TY - JOUR
T1 - Investigating causal relationships between obesity and skin barrier function in a multi-ethnic Asian general population cohort
AU - Yew, Yik Weng
AU - Mina, Theresia
AU - Ng, Hong Kiat
AU - Lam, Benjamin Chih Chiang
AU - Riboli, Elio
AU - Lee, Eng Sing
AU - Lee, Jimmy
AU - Ngeow, Joanne
AU - Elliott, Paul
AU - Thng, Steven Tien Guan
AU - Chambers, John C.
AU - Loh, Marie
N1 - Publisher Copyright:
© 2023, The Author(s).
PY - 2023/10
Y1 - 2023/10
N2 - Background: Skin diseases impact significantly on the quality of life and psychology of patients. Obesity has been observed as a risk factor for skin diseases. Skin epidermal barrier dysfunctions are typical manifestations across several dermatological disturbances. Objectives: We aim to establish the association between obesity and skin physiology measurements and investigate whether obesity may play a possible causal role on skin barrier dysfunction. Methods: We investigated the relationship of obesity with skin physiology measurements, namely transepidermal water loss (TEWL), skin surface moisture and skin pH in an Asian population cohort (n = 9990). To assess for a possible causal association between body mass index (BMI) and skin physiology measurements, we performed Mendelian Randomization (MR), along with subsequent additional analyses to assess the potential causal impact of known socioeconomic and comorbidities of obesity on TEWL. Results: Every 1 kg/m2 increase in BMI was associated with a 0.221% (95%CI: 0.144–0.298) increase in TEWL (P = 2.82E–08), a 0.336% (95%CI: 0.148–0.524) decrease in skin moisture (P = 4.66E–04) and a 0.184% (95%CI: 0.144–0.224) decrease in pH (P = 1.36E–19), adjusting for age, gender, and ethnicity. Relationships for both TEWL and pH with BMI remained strong (Beta 0.354; 95%CI: 0.189–0.520 and Beta –0.170; 95%CI: –0.253 to –0.087, respectively) even after adjusting for known confounders, with MR experiments further supporting BMI’s possible causal relationship with TEWL. Based on additional MR performed, none of the socioeconomic and comorbidities of obesity investigated are likely to have possible causal relationships with TEWL. Conclusion: We establish strong association of BMI with TEWL and skin pH, with MR results suggestive of a possible causal relationship of obesity with TEWL. It emphasizes the potential impact of obesity on skin barrier function and therefore opportunity for primary prevention.
AB - Background: Skin diseases impact significantly on the quality of life and psychology of patients. Obesity has been observed as a risk factor for skin diseases. Skin epidermal barrier dysfunctions are typical manifestations across several dermatological disturbances. Objectives: We aim to establish the association between obesity and skin physiology measurements and investigate whether obesity may play a possible causal role on skin barrier dysfunction. Methods: We investigated the relationship of obesity with skin physiology measurements, namely transepidermal water loss (TEWL), skin surface moisture and skin pH in an Asian population cohort (n = 9990). To assess for a possible causal association between body mass index (BMI) and skin physiology measurements, we performed Mendelian Randomization (MR), along with subsequent additional analyses to assess the potential causal impact of known socioeconomic and comorbidities of obesity on TEWL. Results: Every 1 kg/m2 increase in BMI was associated with a 0.221% (95%CI: 0.144–0.298) increase in TEWL (P = 2.82E–08), a 0.336% (95%CI: 0.148–0.524) decrease in skin moisture (P = 4.66E–04) and a 0.184% (95%CI: 0.144–0.224) decrease in pH (P = 1.36E–19), adjusting for age, gender, and ethnicity. Relationships for both TEWL and pH with BMI remained strong (Beta 0.354; 95%CI: 0.189–0.520 and Beta –0.170; 95%CI: –0.253 to –0.087, respectively) even after adjusting for known confounders, with MR experiments further supporting BMI’s possible causal relationship with TEWL. Based on additional MR performed, none of the socioeconomic and comorbidities of obesity investigated are likely to have possible causal relationships with TEWL. Conclusion: We establish strong association of BMI with TEWL and skin pH, with MR results suggestive of a possible causal relationship of obesity with TEWL. It emphasizes the potential impact of obesity on skin barrier function and therefore opportunity for primary prevention.
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U2 - 10.1038/s41366-023-01343-z
DO - 10.1038/s41366-023-01343-z
M3 - Article
C2 - 37479793
AN - SCOPUS:85165245001
SN - 0307-0565
VL - 47
SP - 963
EP - 969
JO - International Journal of Obesity
JF - International Journal of Obesity
IS - 10
ER -
