Table 2.
Association between moderate to severe atopic dermatitis and lifestyle factors using univariate and multivariate binary logistic regression analysis.
| Model 1 b | Model 2 c | Model 3 d | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Binary logistic regression a | Non‐AD in lifetime, n (%) (N = 51 174) | Moderate to severe AD, n (%) (N = 1288) | Crude OR (95% CI e ) | P e | aOR (95% CI) | P | aOR (95% CI) | P | aOR (95% CI) | P |
| Age, years; mean ± SD | 56.1 ± 12.1 | 51.1 ± 12.4 | 0.97 (0.96–0.97) | < 0.001 | 0.97 (0.97–0.97) | < 0.001 | 0.98 (0.97–0.98) | < 0.001 | 0.98 (0.97–0.98) | < 0.001 |
| Sex | ||||||||||
| Male | 20 956 (41.0) | 386 (30.0) | 1 | – | 1 | – | 1 | – | 1 | – |
| Female | 30 218 (59.0) | 902 (70.0) | 1.62 (1.44–1.83) | < 0.001 | 1.51 (1.34–1.70) | < 0.001 | 1.24 (1.09–1.40) | 0.001 | 1.21 (1.04–1.41) | < 0.02 |
| Hand eczema | ||||||||||
| No | 45 172 (88.8) | 530 (41.3) | 1 | – | 1 | – | 1 | – | 1 | – |
| Yes | 5714 (11.2) | 753 (58.7) | 11.23 (10.01–12.59) | < 0.001 | 10.35 (9.22–11.62) | < 0.001 | 10.05 (8.94–11.28) | < 0.001 | 9.61 (8.43–10.95) | < 0.001 |
| Asthma | ||||||||||
| No | 47 474 (93.0) | 1011 (78.7) | 1 | – | 1 | – | 1 | – | 1 | – |
| Yes | 3575 (7.0) | 273 (21.3) | 3.59 (3.12–4.12) | < 0.001 | 3.28 (2.86–3.77) | < 0.001 | 2.95 (2.55–3.42) | < 0.001 | 3.03 (2.57–3.57) | < 0.001 |
| Smoking | ||||||||||
| Smoking status | < 0.001 | 0.25 | 0.34 | 0.90 | ||||||
| Never smoker | 23 553 (46.8) | 612 (49.2) | 1 | – | 1 | – | 1 | – | 1 | – |
| Former smoker | 18 598 (37.0) | 388 (31.2) | 0.80 (0.71–0.91) | 0.001 | 1.04 (0.91–1.19) | 0.54 | 1.00 (0.87–1.15) | 0.99 | 1.05 (0.90–1.23) | 0.55 |
| Current smoker | 8144 (16.2) | 245 (19.7) | ||||||||
| Cigarettes/day | ||||||||||
| > 0–7.9 | 3219 (6.4) | 94 (7.6) | 1.12 (0.90–1.40) | 0.30 | 1.10 (0.88–1.37) | 0.55 | 1.15 (0.91–1.44) | 0.24 | 1.11 (0.85–1.43) | 0.45 |
| 8–15 | 3461 (6.9) | 108 (8.7) | 1.20 (0.98–1.48) | 0.08 | 1.23 (1.00–1.51) | 0.41 | 1.20 (0.97–1.49) | 0.10 | 1.10 (0.86–1.41) | 0.45 |
| > 15 | 1464 (2.9) | 43 (3.5) | 1.13 (0.83–1.55) | 0.44 | 1.25 (0.91–1.71) | 0.05 | 1.17 (0.84–1.62) | 0.35 | 1.07 (0.73–1.57 | 0.75 |
| Pack‐years | ||||||||||
| 0 | 23 552 (48.0) | 612 (50.6) | 1 | – | 1 | – | 1 | – | 1 | – |
