, and 3.5% to 6.8% of participants reported moderate or severe AD at any given age. There were no associations between AD and cardiometabolic risk factors. Only 2 statistically significant associations with low-density lipoprotein (LDL) cholesterol were observed, but they differed in direction: at age 3 years, AD was associated with lower LDL (mean difference, −0.33; 95% CI, −0.58 to −0.07), whereas at age 10 years, AD was associated with slightly higher LDL (mean difference, 0.14; 95% CI, 0.03–0.24).

No dose-response relationship was found between AD severity and cardiovascular outcomes, and longitudinal patterns of more active or severe AD were not associated with subclinical atherosclerosis measured at ages 17 and 24 years.

However, the researchers noted limitations. First, this observational study is hypothesis-generating and requires validation in other populations. Second, the cohort was predominantly White and UK-based, limiting generalizability, and not all cardiovascular risk factors or changes in therapies were captured over time. Additionally, intermittent measurements and missing variables, such as waist circumference, may have limited detection of subtle cardiometabolic changes.

Despite these limitations, the researchers believe these findings indicate that neither the presence nor severity of AD across childhood and adolescence meaningfully impacts early markers of cardiovascular risk.

“Although the observed beneficial changes were relatively small in magnitude when assessed individually, these risk factor benefits may collectively contribute to the overall benefit of oral semaglutide on MACE [major adverse cardiovascular event] outcomes,” wrote the researchers.

References

1. Ye M, McCulloch CE, Iribarren C, et al. Atopic dermatitis and markers and early cardiovascular risk in children and adolescents. JAMA Netw Open. 2026;9(3):e262962. doi:10.1001/jamanetworkopen.2026.2962

2. Lee SW, Kim H, Byun Y, et al. Incidence of cardiovascular disease after atopic dermatitis development: a nationwide, population-based study. Allergy Asthma Immunol Res. 2023;15(2):231-245. doi:10.4168/aair.2023.15.2.231