The relationship between insulin resistance and disease severity and duration in atopic dermatitis patients

Introduction: Atopic dermatitis is a chronic reccurent inflammatory skin disease characterized by itching, eczema, sleep disturbance and associated with infectious, allergic and psychiatric comorbidities. Aim of this study is to investigate the relationship between insulin resistance and disease severity and duration in atopic dermatitis patients. Materials and Methods: 32 atopic dermatitis patients, aged between 5-61, who applied to the dermatology outpatient clinic of hospital of Bezmialem Vakif University between 1.9.2022 and 1.10.2023, were included in the study. The patients' anamnesis notes, height and weight physical examination information, body mass index (BMI), SCORAD (Severity scoring of atopic dermatitis) and EASI (Eczema area and severity index) values, laboratory values, HOMA-IR( Homeostatic model assessment of insulin resistance), HbA1C, serum triglycerides, HDL, total IgE values were recorded. Patients with a SCORAD value below 25 were classified as mild, between 25-50 as moderate, and above 50 as severe atopic dermatitis. HOMA-IR values above 2,5 were considered insulin resistance. Results: The average HOMA-IR was 2,16 in moderate and severe atopic dermatitis patients, while the average HOMA-IR was 1,62 in mild atopic dermatitis patients. The average SCORAD was 44,78 in children patient with high HOMA-IR values, while the average SCORAD was 41,2 in those with HOMA-IR below 2,5. While the average disease duration of patients with high HOMA-IR values was 120 months, the average disease duration of patients with low HOMA-IR values was 135 months. The average disease duration of all patients was 132 months. There was no significant difference between disease durations of different disease severities. It was determined that %25 (n=8) of our patients have been diagnosed with clinical depression and had medical treatment. Conclusion: There was no statistically significant difference in insulin resistance between moderate-severe atopic dermatitis patients and mild AD patients. However, we found higher mean HOMA-IR and BMI values in the first group than in the second group. This suggests that patients with moderate and severe atopic dermatitis may be more prone to insulin resistance and obesity. Althought not with a statistically significant difference, we also found that the mean SCORAD value was higher in children with higher HOMA-IR values. Insulin resistance may increase the severity of disease in pediatric atopic dermatitis patients. Prolonged disease duration did not increase the severity of atopic dermatitis or insulin resistance. It was determined that the diagnosis and treatment of clinical depression was more common in atopic dermatitis patients than in the healthy population. Insulin resistance in patients receiving systemic treatment was significantly lower than those receiving only topical treatment. Keywords: Atopic dermatitis, insulin resistance