Hidradenitis suppurativa and metabolic syndrome: a comparative cross-sectional study of 3207 patients

Background Hidradenitis suppurativa (HS) is a chronic relapsing inflammatory skin disease. Objectives To evaluate the association between HS and metabolic syndrome and its component morbidities in a large, community-based cohort of patients with HS, using the database of Clalit Health Services, the largest public healthcare provider in Israel. Methods A cross-sectional study was performed. Metabolic syndrome was defined as the presence of at least three of the following conditions: diabetes, hyperlipidaemia, hypertension and obesity. The association between HS and metabolic syndrome was assessed by a multivariate logistic regression model, adjusting for age, sex, diabetes, hypertension, hyperlipidaemia, obesity and smoking status. Results The study included 3207 patients with HS (general frequency of 0.07%) diagnosed by a dermatologist in primary-care centres, and 6412 age- and sex-matched control patients without HS. HS was significantly associated with metabolic syndrome [odds ratio (OR) 1.61, 95% confidence interval (CI) 1.36- 1.89], diabetes (OR 1.41, 95% CI 1.19-1.66), obesity (OR 1.71, 95% CI 1.53-1.91), hyperlipidaemia (OR 1.14, 95% CI 1.02-1.28) and hypertension (OR 1.19, 95% CI 1.03-1.38). Conclusions We found an association between HS and diabetes, hyperlipidaemia, obesity, hypertension and metabolic syndrome among a large community-based cohort of patients with HS. Clinicians should take into account that patients with HS may have one or more undiagnosed components of metabolic syndrome despite their young age. Thus, appropriate targeted screening is advised.