Abstract
Hidradenitis suppurativa (HS) is a chronic, inflammatory and debilitating skin disorder. The exacerbating factors of HS include nutrition and adiposity. We aimed to investigate the relationships between body composition and the adherence to the Mediterranean diet (MD) with the severity of HS in a sample of naive-treatment patients with HS. In this case–controlled, cross-sectional study, we enrolled 41 HS patients and 41 control subjects. Body composition was evaluated by a bioelectrical impedance analysis (BIA) phase-sensitive system. PREvención con DIeta MEDiterránea (PREDIMED) and the 7-day food records were used to evaluate the degree of adherence to the MD and dietary pattern, respectively. The clinical severity was assessed by using the Sartorius HS score. HS patients had a worse body composition, in particular lower phase angle (PhA) (p < 0.001), and a lower adherence to the MD than controls, in spite of no differences in energy intake between the two groups. The receiver operator characteristic (ROC) analysis showing a value of PhA of ≤ 5.7 and a PREDIMED score of ≤ 5.0 identified HS patients with the highest clinical severity of the disease. After adjusting for sex, age, body mass index (BMI), and total energy intake, the HS Sartorius score maintained negative correlations with PhA (p < 0.001), PREDIMED score, and n-3 polyunsaturated fatty acids (p = 0.005). The results of the multivariate analysis showed PhA and PREDIMED score were the major determinants of HS Sartorius score, explaining 82.0% and 30.4% of its variability, respectively (p < 0.001). Novel associations were demonstrated between PhA and the degree of adherence to the MD with the HS severity. PhA and PREDIMED score might represent possible markers of severity of HS in a clinical setting.
Highlights
Hidradenitis suppurativa (HS) or acne inversa, first described by Verneuil’s in 1854 [1], is a chronic inflammatory, debilitating, immune-mediated, suppurative and disabling skin disease, characterized by subcutaneous nodules; its pathophysiology to date is not well understood [2]. the real prevalence of HS is still undefined, a prevalence of 1% was reported in the general population in Europe [3,4], which increased up to 4% among young adult women [5]
In the wake of this evidence, we aimed to investigate the relationships between nutritional status, the adherence to the Mediterranean diet (MD), body composition, and the severity of HS in a sample of naive-treatment patients with HS compared to control group matched for sex, age, and body mass index (BMI)
The chi square (χ2 ) test was used to determine the significance of differences in frequency distribution of gender, smoking habit, physical activity, BMI categories, waist circumference (WC) cut-offs, and dietary components included in the PREDIMED questionnaire
Summary
The real prevalence of HS is still undefined, a prevalence of 1% was reported in the general population in Europe [3,4], which increased up to 4% among young adult women [5]. Epidemiological studies, reported a prevalence between 0.05% and 0.20% [6,7]. Clinical lesions and chronicity are important to establish the diagnosis of HS, while diagnostic tests to facilitate diagnosis are still lacking [8]. Several environmental factors including nutrition and adiposity, contribute to the clinical severity of HS phenotype [11]. Obesity is an important risk factor for HS [12]. Several studies report that the severity of HS is positively associated with body mass index (BMI), with rates of obesity that vary from 12% to
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