Diabetes & Hyperlipidemia Increase Risk of Development of Granuloma Annulare
Granuloma annulare (GA) is a benign, often asymptomatic and self-limiting condition. It is characterized by the generalized distribution of the skin manifestations that cover more than one anatomic site. In a recent study, researchers have found that diabetes and hyperlipidemia may be risk factors for the development of GA and that autoimmunity may play a role in the pathogenesis of GA. The study findings were published in the JAMA Dermatology on June 09, 2021.
Previous studies suggest that granuloma annulare (GA) has been associated with diabetes and several other conditions. However, these studies have been limited by single-centre designs and small sample sizes. Therefore, researchers of the University of Pennsylvania Perelman School of Medicine, Philadelphia, conducted a study to evaluate whether there is an association between GA and type 2 diabetes, hyperlipidemia, autoimmune conditions, and hematologic malignant neoplasms, using a large population-based cohort study.
In this retrospective cohort study, the researchers included a total of 5137 patients with GA and matched them by age and sex with up to 10 randomly selected controls (n = 51 169) with a diagnosis of a nevus or seborrheic keratosis. They collected de-identified data from the US Optum Clinformatics Data Mart Database and analyzed them between January 1, 2016, and June 30, 2019. They used logistic regression was used to evaluate for potential associations between GA and diabetes, hyperlipidemia, autoimmune conditions, and hematologic malignant neoplasms.
Key findings of the study were:
- Upon analysis, the researchers noted that when compared with controls, individuals with GA were more likely to have a baseline
◊ Diabetes (1086 [21.1%] vs 6780 [13.3%]; adjusted odds ratio [aOR], 1.67),
◊ Hyperlipidemia (1669 [32.5%] vs 14 553 [28.4%]; aOR, 1.15),
◊ Hypothyroidism (727 [14.2%] vs 5780 [11.3%]; aOR, 1.24),and
◊ Rheumatoid arthritis (62 [1.2%] vs 441 [0.9%]; aOR, 1.34).
- They also noted that those with GA were more likely to have incident
- Diabetes (144 [2.8%] vs 1061 [2.1%]; aOR, 1.31),
◊ Hypothyroidism (41 [0.8%] vs 252 [0.5%]; aOR, 1.59),
◊ Systemic lupus erythematosus (21 [0.4%] vs 65 [0.1%]; aOR, 3.06), and
◊ Rheumatoid arthritis (26 [0.5%] vs 122 [0.2%]; aOR, 2.05).
- However, they found no association between GA and an increased risk of hematologic malignant neoplasms.
The authors concluded, "This population-based cohort study identified associations between GA and baseline diabetes and hyperlipidemia as well as between GA and both baseline and incident autoimmune conditions. These findings suggest that diabetes and hyperlipidemia may be risk factors for the development of GA and that autoimmunity may be an important factor in the pathogenesis of GA."
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