{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:38:56Z","timestamp":1787027936827,"version":"build-2736575974"},"reference-count":33,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Dicle University Scientific Research Projects Commission","award":["TIP.25.010"],"award-info":[{"award-number":["TIP.25.010"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Rosacea increasingly appears to involve systemic immune and metabolic disturbances rather than isolated cutaneous inflammation. To evaluate inflammatory, platelet, and oxidative\u2013metabolic biomarkers in rosacea and explore their interrelations. Methods: 90 patients with rosacea and 90 healthy controls were evaluated for hematologic inflammatory indices\u2014neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune\u2013inflammation index (SII), pan-immune\u2013inflammation value (PIV), mean platelet volume (MPV), and C-reactive protein (CRP)\u2014along with oxidative\u2013metabolic regulators including sirtuin 1 (SIRT1), sirtuin 3 (SIRT3), visfatin, and irisin. Logistic regression and receiver operating characteristic (ROC) analyses were used to identify independent predictors of rosacea, while inter-marker associations were evaluated using Spearman\u2019s rank correlation. Results: Rosacea patients showed higher NLR, PLR, SII, PIV, MPV, CRP, and LDL cholesterol (p &lt; 0.05) and lower SIRT1, SIRT3, visfatin, and irisin (p &lt; 0.01). MPV independently predicted rosacea (OR = 7.24; AUC = 0.827), whereas SIRT1 inversely correlated with disease risk. SIRT1, SIRT3, and visfatin showed inverse correlations with HbA1c and waist-to-height ratio, while fasting glucose and HOMA-IR remained within normal ranges. Conclusions: Rosacea exhibits dual systemic activation, an inflammatory\u2013platelet and an oxidative\u2013metabolic axis bridging immune dysregulation, mitochondrial stress, and vascular dysfunction. Recognition of these pathways highlights the potential of redox-targeted and metabolic interventions beyond symptomatic treatment.<\/jats:p>","DOI":"10.3390\/diagnostics16020246","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T14:57:25Z","timestamp":1768229845000},"page":"246","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Systemic\u00a0Inflammatory and Oxidative\u2013Metabolic Alterations in Rosacea: A Cross-Sectional Case\u2013Control Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4736-9142","authenticated-orcid":false,"given":"Mustafa","family":"Esen","sequence":"first","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine, Dicle University, 21280 Diyarbak\u0131r, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Demirba\u015f","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine, Kocaeli University, 41001 Kocaeli, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9824-481X","authenticated-orcid":false,"given":"Esin","family":"Diremsizoglu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine, Kocaeli University, 41001 Kocaeli, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2906-8589","authenticated-orcid":false,"given":"Rev\u015fa Evin","family":"Canpolat Erkan","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Faculty of Medicine, Dicle University, 21280 Diyarbak\u0131r, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"6387","DOI":"10.4081\/dr.2016.6387","article-title":"Rosacea: A Clinical Review","volume":"8","author":"Mikkelsen","year":"2016","journal-title":"Dermatol. 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