{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T05:50:05Z","timestamp":1761198605049,"version":"build-2065373602"},"reference-count":66,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:00:00Z","timestamp":1761091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Hidradenitis suppurativa (HS) is a chronic, relapsing inflammatory dermatosis with substantial quality-of-life impact. HS frequently co-exists with obesity and metabolic comorbidities. Cigarette smoking is highly prevalent and has been linked to heightened inflammatory activity and impaired wound healing. The role of cumulative tobacco exposure (packyears) in relation to metabolic comorbidities in HS is less well defined. We therefore investigated whether lifetime pack-years relate to laboratory parameters and the presence of comorbidities in HS. Methods: We conducted a retrospective, single-center study involving 131 patients with HS. We collected clinical data, including disease severity scores and quality of life indices, along with laboratory markers such as complete blood count and C-reactive protein. Smoking status and cumulative exposure (pack-years) were assessed based on patient history. To compare laboratory parameters between smoking subgroups, we used Mann\u2013Whitney U tests. Additionally, we performed logistic regression analyses to evaluate the association between cumulative cigarette exposure and the presence of comorbidities. Results: Among the cohort, 63.4% were active smokers with a median of 15 pack-years. Smokers had significantly higher leukocyte, neutrophil, lymphocyte, monocyte, eosinophil, and basophil counts, indicating elevated systemic inflammation. Hematocrit, hemoglobin, mean corpuscular volume, and mean corpuscular hemoglobin were also significantly higher in smokers, while C-reactive protein levels did not differ notably between groups. Subgroup analysis revealed that patients with arterial hypertension, diabetes mellitus, and hypercholesterolemia had significantly more pack-years than those without these conditions. These comorbidities, components of metabolic syndrome, were strongly associated with higher lifetime tobacco exposure in HS patients. Conclusions: Smoking contributes not only to heightened inflammatory activity in HS but is also significantly associated with the presence of metabolic comorbidities. These findings underscore the importance of early interdisciplinary intervention and structured smoking cessation programs to improve outcomes in HS patients.<\/jats:p>","DOI":"10.3390\/life15111647","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T01:14:02Z","timestamp":1761182042000},"page":"1647","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hidradenitis Suppurativa: Higher Tobacco Pack-Years in Patients with Metabolic Comorbidities"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5995-5458","authenticated-orcid":false,"given":"Yannik","family":"Haven","sequence":"first","affiliation":[{"name":"International Centre for Hidradenitis Suppurativa\/Acne Inversa (ICH), Department of Dermatology, Venereology and Allergology, Ruhr-University, 44791 Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6853-0743","authenticated-orcid":false,"given":"Nessr","family":"Abu Rached","sequence":"additional","affiliation":[{"name":"International Centre for Hidradenitis Suppurativa\/Acne Inversa (ICH), Department of Dermatology, Venereology and Allergology, Ruhr-University, 44791 Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte","family":"Michel","sequence":"additional","affiliation":[{"name":"International Centre for Hidradenitis Suppurativa\/Acne Inversa (ICH), Department of Dermatology, Venereology and Allergology, Ruhr-University, 44791 Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Myszkowski","sequence":"additional","affiliation":[{"name":"International Centre for Hidradenitis Suppurativa\/Acne Inversa (ICH), Department of Dermatology, Venereology and Allergology, Ruhr-University, 44791 Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3653-1560","authenticated-orcid":false,"given":"Lennart","family":"Ocker","sequence":"additional","affiliation":[{"name":"International Centre for Hidradenitis Suppurativa\/Acne Inversa (ICH), Department of Dermatology, Venereology and Allergology, Ruhr-University, 44791 Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioannis A.","family":"Zeglis","sequence":"additional","affiliation":[{"name":"International Centre for Hidradenitis Suppurativa\/Acne Inversa (ICH), Department of Dermatology, Venereology and Allergology, Ruhr-University, 44791 Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eggert","family":"Stockfleth","sequence":"additional","affiliation":[{"name":"International Centre for Hidradenitis Suppurativa\/Acne Inversa (ICH), Department of Dermatology, Venereology and Allergology, Ruhr-University, 44791 Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0418-521X","authenticated-orcid":false,"given":"Falk G.","family":"Bechara","sequence":"additional","affiliation":[{"name":"International Centre for Hidradenitis Suppurativa\/Acne Inversa (ICH), Department of Dermatology, Venereology and Allergology, Ruhr-University, 44791 Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1111\/bjd.19556","article-title":"Aetiology and pathogenesis of hidradenitis suppurativa","volume":"183","author":"Wolk","year":"2020","journal-title":"Br. J. Dermatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1111\/exd.14214","article-title":"What causes hidradenitis suppurativa?