Association between metabolic syndrome and prevalent skin diseases: A systematic review and meta-analysis of case-control studies

Sogand Sodagar; Yekta Ghane; Amirhossein Heidari; Nazila Heidari; Elaheh Khodadust; Seyyed Amir Yasin Ahmadi; Farnoosh Seirafianpour; Hamid Baradaran; Azadeh Goodarzi

doi:10.1002/hsr2.1576

Association between metabolic syndrome and prevalent skin diseases: A systematic review and meta-analysis of case-control studies

Health Sci Rep. 2023 Sep 25;6(9):e1576. doi: 10.1002/hsr2.1576. eCollection 2023 Sep.

Authors

Sogand Sodagar¹, Yekta Ghane², Amirhossein Heidari³, Nazila Heidari¹, Elaheh Khodadust¹, Seyyed Amir Yasin Ahmadi⁴, Farnoosh Seirafianpour⁵, Hamid Baradaran^{6

7}, Azadeh Goodarzi⁸

Affiliations

¹ School of Medicine Iran University of Medical Sciences Tehran Iran.
² School of Medicine Tehran University of Medical Sciences Tehran Iran.
³ Faculty of Medicine, Tehran Medical Sciences Islamic Azad University Tehran Iran.
⁴ Preventive Medicine and Public Health Research Center Iran University of Medical Sciences Tehran Iran.
⁵ Razi Drug Research Center Iran University of Medical Sciences (IUMS) Tehran Iran.
⁶ Institute of Endocrinology and Metabolism Iran University of Medical Sciences Tehran Iran.
⁷ Aging Clinical & Experimental Research Team, Institute of Applied Health Sciences University of Aberdeen Aberdeen UK.
⁸ Department of Dermatology Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine, Iran University of Medical Sciences Tehran Iran.

Abstract

Background and aim: Metabolic syndrome (MetS) is a well-known noncommunicable disease that plays a significant role in emerging other chronic disorders and following complications. MetS is also involved in the pathophysiology of numerous dermatological diseases. We aim to evaluate the association of MetS with the most prevalent dermatological diseases.

Methods: A systematic search was carried out on PubMed, Science Direct, Web of Science, Cochrane, as well as the Google Scholar search engine. Only English case-control studies regarding MetS and any skin disease from the beginning of 2010 up to November 15, 2022, were selected. The study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA).

Results: A total of 37 studies (13,830 participants) met the inclusion criteria. According to our result, patients with psoriasis, hidradenitis suppurativa (HS), vitiligo, androgenetic alopecia (AGA), and lichen planus (LP) have a higher chance of having MetS compared to the general population. Furthermore, people with seborrheic dermatitis (SED) and rosacea are more prone to insulin resistance, high blood pressure (BP), and higher blood lipids. After pooling data, the meta-analysis revealed a significant association between MetS and skin diseases (pooled odds ratio [OR]: 3.28, 95% confidence interval: 2.62-4.10). Concerning the type of disease, MetS has been correlated with AGA (OR: 11.86), HS (OR: 4.46), LP (OR: 3.79), and SED (OR: 2.45). Psoriasis also showed a significant association but with high heterogeneity (OR: 2.89). Moreover, skin diseases and MetS are strongly associated in Spain (OR: 5.25) and Thailand (OR: 11.86). Regarding the metaregression model, the effect size was reduced with increasing age (OR: 0.965), while the size increased with AGA (OR: 3.064).

Conclusions: MetS is closely associated with skin complications. Dermatologists and other multidisciplinary teams should be cautious while treating these patients to prevent severe complications resulting from MetS.

Keywords: androgenic alopecia; dermatology; hidradenitis suppurativa; insulin resistance; lichen planus; metabolic syndrome; psoriasis; rosacea; seborrheic dermatitis; skin disease; vitiligo.