| ≤ 15 | 18 286 (37.3) | 425 (35.2) | 0.89 (0.79–1.01) | 0.08 | 1.001 (0.89–1.15) | 0.871 | 0.98 (0.86–1.12) | 0.79 | 1.00 (0.86–1.16) | 0.98 |
| > 15 | 7189 (14.7) | 172 (14.2) | 0.92 (0.78–1.09) | 0.34 | 1.37 (1.14–1.64) | 0.001 | 1.32 (1.09–1.59) | < 0.01 | 1.25 (1.01–1.54) | < 0.05 |
| Alcohol consumption, drinks/day | 0.001 | 0.01 | < 0.01 | 0.01 | ||||||
| 0 (nondrinker) | 9849 (20.8) | 267 (22.3) | 1 | – | 1 | – | 1 | – | 1 | – |
| ≤ 1 (light drinker) | 23 768 (50.1) | 634 (53.0) | 0.98 (0.85–1.14) | 0.83 | 1.01 (0.87–1.17) | 0.93 | 1.01 (0.87–1.18) | 0.87 | 1.01 (0.85–1.21) | 0.89 |
| > 1–2 (moderate drinker) | 10 160 (21.4) | 196 (16.4) | 0.71 (0.59–0.86) | < 0.001 | 0.87 (0.72–1.05) | 0.14 | 0.88 (0.72–1.07) | 0.20 | 0.86 (0.68–1.08) | 0.18 |
| > 2 (heavy drinker) | 3655 (7.7) | 99 (8.3) | 1.00 (0.79–1.26) | 0.99 | 1.31 (1.02–1.67) | 0.03 | 1.39 (1.08–1.79) | 0.01 | 1.35 (1.01–1.79) | 0.04 |
| Stress | ||||||||||
| Total LTE score | – | – | – | < 0.01 | – | < 0.01 | – | 0.21 | – | 0.29 |
| 0 | 22 684 (45.1) | 511 (40.9) | 1 | – | 1 | – | 1 | – | 1 | – |
| 1 | 13 963 (27.8) | 356 (28.5) | 1.13 (0.99–1.30) | 0.08 | 1.14 (0.99–1.31) | 0.07 | 1.08 (0.94–1.25) | 0.27 | 1.06 (0.91–1.24) | 0.46 |
| 2 | 7937 (15.8) | 208 (16.6) | 1.16 (0.99–1.37) | 0.07 | 1.16 (0.99–1.37) | 0.08 | 1.06 (0.89–1.26) | 0.51 | 0.94 (0.77–1.14) | 0.51 |
| ≥ 3 | 5698 (11.3) | 175 (14.0) | 1.36 (1.15–1.62) | < 0.001 | 1.37 (1.15–1.63) | < 0.001 | 1.21 (1.01–1.46) | 0.04 | 1.17 (0.95–1.43) | 0.14 |
| Total LDI score | – | – | – | < 0.001 | – | < 0.001 | – | < 0.001 | – | < 0.001 |
| 0 | 11 842 (23.6) | 148 (11.8) | 1 | 1 | 1 | 1 | ||||
| 1–2 | 19 897 (39.6) | 447 (35.8) | 1.80 (1.49–2.17) | < 0.001 | 1.57 (1.30–1.90) | < 0.001 | 1.43 (1.18–1.74) | < 0.001 | 1.42 (1.15–1.75) | 0.001 |
| 3–4 | 11 045 (22.0) | 331 (26.5) | 2.40 (1.97–2.92) | < 0.001 | 1.90 (1.56–2.32) | < 0.001 | 1.56 (1.27–1.92) | < 0.001 | 1.52 (1.21–1.90) | < 0.001 |
| ≥ 5 | 7487 (14.9) | 324 (25.9) | 3.46 (2.85–4.22) | < 0.001 | 2.53 (2.07–3.10) | < 0.001 | 2.00 (1.63–2.47) | < 0.001 | 1.92 (1.52–2.42) | < 0.001 |
| Obesity | ||||||||||
| BMI, kg/m2 | 0.03 | 0.01 | 0.26 | 0.23 | ||||||
