Most associations of early-life environmental exposures and genetic risk factors poorly differentiate between eczema phenotypes: the Generation R Study
Background: Childhood eczema is variable in onset and persistence. Objectives: To identify eczema phenotypes during childhood, and their associations with early-life environmental and genetic factors. Methods: In this study of 5297 children from a multiethnic population-based prospective cohort study, phenotypes based on parent-reported physician-diagnosed eczema from age 6 months to 10 years were identified using latent class growth analysis. Information on environmental factors was obtained using postal questionnaires. Four filaggrin mutations were genotyped and a risk score was calculated based on 30 genetic variants. Weighted adjusted multinomial models were used for association analyses. Results: We identified the following five eczema phenotypes: never (76%), early transient (8%), mid-transient (6%) and late transient (8%) and persistent eczema (2%). Early transient and persistent eczema were most common in first-born children, those with a parental history of eczema, allergy or asthma and those with persistent wheezing [range of odds ratio (OR): 1.37, 95% confidence interval (CI) 1.07–1.74 and OR 3.38, 95%CI 1.95–5.85]. Early transient eczema was most common in male children only (OR 1·49, 95% CI 1·18–1·89). Children with late transient or persistent eczema were more often of Asian ethnicity (OR 2·04, 95% CI 1·14–3·65 and OR 3·08, 95% CI 1·34–7·10, respectively). Children with early, late transient and persistent eczema more often had a filaggrin mutation or additional risk alleles (range OR: 1.07, 95%CI 1.02–1.12 and OR 2.21, 95%CI 1.39–3.50). Eczema phenotypes were not associated with maternal education, breastfeeding, day care attendance and pet exposure. Conclusions: Five eczema phenotypes were identified in a multiethnic paediatric population with limited differences in risk profiles, except for sex and ethnicity.
|Persistent URL||dx.doi.org/10.1111/bjd.17879, hdl.handle.net/1765/118701|
|Journal||British Journal of Dermatology|
Hu, C. (C.), Duijts, L, Erler, N.S, Elbert, N.J, Piketty, C. (C.), Bourdès, V. (V.), … Nijsten, T.E.C. (2019). Most associations of early-life environmental exposures and genetic risk factors poorly differentiate between eczema phenotypes: the Generation R Study. British Journal of Dermatology. doi:10.1111/bjd.17879