Hidradenitis Suppurativa and Metabolic Syndrome: Systematic Review

Abstract

Introduction: Hidradenitis suppurativa (HS) is a chronic inflammatory follicular disorder. This review investigates the strength of association between HS and metabolic syndrome components. Methods: A systematic review of 22 observational studies (case-control and cohort) with >100,000 HS patients. Data extracted on obesity, dyslipidemia, hypertension, and type 2 diabetes. Results: HS patients had 3.1-fold higher odds of metabolic syndrome (95% CI: 2.4–4.0). Obesity (OR 2.8), hypertriglyceridemia (OR 2.1), and type 2 diabetes (OR 2.3) showed the strongest associations. Females under 40 years exhibited highest risk. Discussion: Chronic inflammation (TNF-α, IL-17) may drive insulin resistance and adipocyte dysfunction. Reverse causality cannot be excluded; metabolic abnormalities may also worsen HS. Conclusions: Routine metabolic screening should be standard in HS management, with early lifestyle interventions.