Kim Seong Rae, Koh Seong-Joon, Park Hyunsun
Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
Br J Dermatol. 2025 Feb 18;192(3):430-439. doi: 10.1093/bjd/ljae414.
The effects of childhood obesity or weight gain on the development of early-onset follicular occlusion triad (FOT), which includes hidradenitis suppurativa (HS), acne conglobata (AC) and dissecting cellulitis of the scalp (DCS) in children, remain unknown.
To investigate the association between body mass index (BMI) and changes in BMI and the development of early-onset FOT in children.
This nationwide population-based longitudinal cohort study included a cohort of 2 012 928 Korean children who underwent two consecutive health examinations at 30-36 months and 42-48 months of age, respectively, between 2009 and 2020. BMI and changes in BMI were derived during these health screenings. We performed multivariate Cox proportional hazards regression analyses to estimate the risk of early-onset FOT, including HS, AC and DCS.
During follow-up, 1283 FOT events, including 143 cases of HS, 1068 cases of AC and 72 cases of DCS, were identified. Children with obesity had an elevated risk of early-onset FOT than those with a normal weight [FOT: adjusted hazard ratio (aHR) 1.49, 95% confidence interval (CI) 1.21-1.84; HS: aHR 2.30, 95% CI 1.39-3.82; AC: aHR 1.36, 95% CI 1.07-1.73]. BMI gain was correlated with an elevated risk of early-onset FOT, particularly HS, whereas BMI loss was linked to a decreased risk of early-onset FOT, especially HS. Children who developed obesity had an increased risk of early-onset FOT (aHR 1.51, 95% CI 1.07-2.14) vs. those who maintained a normal weight. Children with obesity who reduced to a normal weight exhibited a decreased risk of early-onset FOT [FOT: aHR 0.41, 95% CI 0.17-0.96 (Ptrend = 0.02); HS: Ptrend = 0.05] than children with obesity who retained their weight.
Childhood obesity is associated with an elevated risk of early-onset FOT, including HS and AC. Weight gain is correlated with an increased risk of early-onset FOT, especially HS, while weight loss is associated with a decreased risk of early-onset FOT, particularly HS. Implementing purposeful weight-reduction strategies may be helpful in preventing the development of early-onset FOT.
儿童肥胖或体重增加对早发性毛囊闭锁三联征（FOT）发展的影响尚不清楚，早发性毛囊闭锁三联征包括儿童化脓性汗腺炎（HS）、聚合性痤疮（AC）和头皮穿掘性蜂窝织炎（DCS）。
研究儿童体重指数（BMI）及其变化与早发性FOT发展之间的关联。
这项基于全国人群的纵向队列研究纳入了2012928名韩国儿童，他们在2009年至2020年间分别在30 - 36个月和42 - 48个月龄时接受了两次连续的健康检查。在这些健康筛查中得出BMI及其变化情况。我们进行了多变量Cox比例风险回归分析，以估计早发性FOT（包括HS、AC和DCS）的风险。
在随访期间，共识别出1283例FOT事件，包括143例HS、1068例AC和72例DCS。肥胖儿童发生早发性FOT的风险高于体重正常的儿童[FOT：调整后风险比（aHR）1.49，95%置信区间（CI）1.21 - 1.84；HS：aHR 2.30，95%CI 1.39 - 3.82；AC：aHR 1.36，95%CI 1.07 - 1.73]。BMI增加与早发性FOT风险升高相关，尤其是HS，而BMI降低与早发性FOT风险降低相关，尤其是HS。与体重保持正常的儿童相比，发生肥胖的儿童早发性FOT风险增加（aHR 1.51，95%CI 1.07 - 2.14）。肥胖儿童体重降至正常后，早发性FOT风险降低[FOT：aHR 0.41，95%CI 0.17 - 0.96（P趋势 = 0.02）；HS：P趋势 = 0.05]，低于体重未变的肥胖儿童。
儿童肥胖与早发性FOT（包括HS和AC）风险升高相关。体重增加与早发性FOT风险增加相关，尤其是HS，而体重减轻与早发性FOT风险降低相关，尤其是HS。实施有针对性的减重策略可能有助于预防早发性FOT的发生。
