Skin disease related to metabolic syndrome in women

Effects of Nitric Oxide on Bladder Detrusor Overactivity through the NRF2 and HIF-1α Pathways: A Rat Model Induced by Metabolic Syndrome and Ovarian Hormone Deficiency

Metabolic syndrome (MetS) includes cardiovascular risk factors like obesity, dyslipidemia, hypertension, and glucose intolerance, which increase the risk of overactive bladder (OAB), characterized by urgency, frequency, urge incontinence, and nocturia. Both MetS and ovarian hormone deficiency (OHD) are linked to bladder overactivity. Nitric oxide (NO) is known to reduce inflammation and promote healing but its effect on bladder overactivity in MetS and OHD is unclear. This study aimed to investigate NO's impact on detrusor muscle hyperactivity in rats with MetS and OHD. Female Sprague-Dawley rats were divided into seven groups based on diet and treatments involving L-arginine (NO precursor) and L-NAME (NOS inhibitor). After 12 months on a high-fat, high-sugar diet with or without OVX, a cystometrogram and tracing analysis of voiding behavior were used to identify the symptoms of detrusor hyperactivity. The MetS with or without OHD group had a worse bladder contractile response while L-arginine ameliorated bladder contractile function. In summary, MetS with or without OHD decreased NO production, reduced angiogenesis, and enhanced oxidative stress to cause bladder overactivity, mediated through the NF-kB signaling pathway, whereas L-arginine ameliorated the symptoms of detrusor overactivity and lessened oxidative damage via the NRF2/HIF-1α signaling pathway in MetS with or without OHD-induced OAB.

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

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.

Prevalence of Metabolic Syndrome and Insulin Resistance in Adult Patients with Acne: Association with Traditional Cardiovascular Risk Factors and Acne Severity

Introduction: Acne is a chronic inflammatory disease that affects the pilosebaceous unit, and there are conflicting evidences regarding its association with metabolic syndrome (MS) and insulin resistance (IR). Methods: A cross-sectional study was performed with 162 acne patients, over 20 years of age, matched for age and sex with 78 healthy controls without acne. The measured parameters included waist circumference (WC), body mass index (BMI), systolic blood pressure, diastolic blood pressure, fasting blood glucose, fasting insulin, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides (TG), and total cholesterol. Acne severity was determined according to the Global Acne Grading System. The criteria used for the diagnosis of MS were those of the Harmonizing the Metabolic Syndrome Statement, adjusted for South Americans, and the IR was calculated using the HOMA-IR. Results: The prevalence of MS was significantly higher in cases, compared to controls (12.3% vs. 2.6%, P = 0.014), as was the prevalence of IR (11.7% vs. 3.8%, P = 0.047). In addition, MS and IR showed a positive correlation with the degree of acne severity (P = 0.011 and P = 0.021, respectively). HDL levels were significantly lower in cases (P = 0.012) and showed an association with acne severity (P = 0.038). In the logistic regression model, the risk factor that independently influenced both MS and IR in patients with acne was the WC (P = 0.001). Conclusions: Adults with acne, especially the most severe cases, are significantly more likely to have MS, IR, and lower HDL levels, compared to controls without acne.

Investigation of the relationship between seborrheic dermatitis and metabolic syndrome parameters

BACKGROUND

Seborrheic dermatitis (SD) is a common, chronic inflammatory disease with relapses and remissions.

OBJECTIVES

So we planned to investigate the relationship between SD and metabolic syndrome (Mets).

METHODS

54 patients over 18 years of age without known diabetes mellitus, hypertension, coronary artery disease who were clinically diagnosed with SD in our clinic and 47 healthy controls were included in the study. Body mass index (BMI) was calculated of all participants. Complete blood count, fasting blood sugar (FBG), triglyceride (TG), total cholesterol, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were examined. The relationship between the presence of MetS, disease severity, and duration was investigated.

RESULTS

Average age of patients was 35.4 (sd: 12). Average age of controls was 32.9 (sd: 10.7). MetS was detected in 35.2% (n = 19) of the patient group and 10.6% (n = 5) of the control group. The presence of MetS was higher in SD patients than in the control group (p = 0.004). The rate of people with high TG was significantly higher in the SD group than the controls (p = 0.015). HDL level was significantly lower in the patient group (p = 0.050). Systolic and diastolic blood pressure were high in patients (p = 0.016, p = 0.029).

