Abstract
Approximately 20-25 % of the World’s adult population aged 40 - 75 years have metabolic syndrome (MS). MS is one of the most widespread risk factors for: diabetes mellitus, cardiovascular disorders and skin disorders MS, due to the oxidative stress, supports a chronic inflammatory reaction in the skin and in the other parts of the body. During oxidative stress the net amount of reactive oxygen species (ROS) exceeds the antioxidant capacity of the body causing lipid peroxidation, protein oxidation and oxidative DNA damage. The role of oxidative stress in pathogenesis of early skin changes in patients with MS is not clearly defined. The aim of our study was to compare visual skin changes between patients with MS and without it, and to reveal early histological manifestations of MS in the skin. The study was conducted at the Clinic of Aesthetic Dermatology, Riga, Latvia. 50 patients aged 45-55 were enrolled. The research consisted of a clinical examination, biochemical testing and Punch biopsies. Tissue samples were stained with haematoxylin-eosin, Masson’s Trichrome and also immunohistochemically stainining with antibodies to CD34, CD117, CD20, CD8 and bcl-2. CD1a positive Langerhans cells were evaluated in 3 fields of vision. Data was analyzed with Microsoft Excel 2010 software. Gender ratio was women: men= 1.6:1. Histological changes in the skin of patients with MS were: hyperkeratosis, acanthosis, dermal fibrosis, elastosis and mild thickening of the stratum spinosum. Infiltrates around blood vessels were composed of T lymphocytes (CD3+). More significant expression and accumulation of apoptotic protein Bcl2 in skin of patients with MS in comparison to patients without MS was noted. Initial skin histological changes in MS are dermal elastosis, thickening of stratum spinosum and acanthosis. Mild T lymphocytic infiltration around capillaries possibly reflects the inflammatory component of MS. Increased accumulation of bcl2 anti-apoptotic protein in epidermis was more significantly expressed in patients with MS.
Highlights
20-25 % of the World’s adult population aged 40 - 75 years have metabolic syndrome and they are twice as likely to die from and three times as likely to have a heart attack or a stroke in comparison to those without MS
According to the International Diabetes Federation definition (Alberti et al, 2006) a person can be characterized as having the metabolic syndrome if he has central obesity and two of any of the following factors: raised triglycerides, reduced high density lipoproteins (HDL) cholesterol, raised blood pressure, raised plasma glucose
In the group that consisted of patients with metabolic syndrome the following histological findings in comparison to the group without MS were documented: acanthosis or thickening of the stratum spinosum was variable, the dermal-epidermal junction (DEJ) was flattened, adipocytes in hypodermis were increased in size, collagen bundles were thickened
Summary
20-25 % of the World’s adult population aged 40 - 75 years have metabolic syndrome and they are twice as likely to die from and three times as likely to have a heart attack or a stroke in comparison to those without MS. According to the International Diabetes Federation definition (Alberti et al, 2006) a person can be characterized as having the metabolic syndrome if he has central obesity (waist circumference for women ≥ 80 cm, man ≥ 94 cm) and two of any of the following factors: raised triglycerides, reduced HDL cholesterol, raised blood pressure, raised plasma glucose. The cluster of cardiovascular disease (CVD) risk factors that defy the metabolic syndrome is considered to be the driving force for the uprising CVD epidemic (Hanefeld et al, 2010). Application of early treatment strategies may result in control of symptoms and complications of the MS. Severe sequelae such as myocardial infarction, cerebral stroke and disability still remain very high (Ma et al, 2013)
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