Obesity, Various Other Conditions More Likely in Patients With HS

A new study of patients with hidradenitis suppurativa (HS) is putting a spotlight on the high burden of comorbid conditions facing patients with the condition.

Fifteen years’ worth of data, collected from over 1000 patients with HS in the Rochester Epidemiology Project database, showed that the condition was associated with a greater likelihood of several comorbid conditions, compared with a control population, including psoriasis (2.1% vs 0.8%) and hypertension (14.7% vs 8.8%).

Findings were recently published online with International Journal of Dermatology.

“Our results are similar to those of prior studies demonstrating a significant burden of comorbid conditions in HS patients,” wrote the group, noting that their study is the first American population–based study of its kind. “These varied associations highlight the need for a thorough review of systems, comprehensive physical examination, and possible laboratory monitoring and specialty referrals when caring for HS patients. A discussion with the patient’s primary care physician regarding these comorbid conditions may be prudent and could translate into early management and prevention of complications.”

The researchers noted the retrospective nature of their study and that they were unable to draw associations between HS severity and comorbid conditions.

Based on the available data, the researchers found that compared with controls, patients with HS were more likely to also have various endocrine conditions, including diabetes (12.4% vs 5.7%), hyperlipidemia (14.1% vs 9.1%), polycystic ovary syndrome (1.7% vs 0.5%), and thyroid disease (6.7% vs 4.7%).

In addition, the rate of obesity was more than 3 times higher among patients with HS than among controls (19.1% vs 6.2%). According to the researchers, the link between HS and obesity may be attributed to proinflammatory cytokine release by adipose tissue. In their paper, they urged physicians to consult with their patients about weight loss to reduce their risk of cardiovascular conditions and potentially improve symptoms of HS.

“The association between HS and metabolic and endocrine conditions has been highlighted over the years. A 2019 systematic review and meta-analysis of 5 studies showed that HS patients have an increased risk of metabolic syndrome,” commented the researchers. “Other studies have also found an association between metabolic syndrome and HS. Our study showed no correlation between metabolic syndrome and HS; however, the individual components of metabolic syndrome (ie, diabetes, obesity, hyperlipidemia, and hypertension) were all significantly more common in HS patients.”

Psychiatric and behavioral issues like anxiety (12.1% vs 8.2%), depression (23.6% vs 15.3%), sleep disturbances (9.7%) vs 4.6%), and tobacco smoking (17.8% vs 6.7%) were all more common among patients with HS than among controls. The researchers noted that use of tobacco is among the most common behaviors linked with HS. For example, a previous retrospective analysis of 4 million smokers showed that smokers were twice as likely to have HS than nonsmokers. In the current study, men with HS also were more likely than women with HS to smoke and have substance use issues. Meanwhile, women with HS were more likely to have depression.

Within inflammatory and other conditions, kidney disease (4.5% vs 2.2%) and major cardiac events (0.8% vs 0.1%) were significantly more common among patients with HS while irritable bowel disease and spondyloarthropathy were not.

Reference:

Sokumbi O, Hodge DO, Ederaine SA, Alavi A, Alikhan A. Comorbid diseases of hidradenitis suppurativa: a 15-year population-based study in Olmstead County, Minnesota, USA. Int J Dermatol. Published online April 29, 2022. doi:10.1111/ijd.16228