Biomarkers of systemic inflammation are associated with disease severity and metabolic syndrome in patients with hidradenitis suppurativa

Background Biomarkers associated with disease severity and comorbid metabolic syndrome (MetS) in patients with hidradenitis suppurativa (HS) are lacking. Objective To identify biomarkers associated with disease severity and comorbid MetS in patients with HS. Methods Data on hospital outpatients with HS were obtained through clinical examination and interviews. Indicators of systemic inflammation; C-reactive protein (CRP), erythrocyte sedimentation-rate (ESR), neutrophil/lymphocyte-ratio (NLR), platelet/lymphocyte-ratio (PLR), monocyte/lymphocyte-ratio (MLR), platelet/neutrophil-ratio (PNR), pan-immune-inflammation-value (PIV) and systemic-immune-inflammatory-index (SII), were calculated from blood samples. Results 700 patients were included; of those 444 (63.4%) and 256 (36.6%) were female and male, respectively, with a median age of 38.3 years (IQR=27.9-51.0). Increasing CRP, ESR, NLR, PIV, and SII (p<0.001) were significantly associated with increasing Hurley-stage and IHS4-scores in adjusted analysis. A doubling in CRP (OR 1.59 (1.36-1.85), p<0.001), ESR (OR 1.39 (1.17-1.66), p<0.001) and PIV (OR 1.41 (1.12-1.77) p=0.002) was associated with MetS in adjusted analysis. ESR was the best estimator for severe IHS4 (AUC=0.72 (0.66-0.77), p<0.001) and Hurley III (AUC=0.79 (0.73-0.85), p<0.001) whereas CRP was best for MetS (AUC=0.67 (0.62-0.72), p<0.001). Limitations Patients in a hospital setting tend to have more severe disease. Conclusion Biomarkers like CRP, ESR, and PIV measuring systemic inflammation were associated with disease severity and comorbid MetS in patients with HS.