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  • Population Study Article
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Sex and obesity status modify the association between vitamin D and eczema among adolescents

Pediatric Research volume 94, pages 1235–1242 (2023)Cite this article

Abstract

Background

Epidemiologic studies have reported inconsistent associations between vitamin D and eczema. This study sought to assess whether sex and obesity status could modify the association between vitamin D and eczema.

Methods

A cross-sectional study enrolled 763 adolescents in Kuwait. 25-hydroxyvitamin D (25(OH)D) was measured in venous blood. Current eczema was defined according to clinical history and characteristic morphology and distribution.

Results

In sex-stratified analysis, decreased 25(OH)D levels were associated with increased current eczema prevalence among males (adjusted odds ratio (aOR)tertile 1 vs. tertile 3: 2.14, 95% confidence intervals (CI): 1.07–4.56), but not among females (aORtertile 1 vs. tertile 3: 1.08, 95% CI: 0.71–1.66). Further stratification by obesity status showed that lower 25(OH)D levels were associated with increased current eczema prevalence among overweight/obese males (per 10-unit decrease in 25(OH)D levels: aOR: 1.70, 95% CI: 1.17–2.46). Such an association was weaker and statistically non-significant among overweight/obese females (per 10-unit decrease in 25(OH)D levels: aOR: 1.26, 95% CI: 0.93–1.70).

Conclusions

Sex and obesity status modified the association between vitamin D levels and eczema, with an inverse association observed among overweight/obese males, but not among overweight/obese females. These results suggest that preventive and clinical management strategies could vary by sex and obesity status.

Impact

  • The current study showed that sex and obesity modify the association between vitamin D and eczema among adolescents.

  • An inverse association between vitamin D and eczema was observed among overweight/obese males, but this association was not as pronounced among overweight/obese females.

  • Vitamin D was not associated with eczema among underweight/normal weight males and females.

  • The identification of effect modification by sex and obesity status add to the current scientific knowledge and further highlight the complexity of the association between vitamin D and eczema.

  • These results may promote a more individualized approach to the future prevention and clinical management of eczema.

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Fig. 1: Levels of 25-hydroxyvitamin D (nmol/L) in the total study sample and according to sex and obesity status (underweight/normal weight and overweight/obese).
Fig. 2: Levels of 25-hydroxyvitamin D (nmol/L) according to current eczema status (yes/no) in the total study sample, according to sex, according to obesity status (underweight/normal weight and overweight/obese), and according to both sex and obesity status.
Fig. 3: Predicted probabilities of eczema based on 25-hydroxyvitamin D (nmol/L) levels according to sex and obesity status (underweight/normal weight and overweight/obese), and adjusted odds ratios (aOR) of current eczema per 10-unit decrease in 25-hydroxyvitamin D (nmol/L) levels.

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Data availability

The data that support the findings of this study are available from the corresponding authors [AHZ and/or AA-T] upon reasonable request.

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Acknowledgements

We would like to thank Ms Nadien Rushdi for the coordination of data collection. We would like also to thank schoolchildren and their parents and the staff at the different schools for their cooperation.

Funding

The data for this study were partially collected in the project no. WF 02/13, which was funded by Kuwait University, Research Sector.

Author information

Authors and Affiliations

  1. Department of Community Medicine and Behavioral Sciences, College of Medicine, Kuwait University, Safat, Kuwait

    Ali H. Ziyab, Reem Al-Sabah, Zainab Almousa & Anwar H. AlBaloul

  2. School of Community and Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, VA, USA

    Abdullah Al-Taiar

  3. Department of Food Science and Nutrition, College of Life Sciences, Kuwait University, Safat, Kuwait

    Lemia Shaban

  4. Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Memphis, TN, USA

    Wilfried Karmaus

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  1. Ali H. Ziyab
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  2. Abdullah Al-Taiar
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Contributions

A.H.Z.: conceptualized the epidemiologic study, analyzed and interpreted the data, contributed to data acquisition, and drafted the manuscript. A.A.-T.: conceived, designed, and planned the study, contributed to data analysis and interpretation, data acquisition and curation, funding acquisition, project administration, contributed to drafting the manuscript, and critically revised the manuscript. R.A.-S.: contributed to conception and design of the study, contributed to data acquisition, contributed to data interpretation, and critically revised the manuscript. L.S.: contributed to conception and design of the study, contributed to data acquisition, contributed to data interpretation, and critically revised the manuscript. Z.A.: contributed to conception and design of the study, contributed to data interpretation, contributed to drafting the manuscript, and critically revised the manuscript. A.H.A.-B.: contributed to conception and design of the study, contributed to data acquisition, contributed to data interpretation, and critically revised the manuscript. W.K.: contributed to conception and design of the study, contributed to data interpretation, and critically revised the manuscript. All authors critically revised the manuscript for important intellectual content. The manuscript has been read and approved by all authors.

Corresponding authors

Correspondence to Ali H. Ziyab or Abdullah Al-Taiar.

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Competing interests

The authors declare no competing interests.

Ethical Approval and Consent Statement

Ethical approvals were obtained from the Ethics Committee at the Health Sciences Center, Kuwait University (no. DR/EC/2338) and the Standing Committee for Coordination of Health and Medical Research, Ministry of Health, Kuwait (no. 2015/248). Written informed consent was obtained from the parents and verbal assents from the adolescents.

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Ziyab, A.H., Al-Taiar, A., Al-Sabah, R. et al. Sex and obesity status modify the association between vitamin D and eczema among adolescents. Pediatr Res 94, 1235–1242 (2023). https://doi.org/10.1038/s41390-023-02641-y

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