Screening for Diabetes Mellitus in Patients with Hidradenitis Suppurativa—A Monocentric Study in Germany

Abstract

Hidradenitis suppurativa (HS) is a chronic skin disease that is often associated with metabolic disorders. Diabetes mellitus (DM) is a frequent comorbidity in HS. There is currently no established screening for DM in HS patients. The aim of our study was to identify high-risk groups of HS patients that develop DM and to assess the frequency of different types of DM present in HS patients. To do so, we conducted a monocentric study in 99 patients with HS. All patients underwent detailed clinical and laboratory assessments, including the determination of glycated hemoglobin. Among the 20.2% of patients that presented with DM, type 2 was by far the most prevalent (19 out of 20 patients). Moreover, male gender, age, BMI, Hurley stage, modified Hidradenitis Suppurativa Score (mHSS), DLQI and hypertension all correlated with the glycated hemoglobin levels in the HS patients. In the multivariable analysis, Hurley stage III, older age, and higher BMI were significantly associated with DM. Specifically, patients at Hurley stage III were at a 5.3-fold increased risk of having DM type II compared to patients at earlier Hurley stages. Since many of the HS patients had not been diagnosed, our study reveals shortcomings in the screening for DM and suggest that this should be routinely performed in HS patients at high risk to avoid secondary complications.

Haptoglobin is an independent marker for disease severity and risk for metabolic complications in hidradenitis suppurativa: A prospective study

“…Indeed, it is well-established that a disproportionately high number of HS patients suffer from obesity, metabolic syndrome, and insulin resistance. 2,3,24 Future studies into Hp-phenotyping might provide a mechanistic link between the prevalence of these metabolic alterations and HS pathogenesis. Hp consists of a light α chain and a heavy beta chain.…”

“…The most common comorbidities in our HS collective were obesity (59.5%), hypertension (29.8%) and diabetes mellitus (19.8%). Indeed, it is well‐established that a disproportionately high number of HS patients suffer from obesity, metabolic syndrome, and insulin resistance 2,3,24 . Future studies into Hp‐phenotyping might provide a mechanistic link between the prevalence of these metabolic alterations and HS pathogenesis.…”

“…Nonetheless, pathogenesis of HS remains largely unknown. Importantly, HS is strongly associated with obesity, metabolic syndrome, insulin resistance and cardiovascular diseases 2,3 . Moreover, multiple connections between HS, environmental factors, meta‐inflammation and different hormonal diseases are currently discussed 4,5 …”

“…1 Nonetheless, pathogenesis of HS remains largely unknown.Importantly, HS is strongly associated with obesity, metabolic syndrome, insulin resistance and cardiovascular diseases. 2,3 Moreover, multiple connections between HS, environmental factors, meta-inflammation and different hormonal diseases are currently discussed. 4,5 Notably, therapeutic decisions for the management of HS strongly depend on the severity of the disease, which currently can be quantified using different classification systems…”

Hidradenitis Suppurativa: An Interdisciplinary Problem in Dermatology, Gynecology, and Surgery—Pathogenesis, Comorbidities, and Current Treatments

“…Those with Hurley III classification exhibit a 5.3-fold heightened susceptibility to developing DM compared to individuals classified as Hurley I and II. As a parallel observation, it appears that addressing diabetes mellitus can also lead to an amelioration of HS symptoms, particularly in certain patients [ 6 ].…”