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Systematic review shows regional differences in HS comorbidity prevalence across North America, Europe, and AsiaRegional differences in health risks for hidradenitis suppurativa patients

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Key Takeaway
Regional differences in HS comorbidity prevalence likely reflect lifestyle, diet, and healthcare access factors.

This systematic review and meta-analysis evaluates the prevalence of hidradenitis suppurativa-associated comorbidities in adult and pediatric patients across North America, Europe, and the Middle East/Asia. The study synthesizes data on conditions including diabetes, hypertension, depression, thyroid disorders, smoking, anxiety, and pediatric-specific outcomes. The authors note that absolute numbers and confidence intervals were not reported for the pooled estimates.

The analysis indicates that diabetes carries higher odds in North America compared to Europe with an odds ratio of 1.92. Hypertension shows higher odds in North America compared to the Middle East/Asia with an odds ratio of 2.99. Depression is more common in North America compared to the Middle East/Asia with an odds ratio of 3.46, and also more common in Europe compared to the Middle East/Asia with an odds ratio of 3.19.

Thyroid disorders are more common in North America compared to the Middle East/Asia with an odds ratio of 2.32, and more common in Europe compared to the Middle East/Asia with an odds ratio of 4.01. Smoking is more prevalent in Europe compared to North America with an odds ratio of 0.28, and more prevalent in Europe compared to the Middle East/Asia with an odds ratio of 2.26. In pediatric patients, anxiety is more common in North America with an odds ratio of 0.05, depression is more common in North America with an odds ratio of 0.16, and smoking is more frequent outside North America with an odds ratio of 12.67.

The authors suggest that recognizing these regional patterns may support earlier identification, guide preventive efforts, and inform individualized management strategies in HS. They caution that regional variation in comorbidity prevalence likely reflects differences in lifestyle, diet, sociocultural norms, healthcare literacy, and access to care. Associations are reported without inferring causation between regional differences and comorbidity prevalence.

A systematic review and meta-analysis examined the prevalence of health conditions linked to hidradenitis suppurativa across North America, Europe, and the Middle East/Asia. The study looked at adult and pediatric patients in these regions to see how often they had diabetes, hypertension, depression, thyroid disorders, and other issues.

The analysis found that patients in North America had higher odds of diabetes compared to Europe. They also faced higher odds of hypertension and depression when compared to patients in the Middle East/Asia. In Europe, thyroid disorders were more common than in the Middle East/Asia, and smoking rates were higher than in North America.

Pediatric patients showed different patterns. Anxiety and depression were more common in North America, while smoking was much more frequent outside North America. The study did not report specific numbers or confidence intervals for these findings. Researchers noted that these regional differences likely reflect variations in lifestyle, diet, sociocultural norms, healthcare literacy, and access to care. Recognizing these patterns may help guide preventive efforts and individualized management strategies for people with hidradenitis suppurativa.

What this means for you:
Regional differences in hidradenitis suppurativa comorbidities reflect lifestyle and healthcare access factors.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedMay 2026
View Original Abstract ↓
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder increasingly recognized as a systemic disease with diverse comorbidities. While several comorbid conditions are well documented, regional differences in prevalence remain unclear. OBJECTIVE: The aim of this study was to evaluate regional variation in major comorbidities among HS patients, including diabetes, hypertension, depression, smoking, thyroid disorders, acne, obesity, psoriasis, and inflammatory bowel disease. METHODS: We performed a meta-analysis of proportions using a generalized linear mixed model with a binomial distribution and logit link to compare the prevalence of HS-associated comorbidities across North America, Europe, and the Middle East/Asia. Analyses were stratified by adult and pediatric populations, with regional N-values incorporated. RESULTS: Significant regional differences were observed in metabolic, endocrine, and psychiatric comorbidities. North American patients had higher odds of diabetes compared to Europe (odds ratio [OR] 1.92) and hypertension compared to the Middle East/Asia (OR 2.99). Depression and thyroid disorders were more common in North America (OR 3.46 and 2.32) and Europe (OR 3.19 and 4.01) compared to the Middle East/Asia. Smoking was more prevalent in Europe compared to North America (OR 0.28) and the Middle East/Asia (OR 2.26). Among pediatric patients, anxiety (OR 0.05) and depression (OR 0.16) were more common in North America, while smoking was more frequent outside North America (OR 12.67). CONCLUSIONS: Regional variation in comorbidity prevalence likely reflects differences in lifestyle, diet, sociocultural norms, healthcare literacy, and access to care. Recognizing these patterns may support earlier identification, guide preventive efforts, and inform individualized management strategies in HS.
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