Department of Dermatology and Allergy, University Hospital Charité, Berlin, Germany.
PLoS One. 2012;7(2):e31810. doi: 10.1371/journal.pone.0031810. Epub 2012 Feb 16.
Acne inversa (AI; also designated as Hidradenitis suppurativa) is a common chronic inflammatory skin disease, localized in the axillary, inguinal and perianal skin areas that causes painful, fistulating sinuses with malodorous purulence and scars. Several chronic inflammatory diseases are associated with the metabolic syndrome and its consequences including arteriosclerosis, coronary heart disease, myocardial infraction, and stroke. So far, the association of AI with systemic metabolic alterations is largely unexplored.
A hospital-based case-control study in 80 AI patients and 100 age- and sex-matched control participants was carried out. The prevalence of central obesity (odds ratio 5.88), hypertriglyceridemia (odds ratio 2.24), hypo-HDL-cholesterolemia (odds ratio 4.56), and hyperglycemia (odds ratio 4.09) in AI patients was significantly higher than in controls. Furthermore, the metabolic syndrome, previously defined as the presence of at least three of the five alterations listed above, was more common in those patients compared to controls (40.0% versus 13.0%; odds ratio 4.46, 95% confidence interval 2.02 to 9.96; P<0.001). AI patients with metabolic syndrome also had more pronounced metabolic alterations than controls with metabolic syndrome. Interestingly, there was no correlation between the severity or duration of the disease and the levels of respective parameters or the number of criteria defining the metabolic syndrome. Rather, the metabolic syndrome was observed in a disproportionately high percentage of young AI patients.
This study shows for the first time that AI patients have a high prevalence of the metabolic syndrome and all of its criteria. It further suggests that the inflammation present in AI patients does not have a major impact on the development of metabolic alterations. Instead, evidence is given for a role of metabolic alterations in the development of AI. We recommend monitoring of AI patients in order to correct their modifiable cardiovascular risk factors.
逆向痤疮（AI；也称为化脓性汗腺炎）是一种常见的慢性炎症性皮肤病，局限于腋窝、腹股沟和肛周皮肤区域，导致疼痛、瘘管形成的窦道，伴有恶臭脓性分泌物和疤痕。几种慢性炎症性疾病与代谢综合征及其后果有关，包括动脉硬化、冠心病、心肌梗死和中风。迄今为止，AI 与全身性代谢改变的关联在很大程度上尚未得到探索。
在 80 名 AI 患者和 100 名年龄和性别匹配的对照参与者中进行了一项基于医院的病例对照研究。AI 患者中心性肥胖（优势比 5.88）、高三酰甘油血症（优势比 2.24）、低 HDL-胆固醇血症（优势比 4.56）和高血糖（优势比 4.09）的患病率明显高于对照组。此外，与对照组相比，代谢综合征（先前定义为至少存在上述五种改变中的三种）在这些患者中更为常见（40.0%比 13.0%；优势比 4.46，95%置信区间 2.02 至 9.96；P<0.001）。患有代谢综合征的 AI 患者的代谢改变也比患有代谢综合征的对照组更为明显。有趣的是，疾病的严重程度或持续时间与各自参数的水平或定义代谢综合征的标准数量之间没有相关性。相反，代谢综合征在比例过高的年轻 AI 患者中出现。
本研究首次表明，AI 患者代谢综合征及其所有标准的患病率很高。它进一步表明，AI 患者中存在的炎症对代谢改变的发展没有重大影响。相反，有证据表明代谢改变在 AI 的发展中起作用。我们建议监测 AI 患者，以纠正其可改变的心血管危险因素。
