Different vitiligo characteristics as predictors of increased risk of metabolic syndrome and insulin resistance: A case–control study

Abstract

Background Autoimmune and metabolic disturbances have been reported in association with vitiligo, highlighting possible systemic associations that should be considered. Aims To assess the possible association of metabolic syndrome (MetS) as well as insulin resistance (IR) with vitiligo in different age groups. Methods This case–control study included 142 patients with vitiligo aging ≥ 6 years and 142 age‐ and sex‐matched controls. Participants were assessed for MetS using the International Diabetes Federation (IDF) criteria in addition to IR via homeostasis model assessment of IR (HOMA‐IR). The study was registered at Clinical http://trials.gov, Identifier: NCT03622320, on August 9, 2018. Results As per the IDF criteria, patients with vitiligo showed significantly more frequent association with high fasting plasma glucose levels, high blood pressure readings, central obesity, dyslipidemia, and MetS than controls (p = 0.020, p = 0.034, p = 0.014, p < 0.001, and p = 0.002, respectively). Moreover, patients with vitiligo have significantly higher levels of fasting insulin and HOMA‐IR (p ≤ 0.001). Results obtained from patients with vitiligo and controls with coexistent MetS/IR demonstrated vitiligo as a risk factor for both MetS and IR. Univariate and multivariate logistic regression highlighted that older age was the significant independent predictor for MetS and IR. Conclusion Patients with vitiligo showed a significantly higher incidence of MetS than controls. Vitiligo per se can be considered a risk factor for MetS and IR. Therefore, regular follow‐up and early metabolic derangement diagnoses are mandatory.

Dietary habits in adult Japanese patients with vitiligo

“…High BMI in patients was also a predictive factor for vitiligo on the hands or feet. These results indicate a close relationship between obesity and vitiligo, and are consistent with the previous studies showing that patients with vitiligo are associated with obesity or metabolic syndromes more frequently than healthy controls 14–16 . These findings indicate that control of obesity and/or metabolic syndromes may prevent the development or exacerbation of vitiligo.…”

“…These results indicate a close relationship between obesity and vitiligo, and are consistent with the previous studies showing that patients with vitiligo are associated with obesity or metabolic syndromes more frequently than healthy controls. [14][15][16] These findings indicate that control of obesity and/or metabolic syndromes may prevent the development or exacerbation of vitiligo. Obesity is associated with hyperplasia of visceral adipose tissues, causing hypoxia of adipocytes.…”

Shining a Light on Vitiligo and Associated Comorbidities: What Is the Evidence?

“…Surprisingly, proinflammatory cytokines IL-6, IL-1, and TNF-a associated with insulin resistance and atherosclerosis, have also been recognized as influential cytokines affecting vitiligo pathogenesis, thus accentuating a likely correlation between the two as well as parallels between the syndrome and activity and duration of vitiligo. 15,16 One prospective cross-sectional study showed a significantly higher incidence of metabolic syndrome in vitiligo patients, especially those with a higher Vitiligo Area Severity Index (VASI). In all vitiligo individuals evaluated, fasting glucose, LDL cholesterol, and blood pressure levels were appreciably higher than controls after the exclusion of those affected by comorbidities including obesity, diabetes, and AITD; criteria for metabolic syndrome were met amidst 37.4% of studied vitiligo patients.…”

Vitiligo and insulin resistance as a component of metabolic syndrome: an analysis

“…A study by Karadag et al showed an association between vitiligo and IR, and patients in the study group had higher levels of HOMA-IR, insulin, and C-peptide than those in the control group [28]. Also Ibrahim et al [29] conducted a case-control study in which participants were assessed for metabolic syndrome using the International Diabetes Federation (IDF) criteria in addition to insulin resistance via homeostasis model assessment of IR (HOMA-IR). Their results showed a significantly more frequent association with high fasting plasma glucose levels, high blood pressure readings, central obesity, dyslipidaemia, and metabolic syndrome than controls (p = 0.020, p = 0.034, p = 0.014, p < 0.001, and p = 0.002, respectively) and also significantly higher levels of fasting insulin and HOMA-IR (p ≤ 0.001).…”