Features of body composition in children with atopic dermatitis and different physical development
PEDIATRICS
Abstract
Introduction. Atopic dermatitis is one of the most common dermatological diseases in children
and adolescents. Like any chronic disease requiring dietary restrictions, it can affect physical development
and nutritional status. Aim— to identify features of body composition in children with atopic dermatitis and
different nutritional status based on the body mass index (BMI) Z-score. Materials and methods. This singlecenter,
cross-sectional cohort study included 74 patients with atopic dermatitis aged 6 to 17 years 11 months
(mean age 13.6 years), comprising 40 (54%) boys and 34 (46%) girls. Physical development was assessed using
Z-scores. Nutritional status was initially evaluated using the BMI Z-score. Body composition was subsequently
determined using bioimpedance analysis. Results. According to the SCORAD index, a moderate disease course
was observed in 59 patients (78%; more frequently in the second childhood and adolescent periods), and a severe
course in 15 patients (22%). Satisfactory nutritional status was found in 48 children (66%), obesity in 3 (4%), and
overweight in 10 (14%). Undernutrition of varying degrees was detected in 12 patients (16%). In the group with
undernutrition, body composition was characterized by a deficit in active cell mass (%ACM) in 66.7%, adequate
fat mass (%FM), and a moderate excess of skeletal muscle mass (%SMM) in all children with a BMI Z-score <–1.
Among overweight patients, %FM exceeded the norms in 20% and was sharply exceeded in 60%, while %ACM was
within age norms in 70%, as was %SMM in 50%. All obese patients had a sharp excess of %FM; among them, 25%
had a deficit in both %ACM and %SMM against the background of this excess. Notably, one-third (27%) of children
with satisfactory nutritional status according to BMI Z-score had a sharp excess of %FM, and another 18% had
an excess relative to sex- and age-specific norms. Only one-third of children with average BMI Z-score values
demonstrated normal levels of %ACM, %SMM, and %FM. Conclusions. Based on the BMI Z-score, satisfactory
nutritional status was observed in two-thirds of children with atopic dermatitis (66%), while 13% had deficient
and 21% had excess nutritional status or obesity. In each nutritional status group, patients were identified with
excessive fat accumulation accompanied by reduced active cellular and skeletal muscle mass. These alterations
in body composition began even with satisfactory nutritional status and were more frequent among adolescents
and young adults with severe skin lesions according to the SCORAD index.
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