Association of vitiligo and metabolic syndrome: a case control study

Priyanka Thakur, K. Mehta, P. Chauhan, Ravinder Singh, A. Sharma, Anuj Sharma, Reena Sharma, Prabal Kumar, Sanket Vashist, Sujaya Manvi, Amisha Kukreja, Rohit Negi
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Abstract

Background: Vitiligo is an acquired disorder of depigmentation which involves skin and mucous membranes characterized by development of well-defined white macules on skin, mucosa and overlying hair of the skin can be involved. Systemic nature of the vitiligo might lead to insulin resistance metabolic profile abnormalities. Objective was to study the association between vitiligo and metabolic syndrome. Methods: The study was done in department of dermatology, venereology and leprosy of Dr. R. P. Government Medical College Kangra (Tanda), Himachal Pradesh. The study included 150 cases and 150 controls. Cases: age above 18 years with a diagnosis of vitiligo were included in the study. Pregnant and lactating women were excluded. Patients who had used medications that could affect the metabolic status (like systemic steroid therapy or cyclosporine or on hormonal replacement therapy). Patients already on lipid lowering agents and antidiabetic drugs. The case group was further subdivided into three subgroups according to VIDA score (group A: 1-0, group B: 1-2 and group C: 3-4). Controls: those visiting outdoor patient department and admitted for minor day care procedures Clinical details of patients were recorded regarding age, sex, smoking/alcohol consumption. General physical examination includes height, weight, body mass index, waist circumference, blood pressure. All the patients and controls were subjected to following tests: fasting blood sugar (FBS), cholesterol (CHOL), triglyceride (TAG), low density lipoprotein (LDL), high density lipoprotein (HDL), very low-density lipoprotein (VLDL), fasting serum insulin level (FSIL). Venous samples were taken after 12 hours of fasting. The participants were screened for metabolic syndrome as per national cholesterol education program adult treatment panel III (NCEP ATP III). Metabolic syndrome rates were compared between case and control groups. Results: The mean age was 35.82±12.9 years among cases and 36.97±11.76 years among controls. The M/F ratio of cases being (1:1.6) and controls (1:1). The mean duration of vitiligo was 117.8±105.5 months. Metabolic syndrome was significantly prevalent amid vitiligo cases 74 (49.3%) as compared to controls 23 (15.3%) with OR (95% CI) =5.37 (3.1-9.3). Metabolic syndrome was more frequent in VIDA subgroup 3{71 (47.3%)} and was statistically significant (p≤0.001). Conclusions: The study found association of metabolic syndrome among vitiligo patients. In addition, the study also found that in non-segmental vitiligo, frequency of metabolic syndrome was higher as compared to another pattern. Furthermore, frequency of metabolic syndrome increased as activity of vitiligo increased in the study.
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白癜风与代谢综合征的关系:病例对照研究
背景:白癜风是一种获得性色素脱失症,涉及皮肤和粘膜,其特征是在皮肤、粘膜和皮肤覆盖的毛发上出现界限清晰的白色斑块。白癜风的全身性可能会导致胰岛素抵抗代谢异常。目的:研究白癜风与代谢综合征之间的关系。研究方法研究在喜马偕尔邦康拉(坦达)R. P. 博士政府医学院皮肤病学、性病学和麻风病系进行。研究包括 150 例病例和 150 例对照。病例:年龄在 18 岁以上、确诊为白癜风的患者均被纳入研究范围。孕妇和哺乳期妇女除外。使用过可能影响代谢状态的药物(如全身性类固醇治疗或环孢素或激素替代疗法)的患者。已服用降脂药和抗糖尿病药物的患者。根据 VIDA 评分,病例组又细分为三个亚组(A 组:1-0;B 组:1-2;C 组:3-4)。对照组:到室外患者科室就诊和接受日间护理小手术的患者 记录了患者的年龄、性别、吸烟/饮酒情况等详细资料。一般体格检查包括身高、体重、体重指数、腰围和血压。所有患者和对照组均接受了以下检测:空腹血糖(FBS)、胆固醇(CHOL)、甘油三酯(TAG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、极低密度脂蛋白(VLDL)、空腹血清胰岛素水平(FSIL)。空腹 12 小时后采集静脉样本。根据美国国家胆固醇教育计划成人治疗小组 III(NCEP ATP III)对参与者进行了代谢综合征筛查。比较病例组和对照组的代谢综合征发生率。结果病例组平均年龄(35.82±12.9)岁,对照组平均年龄(36.97±11.76)岁。病例的男女比例为(1:1.6),对照组为(1:1)。白癜风的平均病程为(117.8±105.5)个月。与对照组的 23 例(15.3%)(OR (95% CI) =5.37 (3.1-9.3))相比,代谢综合征在 74 例(49.3%)白癜风患者中明显多见。代谢综合征在 VIDA 亚组 3{71 (47.3%)} 中更为常见,且具有统计学意义(P≤0.001)。结论研究发现,白癜风患者中存在代谢综合征。此外,研究还发现,在非节段型白癜风患者中,代谢综合征的发病率高于其他类型。此外,代谢综合征的发生率随着白癜风活动度的增加而增加。
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