Audience members said these cross-sectional case-control studies can’t demonstrate causality, which would require prospective studies. Dr. Miller agreed. "I think we should be careful about saying what causes what. We’ve shown an association. It could all be due to patient lifestyle. These patients do get depressed, and maybe they sit around at home and get obese, and those fat cells do make inflammatory cytokines," she said.
However, the GESUS study contains information on participants’ physical activity and diet that Dr. Miller is now analyzing. She believes the results will shed light on the mechanism underlying the association between hidradenitis suppurativa and metabolic syndrome.
Hidradenitis suppurativa manifests as extremely painful, chronic, scarring abscesses, cysts, nonhealing tracts, and localized infections affecting mostly intertriginous sites including the underarms, groin, and buttocks.
The GESUS study is funded by the Danish Agency for Science, Technology and Innovation. Dr. Miller reported having no financial conflicts. The German study was unsponsored.