| Underweight (< 18.5) | 350 (0.7) | 14 (1.1) | 1.56 (0.91–2.68) | 0.11 | 1.12 (0.65–1.93) | 0.68 | 1.22 (0.69–2.14) | 0.49 | 1.31 (0.73–2.37) | 0.37 |
| Normal weight (18.5–24.9) | 22 946 (44.9) | 588 (45.7) | 1 | – | 1 | – | 1 | – | 1 | – |
| Overweight (25–29.9) | 20 491 (40.1) | 472 (36.7) | 0.90 (0.80–1.02) | 0.09 | 1.12 (0.99–1.27) | 0.08 | 1.05 (0.93–1.20) | 0.44 | 1.03 (0.89–1.19) | 0.71 |
| Class I obesity (30–34.9) | 5676 (11.1) | 165 (12.8) | 1.13 (0.95–1.35) | 0.16 | 1.38 (1.16–1.66) | < 0.001 | 1.23 (1.02–1.47) | 0.03 | 1.25 (1.02–1.54) | 0.03 |
| Class II/III obesity (≥ 35) | 1696 (3.3) | 48 (3.7) | 1.10 (0.82–1.49) | 0.51 | 1.19 (0.88–1.60) | 0.27 | 0.97 (0.71–1.33) | 0.84 | 0.98 (0.69–1.40) | 0.91 |
| WC, cm | ||||||||||
| Male | ||||||||||
| < 102 | 15 725 (75.1) | 291 (75.6) | 1 | – | 1 | – | 1 | – | 1 | – |
| ≥ 102 | 5226 (24.9) | 94 (24.4) | 0.97 (0.77–1.23) | 0.81 | 1.15 (0.90–1.46) | 0.27 | 1.06 (0.83–1.36) | 0.64 | 1.04 (0.79–1.38) | 0.78 |
| Female | ||||||||||
| < 88 | 17 758 (58.8) | 540 (59.9) | 1 | – | 1 | – | 1 | – | 1 | – |
| ≥ 88 | 12 450 (41.2) | 362 (40.1) | 0.96 (0.84–1.09) | 0.52 | 1.14 (0.99–1.31) | 0.06 | 1.03 (0.89–1.19) | 0.74 | 1.03 (0.87–1.21) | 0.74 |
| Physical activity, min/week | ||||||||||
| MVPA | 0.01 | 0.22 | 0.26 | 0.09 | ||||||
| 0 | 2982 (6.3) | 85 (7.3) | 1 | – | 1 | – | 1 | – | 1 | – |
| > 0–249 | 14 649 (31.1) | 401 (34.6) | 0.96 (0.76–1.22) | 0.74 | 0.90 (0.7–1.15) | 0.40 | 0.93 (0.72–1.19) | 0.54 | 1.02 (0.78–1.33) | 0.89 |
| > 249–743 | 14 690 (31.2) | 353 (30.4) | 0.84 (0.66–1.07) | 0.16 | 0.88 (0.69–1.12) | 0.29 | 0.91 (0.71–1.17) | 0.46 | 0.95 (0.72–1.25) | 0.71 |
| > 743 | 14 725 (31.3) | 321 (27.7) | 0.77 (0.60–0.97) | 0.03 | 1.02 (0.80–1.31) | 0.87 | 1.06 (0.82–1.36) | 0.67 | 1.19 (0.90–1.56) | 0.23 |
| VPA | 0.14 | 0.41 | 0.71 | 1 | 0.86 | |||||
| 0 | 7306 (15.5) | 195 (16.8) | 1 | – | 1 | – | 1 | – | 1 | – |
| > 0–120 | 14 172 (30.1) | 374 (32.2) | 0.99 (0.83–1.178) | 1.00 | 0.94 (0.79–1.12) | 0.46 | 0.95 (0.80–1.15) | 0.62 | 1.01 (0.83–1.23) | 0.95 |
| > 120–295 | 12 313 (26.2) | 290 (25.0) | 0.88 (0.73–1.06) | 0.18 | 0.86 (0.71–1.03) | 0.10 | 0.90 (0.74–1.09) | 0.27 | 0.97 (0.79–1.19) | 0.75 |
| > 295 | 13 255 (28.2) | 301 (25.9) | 0.85 (0.71–1.02) | 0.08 | 0.91 (0.76–1.10) | 0.34 | 0.97 (0.80–1.17) | 0.73 | 1.05 (0.85–1.29) | 0.66 |
