Prevalence of Metabolic Syndrome and its components in a Brazilian sample of pemphigus patients

Abstract

BACKGROUNDPemphigus foliaceus and pemphigus vulgaris are endemic in the northeastern region of São Paulo State, Brazil. They are treated mainly with systemic corticosteroids, which may provoke osteoporosis; atherosclerosis, higher blood pressure, insulin resistance, glucose intolerance, hyperlipidemia and abdominal obesity. These side effects of corticoids also constitute criteria for the diagnosis of metabolic syndrome.OBJECTIVEThe prevalence of metabolic syndrome and each component of metabolic syndrome in Pemphigus foliaceus and pemphigus vulgaris groups was compared with Brazilian casuistic samples.METHODSData of 147 patients (pemphigus foliaceus 48.9% and pemphigus vulgaris 51.1%) were compiled from medical records regarding metabolic syndrome and its components, and included in the analysis.RESULTSThere was no significant difference regarding the prevalence of metabolic syndrome in pemphigus groups compared with the Brazilian casuistic samples. The analysis of each component of metabolic syndrome showed a higher prevalence of: higher blood pressure in male subjects with pemphigus vulgaris, and in pemphigus foliaceus in both genders; diabetes mellitus in both genders for pemphigus vulgaris and pemphigus foliaceus; obesity in females for pemphigus vulgaris and pemphigus foliaceus, and hypertriglyceridemia in both genders for pemphigus vulgaris and pemphigus foliaceus groups that were statistically significant compared to the Brazilian reports. Furthermore, the study noted a higher incidence of cardiovascular events in both genders in pemphigus foliaceus and pemphigus vulgaris groups than in Brazilian casuistic samples.CONCLUSIONThe components of metabolic syndrome are more numerous in pemphigus when compared with Brazilian casuistic samples. Future studies are necessary to assure that metabolic syndrome may be associated with pemphigus per se, including a greater casuistic sample of patients who have not taken corticoids.

Incidence and death rate of pemphigus vulgaris and pemphigus foliaceus in Korea: A nationwide, population‐based study (2006–2015)

“…However, the increased incidence of PV and PF in individuals with metabolic conditions was reported here. A previous Brazilian study showed that patients with pemphigus had an increased risk of metabolic syndrome because of steroid treatment of pemphigus . In our study, the incidence of PV and PF was increased in individuals with hypertension, dyslipidemia and diabetes mellitus.…”

“…A previous Brazilian study showed that patients with pemphigus had an increased risk of metabolic syndrome because of steroid treatment of pemphigus. 36 In our study, the incidence of PV and PF was increased in individuals with hypertension, dyslipidemia and diabetes mellitus. Considering that the side-effects of glucocorticoids include osteoporosis, atherosclerosis, increased blood pressure, insulin resistance, glucose intolerance, hyperlipidemia and central obesity, the importance of comorbid metabolic diseases in PF and PV individuals should be emphasized.…”

Comorbidities and inpatient mortality for pemphigus in the U.S.A.

“…Cardiovascular disease has recently been shown to be associated with pemphigus . Excess cardiovascular risk may be due to chronic inflammation, decreased physical activity secondary to itch and pain, as found in other inflammatory skin disorders, or use of systemic corticosteroids.…”

“…Identification and management of the comorbidities of pemphigus are critically important to decrease disease‐associated morbidity and mortality. In various cohort studies and case reports, pemphigus has been associated with cardiovascular diseases such as type 2 diabetes mellitus and hyperlipidaemia; infections; various autoimmune diseases, such as autoimmune thyroiditis and the inflammatory bowel diseases; side‐effects from long‐term steroid use such as decreased bone mineral density and adrenal insufficiency; and malignancies and psychiatric comorbidities . Many of these studies had conflicting results about certain comorbidities and were limited by small sample sizes, which resulted in insufficient statistical power.…”

Validation of database search strategies for the epidemiological study of pemphigus and pemphigoid

“…Dear Editor , Previous studies have explored the epidemiology of autoimmune blistering disease (AIBD), but all have been limited to single centres with cohorts that typically have at most a few 100 patients . In order to truly understand the epidemiology of AIBD, evaluation of large‐scale datasets that are representative of the broader population is needed.…”