Risk of HS in DM according to smoking status.

IntroductionHidradenitis suppurativa (HS) is a chronic, inflammatory skin condition characterized by painful, recurrent abscesses and tunnels under the skin. It is influenced by a complex interplay of genetic, environmental, and metabolic factors. Smoking, diabetes mellitus, obesity, and other metabolic disorders have been identified as risk factors for HS, potentially exacerbating the severity and progression of the condition. Given the higher prevalence of HS in individuals with type 2 diabetes mellitus (T2DM), understanding modifiable risk factors such as smoking is crucial for improving patient outcomes.ObjectivesTo investigate the association between changes in smoking intensity and the risk of HS in patients with T2DM, with the goal of elucidating how smoking contributes to the development or worsening of HS in this high-risk population.MethodsThis retrospective cohort study analyzed data from the Korean National Health Insurance Service, comprising 1,705,427 participants. The study examined smoking status, changes in smoking intensity, and the incidence of HS in individuals with T2DM, adjusting for potential confounders such as age, gender, and comorbid conditions.ResultsThe study found a 23.6% increased risk of HS in individuals who continued smoking compared to nonsmokers (adjusted hazard ratio (aHR), 1.236; 95% confidence interval (CI), 1.075–1.421). Additionally, participants with increased cigarette consumption had a 28.5% higher risk of HS compared to nonsmokers (aHR, 1.285; 95% CI, 1.048–1.577). However, no significant differences were observed in the association between changes in smoking intensity and the risk of HS when stratified by BMI.ConclusionsThis study highlights the association between smoking and the increased risk of HS in individuals with T2DM, underscoring the importance of smoking cessation as a potential strategy for mitigating HS risk in at-risk DM populations. Additional research is needed to further explore the mechanisms by which smoking exacerbates HS in T2DM and to identify effective interventions for this group.

引言：化脓性汗腺炎（Hidradenitis suppurativa, HS）是一种慢性炎症性皮肤病，以疼痛性、复发性皮下脓肿及窦道为特征。其发病受遗传、环境与代谢因素的复杂交互作用影响。吸烟、糖尿病（diabetes mellitus）、肥胖及其他代谢紊乱已被确定为HS的危险因素，可能加重该病的严重程度与进展。鉴于2型糖尿病（type 2 diabetes mellitus, T2DM）患者中HS的患病率更高，明确吸烟这类可改变的危险因素对于改善患者预后至关重要。

研究目的：本研究旨在探讨2型糖尿病患者吸烟强度变化与HS发病风险的关联，以阐明吸烟在这一高危人群中如何促进HS的发生或病情恶化。

研究方法：本回顾性队列研究分析了韩国国民健康保险服务（Korean National Health Insurance Service）的数据，共纳入1,705,427名参与者。研究考察了2型糖尿病患者的吸烟状态、吸烟强度变化及HS的发病情况，并对年龄、性别、合并症等潜在混杂因素进行了校正。

研究结果：研究显示，与不吸烟者相比，持续吸烟者的HS发病风险升高23.6%（校正后风险比（adjusted hazard ratio, aHR）为1.236；95%置信区间（confidence interval, CI）为1.075~1.421）。此外，香烟消费量增加的参与者相较于不吸烟者，HS发病风险升高28.5%（aHR=1.285；95%CI=1.048~1.577）。但按体质量指数（body mass index, BMI）分层分析后，未观察到吸烟强度变化与HS发病风险之间存在显著关联。

结论：本研究证实了2型糖尿病患者吸烟与HS发病风险升高之间的关联，强调戒烟作为降低该高危糖尿病人群HS发病风险的潜在策略的重要性。未来仍需开展更多研究，进一步阐明吸烟加重2型糖尿病患者HS病情的机制，并为该人群确定有效的干预措施。