Prevalence of Metabolic Syndrome in Chronic Spontaneous Urticaria and Associated Risk-Factors-An Analytical...

Chronic spontaneous urticaria (CSU) is a persistent low-grade inflammatory condition, which may be associated with metabolic syndrome (MetS).

To estimate the prevalence of MetS in CSU patients and identify associated risk factors.

We conducted a cross-sectional study including 74 CSU patients and 58 age-and-sex-matched healthy controls. Disease duration was assessed in all CSU patients along with disease activity and control using the UAS7 and UCT scores respectively. MetS was diagnosed by NCEP-ATP III criteria in all study participants. Additional biochemical parameters included absolute eosinophil and basophil counts. The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), mean platelet volume (MPV), and serum total IgE, to identify potential risk factors for MetS.

CSU patients (mean age 35.4 ± 11.5 years, M: F 36:38) showed a higher prevalence of MetS, vs. healthy controls (mean age 31.9 ± 9.7 years, M: F 20:38), although statistically comparable [cases vs. controls 24.3% vs. 20.7%, P = 0.8]. CSU patients had higher diastolic blood pressure (P = 0.004) and lower HDL level (P = 0.014), (vs. controls). The median (IQR) duration of CSU was 6 (4-12) months and every third patient presented with uncontrolled CSU (UCT <12). There was no significant association between MetS and clinical disease characteristics such as duration, angioedema, symptomatic dermographism, disease severity, and control. However, CSU patients with metabolic syndrome had significantly higher age (P = 0.0002), higher serum total IgE (P = 0.0001), and higher mean platelet volume (P = 0.04), compared to those with normal metabolic status. Multivariate regression analysis revealed higher age (OR 1.2, P = 0.004) and higher fasting blood sugar (OR 1.5, P = 0.03) to be significant risk factors for MetS.

MetS is more prevalent in CSU patients compared to healthy controls, although statistically comparable. All CSU patients need screening for underlying MetS, independent of their disease characteristics. Notably, higher age at presentation, higher total serum IgE, higher MPV, and raised FBS may aggravate the risk for MetS.