Research Suggests Increased Risk for Metabolic Syndrome for Vitiligo Patients

Sarah Ibrahim, MD

Vitiligo may be considered a risk factor for metabolic syndrome (MetS) as well as insulin resistance (IR), a recent study finds.

Associated systemic autoimmune disorders have previously been linked to vitiligo, and researchers in recent decades have begun to assess systemic associations with the skin condition. The study, led by Sarah Ibrahim, MD, of the Faculty of Medicine, Dermatology Department at Cairo University, was conducted to examine these associations further.

“The mere presence of vitiligo regardless of its variant necessitates evaluation for associated metabolic derangements that tend to increase with advanced age,” Ibrahim and colleagues wrote. “Therefore, changing the recommended panel of investigations for patients with vitiligo that includes the well-documented scope of autoimmune diseases to encompass metabolic disorders is essential.”

Background

The investigators used a case-control study design and recruited a total of 142 vitiligo patients and 142 controls from the population in Egypt, the country in which the study took place. Patients were ≥ 6 years of age and were assessed for MetS through both the International Diabetes Federation (IDF) criteria and IR via homeostasis model assessment of IR (HOMA-IR).

The researchers excluded those patients with histories of alcohol consumption, generalized edema, smoking, or those being given systemic corticosteroids or other systemic vitiligo treatments. They also excluded those with a history of chronic illness, which included neoplastic, collagen, and hematologic disorders.

Patients and controls received questions on their history of associated dyslipidemia, diabetes mellitus (DM), hypertension (HTN), and obesity. Both groups were also evaluated for MetS through the use of IDF criteria. The investigators ascertained the patients’ ages at disease onset as well as the disease duration, assessing the extent of patients’ condition through their vitiligo extent score (VES) and body surface area by hand units (BSA), and disease activity as per vitiligo disease activity score (VIDA).

Findings

The research team found that of the 139 patients and 142 controls who were analyzed (3 patients’ samples were hemolyzed), median age of vitiligo onset was 15 years with 105 participants having active vitiligo (75.5%). When they analyzed patients’ demographic data, the investigators found no significant differences between vitiligo patients and controls with regard to gender, age, diets, or positive family history of DM, HTN, obesity, or dyslipidemia (P = 0.724, P = 0.838, P = 0.807, P = 0.639, P = 0.259, P = 0.211, and P = 0.109, respectively).

The researchers found that participants with vitiligo demonstrated significantly more frequent association with high blood pressure readings, high fasting plasma glucose levels, central obesity, dyslipidemia, and MetS than the control arm (P = 0.034, P = 0.020, P = 0.014, P < 0.001, and P = 0.002, respectively). Vitiligo patients also had higher levels of fasting insulin and HOMA-IR (P ≤ 0.001). Older age was reported as the significant MetS and IR independent predictor.

“Patients with vitiligo showed a significantly higher incidence of MetS than controls,” they wrote. “Vitiligo per se can be considered a risk factor for MetS and IR. Therefore, regular follow-up and early metabolic derangement diagnoses are mandatory.”

The study, “Different vitiligo characteristics as predictors of increased risk of metabolic syndrome and insulin resistance: A case–control study,” was published in the Journal of Cosmetic Dermatology.