Research Finds Vitiligo Patients May Be More Prone to Metabolic Syndrome

EGYPT: According to a recent study that appeared in the Journal of Cosmetic Dermatology, vitiligo may be regarded as a risk factor for both insulin resistance and the metabolic syndrome.

Research has attempted to examine systemic links with vitiligo in recent decades. Associated systemic autoimmune illnesses have previously been connected to the skin condition.

According to Sarah Ibrahim, MD, of Cairo University's Faculty of Medicine's Department of Dermatology, and colleagues, "the mere presence of vitiligo irrespective of its subtype demands evaluation for accompanying metabolic derangements that tend to develop with advanced age."

Consequently, they continued, "it is crucial to expand the suggested panel of investigations for individuals with vitiligo from the well-documented scope of autoimmune diseases to incorporate metabolic abnormalities."

The researchers aimed to determine if the metabolic syndrome (MetS) and insulin resistance (IR) were linked to vitiligo in various age groups.

The team employed a case-control study design and selected 142 vitiligo patients and 142 controls from the general Egyptian community for the investigation. Patients were evaluated for MetS using the International Diabetes Federation (IDF) criteria and for IR using the homeostasis model assessment of IR (HOMA-IR) when they were under the age of six. Patients who had consumed alcohol in the past, had widespread edema, smoked, or were receiving systemic corticosteroids or other systemic vitiligo therapies were not included in the study. Additionally, they eliminated people who had a history of chronic illnesses, such as neoplastic, collagen, or hematologic conditions.

Patients and controls were questioned about their family history of related obesity, hypertension, diabetes mellitus, and dyslipidemia. IDF criteria were also used to assess both groups for MetS. The researchers determined the patients' ages at illness onset and disease duration. They evaluated the severity of the patients' conditions using their body surface area by hand units (BSA) and vitiligo extent score (VES), as well as disease activity using the vitiligo disease activity score (VIDA).

Major highlights of the study:

• The median age of vitiligo onset was 15 years, with 105 participants having active vitiligo (75.5%) among the 139 cases and 142 controls that were studied.
• Regarding gender, age, diet, or a family history of diabetes, hypertension, obesity, or dyslipidemia, there were no differences between vitiligo patients and controls that were statistically significant (P = 0.724, P = 0.838, P = 0.807, P = 0.639, P = 0.259, P = 0.211, and P = 0.109, respectively).
• In comparison to participants in the control group, patients with vitiligo showed significantly higher rates of high blood pressure readings, high fasting plasma glucose levels, central obesity, dyslipidemia, and MetS (P = 0.034, P = 0.020, P = 0.014, P< 0.001, and P = 0.002, respectively).
• Patients with vitiligo also showed increased fasting insulin and HOMA-IR readings (P≤ 0.001).
• The major MetS and IR independent predictor was found to be older age.

MetS incidence was noticeably greater in vitiligo patients compared to controls. The authors concluded that vitiligo itself can be viewed as a risk factor for MetS and IR.

Hence, routine monitoring and early metabolic derangement diagnosis are essential, they continued.

REFERENCE

Ibrahim, S, El-Tahlawi, S, Mogawer, RM, El Ansary, M, Esmat, S, El-Hawary, M. Different vitiligo characteristics as predictors of increased risk of metabolic syndrome and insulin resistance: A case–control study. J Cosmet Dermatol. 2022; 00: 1- 8. doi: 10.1111/jocd.15446