Relationship between bullous pemphigoid and metabolic syndrome: a 12-year case–control study conducted in China

Abstract

Background: Hypertension, diabetes, dyslipidemia, and obesity are prevalent in patients with bullous pemphigoid (BP) and are all components of metabolic syndrome (MS). However, the prevalence of MS in patients with BP is unknown. We aimed to evaluate the relationship between MS and BP and to define the clinical and laboratory characteristics of patients with both conditions. Methods: This retrospective case–control study was conducted for 12 years at Peking Union Medical College (162 with BP and 162 age and sex-matched controls). The components of MS were analyzed and logistic regression was used to identify independent risk factors for BP. In addition, the clinical and laboratory characteristics of patients with BP ± MS were compared. Results: The prevalence of MS in patients with BP was 35.2% and that in controls was 14.8% ( p < 0.001). After adjustment for sex and age, multivariate analysis demonstrated a positive correlation between BP and MS [odds ratio (OR) 2.490, 95% confidence interval (CI) 1.040–5.963], diabetes (OR 1.870, 95% CI 1.029–3.396), and overweight or obesity (OR 1.807, 95% CI 1.026–3.182). In the BP group, participants with MS were older ( p = 0.006), were less likely to present erythema ( p = 0.028), and had higher serum C3 ( p = 0.007) and incidence of infection within 1 year of their diagnosis ( p = 0.035) than participants without MS. Conclusion: MS and its components hyperglycemia and overweight were found to be independently associated with BP. Therefore, clinicians should screen for MS in patients with BP, especially if they are older, present less erythema, or have a high serum C3.

Improvement in Cutaneous Conditions Can Benefit Some Health Conditions in the Elderly

“…The links of seborrheic dermatitis and bullous pemphigoid to neurological, metabolic and cardiovascular diseases have also been well documented. [74][75][76][77] Taken together, the bulk of evidence indicates a link between dermatoses and aging-associated disorders. Since the association of cutaneous inflammation with obesity and cognitive impairment has been fairly well summarized in previous publications, 31,46 here we only summarize the evidence of the link between dermatoses and other aging-associated disorders (Supplementary Table 1).…”

Comorbidity in bullous pemphigoid: up-date and clinical implications

“…Eighteen of the selected 48 studies discussed metabolic diseases in patients with BP (Table 2). Apart from neurologic disorders metabolic diseases such as diabetes mellitus, arterial hypertension, cardiac diseases and renal impairment appear to be associated with BP (7,40,42,43). Individuals suffering from BP showed a significantly higher prevalence of metabolic syndrome than Screening method for published studies.…”