Metabolic syndrome in Egyptian patients with vitiligo: a case–control study

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Abstract

Background

Metabolic syndrome (MS) is a complex of interrelated risk factors for cardiovascular diseases, diabetes mellitus, and stroke. Vitiligo is an acquired depigmenting skin disease of unknown origin and multifactorial pathogenesis. There is growing evidence that vitiligo can also be related to systemic inflammatory disorders such as obesity and MS.

Objective

To clarify the association of vitiligo with chronic vascular and metabolic disorders that constitute MS.

Patients and methods

A case–control study was carried out on 102 vitiligo patients and 89 age-matched and sex-matched healthy controls. MS and its individual components (abdominal obesity, hypertension, insulin resistance, and dyslipidemia) were compared between cases and controls.

Results

BMI, waist circumference (WC), and serum triglycerides (TGs) were significantly lower in the patient group than the control group, whereas diastolic blood pressure, serum high-density lipoprotein cholesterol, serum fasting insulin, and insulin resistance were significantly higher in the patient group than the control group. There were no significant differences between cases and controls regarding systolic blood pressure, fasting blood glucose, and number of patients having MS. Serum fasting insulin was significantly the highest in patients with acrofacial vitiligo compared with other types of vitiligo. Patients with MS had significantly higher mean age, disease duration, Vitiligo Area Scoring Index (disease severity), and insulin resistance compared with patients without MS. Age, serum TGs, body weight, BMI, WC, and insulin resistance showed significant positive correlations with Vitiligo Area Scoring Index (disease severity).

Conclusion

Vitiligo patients showed a better lipid profile, with higher levels of high-density lipoprotein cholesterol and lower TGs and WC values. In patients with vitiligo, increased insulin levels and insulin resistance may be related to other mechanisms than obesity, such as production of cytokines or autoimmune reaction to melanocytes. Further large-scale studies are needed to confirm these findings.

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