| Diet | ||||||||||
| Vegetarian/vegan | ||||||||||
| No | – | – | 1 | – | 1 | – | 1 | – | 1 | – |
| Yes | 1043 (2.1) | 32 (2.6) | 1.24 (0.87–1.77) | 0.23 | 1.151 (0.1–1.65) | 0.44 | 0.89 (0.62–1.29) | 0.55 | 1.14 (0.76–1.70) | 0.53 |
| Total LLDS score | – | – | – | 0.07 | – | 0.98 | – | 0.84 | – | 0.90 |
| 0–18 | 6745 (15.1) | 194 (17.3) | 1 | – | 1 | – | 1 | – | 1 | 0.62 |
| 19–22 | 9275 (20.8) | 250 (22.3) | 0.94 (0.78–1.13) | 0.50 | 1.03 (0.85–1.25) | 0.76 | 1.04 (0.85–1.27) | 0.69 | 1.06 (0.86–1.30) | 0.61 |
| 23–25 | 8524 (19.1) | 214 (19.1) | 0.87 (0.72–1.06) | 0.18 | 1.01 (0.83–1.24) | 0.92 | 1.00 (0.81–1.23) | 0.98 | 1.06 (0.85–1.32) | 0.83 |
| 26–29 | 10 205 (22.8) | 237 (21.2) | 0.82 (0.67–0.98) | 0.03 | 0.969 (0.80–1.18) | 0.76 | 0.93 (0.76–1.15) | 0.51 | 0.98 (0.79–1.22) | 0.61 |
| 30–48 | 9936 (22.2) | 224 (20.0) | 0.78 (0.65–0.95) | 0.01 | 0.97 (0.815–1.22) | 0.92 | 1.01 (0.82–1.25) | 0.93 | 1.06 (0.85–1.33) | 0.43 |
| Sleep duration, h/day | – | – | – | 0.03 | – | 0.02 | – | 0.10 | – | 0.62 |
| ≤ 7 | 21 896 (43.4) | 552 (43.3) | 1.01 (0.90–1.13) | 0.83 | 1.15 (1.02–1.29) | 0.02 | 1.08 (0.96–1.22) | 0.21 | 1.04 (0.90–1.18) | – |
| > 7–9 | 27 903 (55.3) | 695 (54.5) | 1 | – | 1 | – | 1 | – | 1 | 0.21 |
| > 9 | 671 (1.3) | 28 (2.2) | 1.68 (1.14–2.46) | < 0.01 | 1.48 (1.00–2.18) | < 0.05 | 1.48 (0.98–2.23) | 0.06 | 1.34 (0.85–2.11) | |
AD, atopic dermatitis; BMI, body mass index; LDI, Long‐term Difficulties Inventory; LLDS, Lifelines Diet Score; LTE, List of Threatening Events; MVPA, moderate to vigorous physical activity; OR, adjusted odds ratio; VPA, vigorous physical activity; WC, waist circumference.
a
All characteristics excluding BMI and WC are self‐reported.
b
Model 1 included age and sex.
c
Model 2 included age, sex, asthma and hand eczema.
d
Model 3 included age, sex, asthma, hand eczema, smoking status, alcohol, LDI, BMI, MVPA, vegetarian/vegan, LLDS, sleep duration. Because of the overlap between variables, WC and sex, smoking status and smoking pack‐years, MVPA and VPA, and LTE and LDI were not entered at the same time in Model 3.
e
Bold type: if P < 0.05, it was considered statistically significant.