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. 2024 Jul 1;160(7):725-731.
doi: 10.1001/jamadermatol.2024.1544.

Sodium Intake and Atopic Dermatitis

Brenda M Chiang  1 , Morgan Ye  1 , Aheli Chattopadhyay  1 , Yagmur Halezeroglu  1 , Erin L Van Blarigan  2   3 , Katrina Abuabara  1   4
Affiliations

Sodium Intake and Atopic Dermatitis

Brenda M Chiang et al. JAMA Dermatol. .

Abstract

Importance: The association of diet with atopic dermatitis (AD) remains poorly understood and could help explain heterogeneity in disease course.

Objective: To determine the extent to which a higher level of dietary sodium intake, estimated using urine sodium as a biomarker, is associated with AD in a large, population-based cohort.

Design, setting, and participants: This cross-sectional study of adult participants (aged 37-73 years) from the UK Biobank examined 24-hour urine sodium excretion, which was estimated using a single spot urine sample collected between March 31, 2006, and October 1, 2010, and calculations from the sex-specific International Cooperative Study on Salt, Other Factors, and Blood Pressure equation, incorporating body mass index; age; and urine concentrations of potassium, sodium, and creatinine. The data were analyzed between February 23, 2022, and March 20, 2024.

Exposure: The primary exposure was 24-hour urinary sodium excretion.

Main outcome and measure: The primary outcome was AD or active AD based on diagnostic and prescription codes from linked electronic medical records. Multivariable logistic regression models adjusted for age, sex, race and ethnicity, Townsend Deprivation Index, and education were used to measure the association.

Results: The analytic sample comprised 215 832 participants (mean [SD] age, 56.52 [8.06] years; 54.3% female). Mean (SD) estimated 24-hour urine sodium excretion was 3.01 (0.82) g per day, and 10 839 participants (5.0%) had a diagnosis of AD. Multivariable logistic regression revealed that a 1-g increase in estimated 24-hour urine sodium excretion was associated with increased odds of AD (adjusted odds ratio [AOR], 1.11; 95% CI, 1.07-1.14), increased odds of active AD (AOR, 1.16; 95% CI, 1.05-1.28), and increased odds of increasing severity of AD (AOR, 1.11; 95% CI, 1.07-1.15). In a validation cohort of 13 014 participants from the National Health and Nutrition Examination Survey, a 1 g per day higher dietary sodium intake estimated using dietary recall questionnaires was associated with a higher risk of current AD (AOR, 1.22; 95% CI, 1.01-1.47).

Conclusions and relevance: These findings suggest that restriction of dietary sodium intake may be a cost-effective and low-risk intervention for AD.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Abuabara has reported receiving research funding to her institution from Pfizer and Cosmetique Internacional/La Roche Posay and consulting fees from Target RWE, Sanofi, Nektar, and Amgen. No other disclosures were reported.

Figures

Figure.
Figure.. UK Biobank Participant Flowchart
aThe International Cooperative Study on Salt, Other Factors, and Blood Pressure (INTERSALT) equation variables include sex, urine potassium level, urine creatinine level, urine sodium level, body mass index, and age. bIncluding ethnicity, education, and Townsend Deprivation Index.
See this image and copyright information in PMC

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