Screening for the presence of scleroedema adultorum of Buschke in patients with diabetes mellitus: newly diagnosed patients had a high prevalence of dyslipidaemia

Lipids in Health and Disease

Beáta Bódis¹  Endre Kálmán²  Cecília Varjú³  László Czirják³  Viktória Csonka⁴  Dániel Kovács⁵  Nelli Farkas⁶ 

[1] 1st Department of Internal Medicine, Medical School, University of Pécs, Pécs, Hungary;Department of Pathology, Medical School, University of Pécs, Pécs, Hungary;Department of Rheumatology and Immunology, Medical School, University of Pécs, Akác u. 1, H-7632, Pécs, Hungary;Department of Rheumatology and Immunology, Medical School, University of Pécs, Akác u. 1, H-7632, Pécs, Hungary;Department of Internal Medicine, Teaching Hospital Mór Kaposi, Kaposvár, Hungary;Department of Vascular Surgery, Medical School, University of Pécs, Pécs, Hungary;Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary;

关键词: Scleroedema;    Scleroderma-like;    Fibromucinous thickening;    Diabetes mellitus;    Dyslipidaemia;    Non-alcoholic fatty liver disease (NAFLD);   

DOI  :  10.1186/s12944-021-01473-1

来源: Springer

【 摘 要 】

BackgroundScleroedema adultorum of Buschke is a rare disorder characterized by fibromucinous thickening of the dermis that manifests mainly at the nape of the neck and on the upper back and shoulders. This study screened patients with diabetes mellitus for skin hardening caused by scleroedema adultorum of Buschke and characterized the clinical and laboratory findings in patients with newly identified cases, with a focus on lipid metabolism abnormalities and vascular complications.MethodsOut of 113 consecutive patients with diabetes, 11 (9.7%) new scleroedema patients, all with type 2 diabetes, were found. Their clinical and laboratory data were compared to those of the rest of the screened patients and to those of a cohort of 15 patients with scleroedema and diabetes who were already being treated in a tertiary clinical centre at the University of Pécs.ResultsHigher proportions of patients with dyslipidaemia, hypertriglyceridemia (P < 0.05) and increased mean levels of non-high-density lipoprotein cholesterol (non-HDL-C) were found (P < 0.01) in both scleroedema groups than in the group without scleroedema. Stroke and venous thromboembolism (VTE) were more frequently found in the histories of both the newly identified scleroedema group (each 3/11; 27.3%) and the treated cohort (each 6/15; 40.0%) than in the group without scleroedema (6/102; 5.9% in cases of stroke P = 0.021, P < 0.001; and 14/102; 13.7%; P < 0.05 in cases of VTE, respectively). Based on binary logistic regression, a high non-HDL-C level (odds ratio (OD): 3.338, confidence interval (CI): 1.77–6.28; P < 0.001) and insulin treatment (OR 7.64, CI 1.9–29.3; P = 0.003) were independent predictors of scleroedema in patients with diabetes mellitus.ConclusionsDiabetes patients with scleroedema had more severe dyslipidaemia and higher occurrence of vascular complications compared to those without scleroedema. In addition to poorly controlled type 2 diabetes mellitus requiring insulin treatment, high non-HDL-C levels may be another contributing factor to the development of scleroedema.Trial registrationNCT04335396.

【 授权许可】

CC BY