Cardiometabolic Inflammation in Vitiligo: Association with Metabolic Syndrome and Inflammatory Biomarkers

Background: Vitiligo, previously considered a localized skin disease, is now regarded as a systemic condition due to its association with autoimmune and metabolic abnormalities. The relationship between metabolic syndrome (MetS) and vitiligo is not clearly established. Chronic inflammation and oxidative stress may also contribute to inflammation-related cardiometabolic processes, even in the absence of MetS. Objectives: To investigate MetS components and inflammatory biomarkers (TNF-α, IL-6, GDF-15, and CCL-7) in patients with vitiligo without comorbidities and to compare the findings with healthy individuals. Methods: In this case–control study, 43 patients with vitiligo and 43 frequency-matched controls (18–65 years) were included. Participants with systemic diseases, smoking or alcohol use, or medications affecting metabolic parameters were excluded. Disease severity and activity were assessed using VASI, BSA, and VIDA scores. Anthropometric data, blood pressure, and laboratory parameters were recorded. Serum biomarker levels were measured by ELISA. Results: The two groups were similar in terms of age and sex. Systolic blood pressure was higher in the vitiligo group (P=0.011), whereas other metabolic parameters and MetS prevalence were comparable. Longer disease duration was associated with the presence of MetS (P=0.008). TNF-α, IL-6, GDF-15, and CCL-7 levels were significantly higher in patients than controls. Among these, GDF-15 and CCL-7 were associated with disease activity, while TNF-α and IL-6 were not. Multivariable regression analysis demonstrated that GDF-15 remained independently associated with vitiligo after adjusting for age, sex, and BMI, whereas the association with CCL-7 was no longer statistically significant. Conclusion: MetS prevalence was not increased in vitiligo; however, elevated inflammatory biomarkers may reflect inflammation-related cardiometabolic processes. After adjusting for age, sex, and BMI, GDF-15 remained independently associated with vitiligo, whereas the association with CCL-7 was no longer statistically significant.