Trends in body mass index before and after diagnosis of hidradenitis suppurativa

Abstract

Background A temporal relationship between hidradenitis suppurativa (HS) and obesity has not been established. Objectives To compare baseline body mass index (BMI) and change in BMI for patients with HS and controls before and after diagnosis. Methods We performed a retrospective case-control analysis of 1284 patients with HS and controls matched for age, sex, race and calendar year between 1 January 1999 and 9 September 2019. BMI 7 years prior to first HS diagnosis, and rate of BMI change, were compared for patients with HS and controls using linear mixed effects models. Results Baseline BMI was higher among patients with HS than controls [mean difference 3Á03 kg m −2 , 95% confidence interval (CI) 2Á44-3Á62; P < 0Á001)]. This difference was larger for women [mean difference 3Á37 kg m −2 (95% CI 2Á73-4Á01)] than men [mean difference 1Á27 kg m −2 (95% CI − 0Á20-2Á73; interaction P = 0Á01)], and for patients with HS diagnosed before age 40 years [mean difference 4Á10 kg m −2 (95% CI 3Á15-5Á06)] than those diagnosed after age 40 years [mean difference 2Á38 kg m −2 (95% CI 1Á63-3Á12; interaction P < 0Á001)]. Prior to diagnosis, average annual increase in BMI among patients with HS was slightly higher than controls. There was no statistically significant change in annual BMI among patients with HS following diagnosis. Conclusions Baseline BMI and, to a lesser extent, rate of BMI change appear to be risk factors for developing HS. The influence of BMI may play a larger role among female patients and younger patients.

Pathophysiology of hidradenitis suppurativa: a systematic review of the literature

“…Wright, S. 93 Retrospective case-control analysis of 1284 patients with HS and controls matched for age, sex, and race.…”

“…Approximately 90% of patients are current or former smokers, and smoking appears to contribute to disease onset and progression 95 . The underlying mechanisms are still not clear, but nicotine is known to promote proinflammatory cytokines, induce epidermal hyperplasia, and interfere with the microbiome 93 . Obesity might contribute to HS pathogenesis through subclinical inflammation, metabolic changes, and friction 99,100 .…”

Hidradenitis Suppurativa: The Influence of Gender, the Importance of Trigger Factors and the Implications for Patient Habits

“…Quite recently, a retrospective analysis of 1284 HS patients relative to age-, sex- and race-matched controls (enrolled between 1999 and 2019) was conducted by Wright et al The researchers found that baseline BMI was higher among HS patients than controls ( p < 0.001). This difference was larger for women than men [ 66 ]. Individual patient data from the PIONEER 1 and PIONEER 2 studies revealed that an increase in BMI (overweight and obese category) was associated with decreased odds of achieving Hidradenitis Suppurativa Clinical Response (HiSCR).…”

Increased risk of COVID‐19‐related hospitalization in patients with hidradenitis suppurativa

“…Dear Editor, There is a significant overlap between comorbidities associated with HS 1,2 and severe COVID-19 illness. [3][4][5] Additionally, immunomodulating medications for HS may influence the course of COVID-19 illness. We sought to compare the risk of COVID-19-related hospitalization between HS patients and controls and to compare risk according to immunomodulator use.…”