Hidradenitis suppurativa is associated with cardiometabolic comorbidities in a racially and ethnically diverse safety net population: A cross-sectional analysis

Hidradenitis suppurativa is associated with cardiometabolic comorbidities in a racially and ethnically diverse safety net population: A cross-sectional analysisTo the Editor: Hidradenitis suppurativa (HS) is a systemic inflammatory disease that disproportionately impacts patients of color in the United States. 1 Previous studies identified associations between HS and the cardiometabolic comorbidities (CMCs) diabetes, hypertension, and hyperlipidemia, 2 but most analyzed predominantly White populations, 1 and only 2 controlled for obesity. 3,4Given the complex and poorly understood relationships between HS, obesity, race/ethnicity, socioeconomics, and CMCs, 1 we analyzed CMC rates in patients with and without HS among a racially/ethnically diverse safety net population after controlling for obesity.We performed a cross-sectional study of patients at Zuckerberg San Francisco General Hospital from August 2019 to June 2023 (IRB#20-33109).We compared rates of CMCs (diabetes, hyperlipidemia, hypertension, and obesity [Body mass index [ 30]), between patients with and without HS matched 1:2 on patient-reported gender, age, and race/ethnicity.Patients with HS were identified by International Classification of Diseases (ICD)-10 code and verified through chart review.Continuous variables were compared using simple Student t test, categorical variables were compared using 2 testing.We investigated the association of HS (exposure) with diabetes, hypertension, and hyperlipidemia (outcomes) after controlling for patient-reported gender, age, race/ethnicity, obesity, and smoking status (covariates) in multivariable logistic regression.A P-value \ .05 was significant, and analysis was performed in STATA.Our analysis included 303 patients with HS and 606 patients without HS (38% Black, 34% Hispanic, and 87% publicly insured).Patients with HS had higher rates of obesity (74% vs 50%, P \ .01),diabetes (39% vs 19%, P \ .01),and hypertension (46% vs 32%, P \.01), but not hyperlipidemia (39% vs 34%, P .11)(Table I).After controlling for covariates, HS patients had 2.32 times the odds of diabetes (P \.01, 95% CI [1.63-3.30])and 1.66 times