Metabolic and Endocrine Comorbidities in Hidradenitis Suppurativa: A Nationwide Study

Abstract

Introduction: Hidradenitis suppurativa (HS) or acne inversa is a chronic, inflammatory, recurrent, debilitating skin disease. There have been studies linking HS to metabolic syndrome [1]. However, there is a scarcity of studies on metabolic and endocrine co-morbidities of hospitalized HS patients. This study aims to compare the prevalence of metabolic and endocrine co-morbidities in hospitalized HS patients to hospitalized non-HS patients. Methods: Data were abstracted from the National Inpatient Sample (NIS) 2016 and 2017 Database. NIS is the largest inpatient hospitalization database in the United States. The NIS was searched for hospitalizations for adult patients aged 18 years or above with a principal or secondary diagnosis of HS and those without any diagnosis of HS. Chi-square test was used to compare the prevalence of common metabolic and endocrine comorbidities between HS and non-HS hospitalized patients. Co-morbidities were obtained from secondary diagnoses. We used ICD-10 codes to obtain HS hospitalizations and co-morbidities. STATA, version 16 was used for analysis. Results: There were over 71 million discharges in the combined 2016 and 2017 NIS database. Out of which, 40,275 hospitalizations had a diagnosis of HS. HS hospitalizations had higher prevalence of type 2 diabetes (33.1% vs 24.5%, p<0.0001), type 1 diabetes mellitus (1.9% vs 0.9%, p<0.0001), obesity (35.8% vs 14.3%, p<0.0001), lower prevalence of dyslipidemia (21.3% vs 31.8%, p<0.0001), hypothyroidism (6.3% vs 12.0%, p<0.0001) and similar prevalence of hyperthyroidism (0.4% vs 0.5%, p=0.2373) compared to non-HS hospitalizations Conclusion: Hospitalized HS patients have a higher prevalence of type 1 & 2 diabetes mellitus and obesity compared to hospitalized non-HS patients. An interdisciplinary approach involving the endocrinologist, dermatologist, and hospitalist may be needed to optimally manage these co-morbidities in hospitalized HS patients.