CONCLUSIONS

Seborrheic dermatitis should be considered as a MetS marker and the presence of MetS should be examined in this group of patients. This can be helpful for the early diagnosis of a systemic disease complex with numerous complications. Also, treatment of MetS can also improve SD lesions.

Cutaneous Manifestations and Hormonal Changes Among Polycystic Ovary Syndrome Patients at a Tertiary Care Center

Background: Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine disorder affecting 5%-10% of women worldwide. PCOS patients usually present with cutaneous manifestations of hyperandrogenism, such as acne, hirsutism, and androgenic alopecia.

Objective: To estimate the prevalence of dermatological manifestations and their association with hormonal changes in PCOS patients. In addition, this study aimed to estimate the prevalence of comorbidities associated with PCOS and to demonstrate the referral pattern among Dermatology, Gynecology, and Primary Health Care (PHC).

Methods: This is a cross-sectional study conducted at King Abdulaziz Medical City (KAMC) in Jeddah, Saudi Arabia. All PCOS patients who attended KAMC from 2016 to 2021 were included. Data were collected through a retrospective chart review of the electronic medical record system (BestCare) and by utilizing a structured data collection sheet.

Results: A total of 447 female patients were diagnosed with PCOS with a median age of 29 years and a median BMI of 28.76 kg/m².The prevalence of cutaneous manifestations among patients was 68%. Hirsutism (47.3%), acne vulgaris (40.6%), and androgenic alopecia (20.3%) were the most common manifestations. The most common hormonal abnormalities were raised luteinizing hormone (LH) levels in 220 (49.1%) patients and raised LH/follicle-stimulating hormone (FSH) ratio in 159 (35.5%) patients. FSH, LH/FSH ratio, and age were significant predictors for acne vulgaris (P-value=0.01, 0.04, and 0.01, respectively). Obesity (44.20%), infertility (25.70%), and dyslipidemia (17%) were the most common comorbidities in our sample. Most patients' first visits and follow-ups were in PHC. 

Conclusion: The prevalence of cutaneous manifestations among PCOS patients is relatively high and plays a significant role in making the diagnosis. Therefore, physicians across multiple specialties need to be more aware of the full spectrum of PCOS presentations to alleviate it from its under-diagnosed status.

Early identification of metabolic syndrome risk: A review of reviews and proposal for defining pre-metabolic syndrome status

AIMS

a) To analyze the relationship of known and emerging biomarkers/indicators for early risk identification of cardiometabolic health risk; b) to identify early risk markers to be used in both clinical and nonclinical settings; and c) to propose a definition of early risk identification in terms of pre-metabolic syndrome (PreMetSyn).

DATA SYNTHESIS

Pubmed/Medline, Web of Science, Embase, and Cochrane were searched for Systematic Reviews and Meta-analysis. Selected studies were evaluated, and relevant data were extracted and synthesized.

CONCLUSIONS

Serum uric acid is a good predictive biomarker of metabolic syndrome (MetSyn) and has been associated with non-alcoholic liver fat disease (NAFLD) and type 2 diabetes. NAFLD emerges as an early risk indicator of PreMetSyn by itself. Muscle strength should also be included as an early risk marker of cardiometabolic health. High serum triglycerides and waist circumference confirm their predictive value regarding MetSyn. Indicators related to an inflammatory/pro-inflammatory status usually linked to MetSyn showed limited evidence as robust biomarkers for PreMetSyn. Authors suggest defining PreMetSyn related to cardiometabolic risk. It is also necessary to determine how close people are to the cut-off point of MetSyn components, including emerging indicators proposed by our review. Some biomarkers could be used as indicators of PreMetSyn, before any of the MetSyn components appear, allowing early health interventions to prevent its development. Defining a PreMetSyn status might consider both emerging indicators and those variables already included in the definition of MetSyn. New indicators should be considered to create a new risk score specifically meant for PreMetSyn.