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Risk factors for ischaemic heart disease in patients with dermatitis herpetiformis
1Department of Dermatology, North Staffs NHS Trust, Stoke-on-Trent, England.
Insights
Patients with dermatitis herpetiformis (DH) show lower ischemic heart disease mortality. DH patients have better cardiovascular risk factors, including lower lipids, fibrinogen, and less smoking, suggesting a protective effect.
Area of Science:
- Cardiology
- Dermatology
- Epidemiology
Background:
- Dermatitis herpetiformis (DH) patients exhibit unexpectedly low mortality from ischemic heart disease (IHD).
- The underlying reasons for this protective association remain unclear.
- Cardiovascular risk factors may differ between DH patients and the general population.
Purpose of the Study:
- To compare cardiovascular risk factors in patients with DH versus controls.
- To investigate potential mechanisms behind the reduced IHD risk in DH.
Main Methods:
- A case-control study comparing 29 DH patients with 57 age- and sex-matched controls.
- Assessment of risk factors including lipids, fibrinogen, smoking history, and social class.
Main Results:
- DH patients demonstrated significantly lower cholesterol, triglycerides, apolipoprotein B, and fibrinogen levels.
- Higher HDL2 levels were observed in DH patients.
- DH patients reported lower smoking rates and higher social class compared to controls.
Conclusions:
- DH patients possess a more favorable cardiovascular risk factor profile.
- Further research is warranted to elucidate the mechanisms, potentially involving intestinal abnormalities, gluten-free diet, or immunomodulatory effects of smoking.
Abstract:
For reasons that are unclear, patients with dermatitis herpetiformis (DH) have a lower than expected mortality rate from ischaemic heart disease. We have compared risk factors for ischaemic heart disease (lipids, fibrinogen levels, smoking history and social class) in 29 DH patients and 57 controls matched for age and sex. Patients with DH had significantly lower cholesterol, triglycerides, apolipoprotein B and fibrinogen and higher HDL2; they also smoked less and were of higher social class. The mechanisms underlying these observations merit further investigation. Intestinal abnormalities or gluten-free diet may account for differences in lipid fractions, and the immunomodulatory properties of cigarette smoke may protect against the development of DH.