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Bone Metabolism in Patients with Hidradenitis Suppurativa: A Case-control Study
Iñigo Navarro1, Marcos A González-López2, Isabel Sierra3
1Division of Dermatology, Hospital University Marqués de Valdecilla, Santander, Spain.
Insights
Patients with hidradenitis suppurativa (HS) show lower bone scores and hip bone density. Vitamin D deficiency is also prevalent in HS patients, indicating potential bone health concerns.
Area of Science:
- Dermatology
- Endocrinology
- Rheumatology
Background:
- Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition affecting hair follicles.
- Emerging evidence suggests potential systemic implications of HS beyond the skin.
Purpose of the Study:
- To investigate the association between hidradenitis suppurativa (HS) and bone health.
- To assess trabecular bone score (TBS), bone mineral density (BMD), bone remodeling markers, and calciotropic hormones in HS patients compared to controls.
Main Methods:
- A case-control study involving 81 HS patients and 79 controls.
- Evaluated demographic, anthropometric, and laboratory data, including TBS, BMD, serum 25-hydroxyvitamin D (25OHD), PINP, and CTX.
Main Results:
- HS patients exhibited lower serum 25OHD levels, with 62% showing vitamin D deficiency.
- Increased serum PINP and decreased CTX levels were observed in HS patients.
- Lower TBS and total hip BMD were found in HS patients, while lumbar BMD was similar to controls.
Conclusions:
- Hidradenitis suppurativa is associated with reduced bone quality (lower TBS) and hip bone density.
- High prevalence of vitamin D deficiency in HS patients warrants attention.
- No correlation found between disease severity and the assessed bone parameters.
Abstract:
Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the hair follicles. The aim of this case-control study was to assess whether HS is associated with disturbances in trabecular bone score, bone mineral density, bone remodelling markers, and calciotropic hormones. A total of 81 patients and 79 controls of similar age and sex were included. Demographic, anthropometric, laboratory data, trabecular bone score, bone mineral density, serum 25-hydroxyvitamin D (25OHD), serum amino-terminal pro-peptide of type 1 collagen (PINP), and C-terminal telopeptide of type 1 collagen (CTX) concentrations were assessed in both groups. Patients with HS had lower serum 25OHD levels than controls, and approximately 62% of them had vitamin D deficiency. Serum PINP was increased and CTX was decreased in patients with HS. Fully adjusted trabecular bone score values were lower in patients with HS compared with controls. Adjusted lumbar bone mineral density was similar in HS and controls, whilst total hip bone mineral density was lower in patients with HS. There were no statistical differences regarding disease severity in terms of 25OHD, serum turnover markers, bone mineral density, or trabecular bone score values. This study shows that patients with HS have lower trabecular bone score and total hip bone mineral density values than population-based controls. In addition, the prevalence of vitamin D deficiency is high in subjects with HS.
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