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A large cohort study of Danish children has found that the lightest and heaviest infants are at elevated risk of later developing hidradenitis suppurativa (HS), though height did not impact future risk of the skin condition.
The paper, published online ahead of print in JAMA Dermatology (Apr. 29, 2020) looked at data on 347,200 schoolchildren from the Copenhagen School Health Records Register, who had been born from 1930 to 1996. This data was then compared to data in the Danish National Patient Register of hospital discharge diagnoses to identify cases of HS.
Information on birth weight was reported by parents or guardians, while childhood weight and height were measured by school physicians or nurses at ages seven through 13 years.
The investigators found that during the follow-up period from 1977 to 2017, 1,037 individuals (677 females; median age at diagnosis, 39 years [range, 15 to 73 years]) received a diagnosis of HS.
They found a U-shaped, nonlinear association between birth weight and HS, such that both the lightest and heaviest babies (2.00-2.75 kg; hazard ratio (HR), 1.36 [95% CI, 1.10-1.68], and 4.26-5.50 kg; HR, 1.39 [95% CI, 1.01-1.93], respectively) had increased risks of HS compared to normal-weight babies (3.26-3.75 kg; p=0.04 for deviation from linearity).
The risk of HS increased significantly with increasing BMI z score at each age from seven to 13 years, from an HR of 1.32 (95% CI, 1.24-1.40) per body mass index (BMI) z score at seven years of age to an HR of 1.50 (95% CI, 1.40-1.61) per BMI z score at 13 years of age.
Children with a normal weight at seven years of age but who were overweight at 13 years of age had a significantly increased risk of HS (HR, 2.11 [95% CI, 1.63-2.74]) compared to children who had normal weight at ages seven and 13. Those who were persistently overweight at both ages also had an increased risk of HS (HR, 2.61 [95% CI, 2.02-3.38]). In contrast, children who were overweight at seven years of age but had normal weight at 13 years of age did not have a significantly increased risk of HS (HR, 1.05 [95% CI, 0.67-1.67]).
Childhood height at all ages was not associated with risk of HS.
The authors write in the paper that their findings show: “Early body weight monitoring provides the opportunity to implement preventive measures aimed at reducing body mass index and development of hidradenitis suppurativa.”