Cumulative Inflammation and HbA1c Levels Correlate with Increased Intima-Media Thickness in Patients with Severe Hidradenitis Suppurativa

Abstract

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that has been associated with a greater risk of metabolic and cardiovascular comorbidities. The aim of this study is to assess cardiovascular risk by means of intima-media thickness (IMT), metabolic syndrome, and other potential biomarkers in patients with severe hidradenitis suppurativa who are candidates for biologic therapy and to explore potentially associated factors. A cross-sectional study was performed. Body mass index (BMI), carotid intima-media thickness (IMT), and blood tests, including glycemic and lipid profile, insulin, vitamin D, and inflammation markers were performed. Fifty patients were included in the study; the male/female ratio was 3:2. The mean age was 38 years, and the mean disease duration was 21.8 years. The mean carotid IMT was 651.39 μm. A positive association of IMT with disease duration, tobacco consumption, and HbA1c levels was observed. HbA1c correlated with the age of onset, hypertension, metabolic syndrome, and glucose levels. Vitamin D levels inversely correlated with the number of areas affected. In conclusion, patients with severe HS present a higher cardiovascular risk, but it is not distributed equally within the patients: Tobacco consumption, inadequate glycemic control, and disease duration could be useful clinical and biochemical markers to identify patients at higher risk.

Exploring the role of systemic immune‐inflammation index and neutrophil‐lymphocyte ratio in cardiovascular risk stratification for patients with hidradenitis suppurativa: A cross‐sectional study

“…of inflammation and glycemic disorders. 5 Similar results have been found for patients with psoriasis. 6 Although this technique seems to be useful, it is time-consuming and may have a large interobserver variability.…”

“…As previously described, HS is associated with an increase in cardiovascular risk 1,2,5 . The pathophysiological link between both processes, HS and cardiovascular disease, underlies the relationship between inflammation and atherosclerosis.…”

“…Regarding ultrasonography, the measurement of the intima‐media thickness (IMT) in the common carotid artery of patients with HS has been reported to be associated with higher burden of inflammation and glycemic disorders 5 . Similar results have been found for patients with psoriasis 6 .…”

“…As previously described, HS is associated with an increase in cardiovascular risk. 1,2,5 The pathophysiological link between both processes, HS and cardiovascular disease, underlies the relationship between inflammation and atherosclerosis. It is likely that the presence of a high inflammatory load will accelerate the process of atherogenesis, leading to accelerated development of cardiovascular complications.…”

“…Cardiovascular and hemogram risk markers in the sampleSuppurativa Severity Score System; IMT, intima-media thickness; LDL, low-density lipoprotein; NLR, neutrophil-lymphocyte ratio; SE standard error; SII, systemic immune-inflammation index. Bold values are those within statistical significance.factors, such as insulin resistance and glycemic disorders 5. In short, all of these methods could indirectly reflect an increased burden of atherosclerosis or CVR in patients.…”