Association between metabolic syndrome and prevalent skin diseases: A systematic review and meta‐analysis of case‐control studies

Abstract

Background and Aim

Metabolic syndrome (MetS) is a well‐known noncommunicable disease that plays a significant role in emerging other chronic disorders and following complications. MetS is also involved in the pathophysiology of numerous dermatological diseases. We aim to evaluate the association of MetS with the most prevalent dermatological diseases.

Methods

A systematic search was carried out on PubMed, Science Direct, Web of Science, Cochrane, as well as the Google Scholar search engine. Only English case‐control studies regarding MetS and any skin disease from the beginning of 2010 up to November 15, 2022, were selected. The study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA).

Results

A total of 37 studies (13,830 participants) met the inclusion criteria. According to our result, patients with psoriasis, hidradenitis suppurativa (HS), vitiligo, androgenetic alopecia (AGA), and lichen planus (LP) have a higher chance of having MetS compared to the general population. Furthermore, people with seborrheic dermatitis (SED) and rosacea are more prone to insulin resistance, high blood pressure (BP), and higher blood lipids. After pooling data, the meta‐analysis revealed a significant association between MetS and skin diseases (pooled odds ratio [OR]: 3.28, 95% confidence interval: 2.62−4.10). Concerning the type of disease, MetS has been correlated with AGA (OR: 11.86), HS (OR: 4.46), LP (OR: 3.79), and SED (OR: 2.45). Psoriasis also showed a significant association but with high heterogeneity (OR: 2.89). Moreover, skin diseases and MetS are strongly associated in Spain (OR: 5.25) and Thailand (OR: 11.86). Regarding the metaregression model, the effect size was reduced with increasing age (OR: 0.965), while the size increased with AGA (OR: 3.064).

Conclusions

MetS is closely associated with skin complications. Dermatologists and other multidisciplinary teams should be cautious while treating these patients to prevent severe complications resulting from MetS.

Key points

• Metabolic syndrome (MetS) is one of the major scourges among noncommunicable diseases, with a prevalence of 25%−33% of all individuals suffering from this condition globally.

• Skin manifestations can occur in the case of any pathophysiological disorder that results in a loss of metabolic control or involves inflammatory factors such as interleukins, TNF, and oxidative stress.

• Patients with psoriasis, vitiligo, hidradenitis suppurativa, and lichen planus are more likely to suffer from MetS compared to the general population.

• People suffering from seborrheic dermatitis and rosacea are more prone to insulin resistance, high blood pressure, and higher blood lipids.

• The relationship between discoid lupus, acne, atopic dermatitis, alopecia areata, and blistering diseases like pemphigus vulgaris has not been examined yet in case‐control studies; however, there has been some evidence of relationships in the field of MetS components, including insulin resistance.