\u201415 years after","volume":"29","author":"Zouboulis","year":"2020","journal-title":"Exp. Dermatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1038\/s41572-020-0149-1","article-title":"Hidradenitis suppurativa","volume":"6","author":"Sabat","year":"2020","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e139932","DOI":"10.1172\/jci.insight.139932","article-title":"Immunopathogenesis of hidradenitis suppurativa and response to anti-TNF-\u03b1 therapy","volume":"5","author":"Lowe","year":"2020","journal-title":"JCI Insight"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1111\/bjd.21043","article-title":"Damage in hidradenitis suppurativa: A narrative review emphasizing the need for a novel outcome measure","volume":"187","author":"Fritsche","year":"2022","journal-title":"Br. J. Dermatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1093\/ced\/llad182","article-title":"Obesity and hidradenitis suppurativa: Targeting meta-inflammation for therapeutic gain","volume":"48","author":"Mintoff","year":"2023","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1111\/ced.14478","article-title":"Clinical and demographic features of hidradenitis suppurativa: A multicentre study of 1221 patients with an analysis of risk factors associated with disease severity","volume":"46","author":"Aksoy","year":"2021","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"564","DOI":"10.1016\/j.clindermatol.2023.08.020","article-title":"Epidemiology of hidradenitis suppurativa","volume":"41","year":"2023","journal-title":"Clin. Dermatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1111\/bjd.13777","article-title":"Hidradenitis suppurativa and metabolic syndrome: A comparative cross-sectional study of 3207 patients","volume":"173","author":"Shalom","year":"2015","journal-title":"Br. J. Dermatol."},{"doi-asserted-by":"crossref","unstructured":"Abu Rached, N., Dietrich, J.W., Ocker, L., Stockfleth, E., Haven, Y., Myszkowski, D., and Bechara, F.G. (2025). Endotyping Insulin-Glucose Homeostasis in Hidradenitis Suppurativa: The Impact of Diabetes Mellitus and Inflammation. J. Clin. Med., 14.","key":"ref_10","DOI":"10.3390\/jcm14072145"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e13541","DOI":"10.1111\/dth.13541","article-title":"Psychiatric comorbidities in patients with hidradenitis suppurativa","volume":"33","author":"Misitzis","year":"2020","journal-title":"Dermatol. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1111\/bjd.16261","article-title":"Tobacco smoking and hidradenitis suppurativa: Associated disease and an important modifiable risk factor","volume":"178","author":"Micheletti","year":"2018","journal-title":"Br. J. Dermatol."},{"key":"ref_13","first-page":"e1305","article-title":"The influence of body mass index and smoking on the severity of hidradenitis suppurativa in the Slovenian population","volume":"37","author":"Falabella","year":"2023","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.jdermsci.2017.04.006","article-title":"A retrospective institutional study of the association of smoking with the severity of hidradenitis suppurativa","volume":"87","author":"Dessinioti","year":"2017","journal-title":"J. Dermatol. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1111\/bjd.15939","article-title":"Incidence of hidradenitis suppurativa among tobacco smokers: A population-based retrospective analysis in the U.S.A","volume":"178","author":"Garg","year":"2018","journal-title":"Br. J. Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e14919","DOI":"10.1111\/dth.14919","article-title":"Systemic antibiotics in hidradenitis suppurativa: Efficacy and effects of body mass index and smoking pack-year on the response to therapy","volume":"34","author":"Iannone","year":"2021","journal-title":"Dermatol. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1042\/cs0880485","article-title":"Cigarette smoking influences cytokine production and antioxidant defences","volume":"88","author":"Tappia","year":"1995","journal-title":"Clin. Sci."},{"key":"ref_18","first-page":"95","article-title":"Cigarette Smoke-induced Oxidative Stress: A Systematic Review","volume":"1","author":"Thirumalai","year":"2021","journal-title":"IJPSCR Int. J. Phramaceutical Sci. Clin. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1080\/08958378.2024.2319315","article-title":"Comparison of the effects of active and passive smoking of tobacco cigarettes, electronic nicotine delivery systems and tobacco heating products on the expression and secretion of oxidative stress and inflammatory response markers. A systematic review","volume":"36","author":"Pawliczak","year":"2024","journal-title":"Inhal. Toxicol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1161\/ATVBAHA.118.312338","article-title":"Smoking and Increased White and Red Blood Cells","volume":"39","author":"Pedersen","year":"2019","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1182\/blood.V41.6.845.845","article-title":"Effect of Smoking on Tissue Oxygen Supply","volume":"41","author":"Sagone","year":"1973","journal-title":"Blood"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1378\/chest.06-2179","article-title":"Systemic effects of smoking","volume":"131","author":"Yanbaeva","year":"2007","journal-title":"Chest"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/0009-8981(85)90133-0","article-title":"Raised C-reactive protein levels in serum from smokers","volume":"153","author":"Das","year":"1985","journal-title":"Clin. Chim. Acta"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1016\/j.jaad.2015.08.052","article-title":"Correlation of inflammatory serum markers with disease severity in patients with hidradenitis suppurativa (HS)","volume":"73","author":"Hessam","year":"2015","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1007\/s00403-019-02014-8","article-title":"Serum amyloid A and C-reactive protein levels and erythrocyte sedimentation rate are important indicators in hidradenitis suppurativa","volume":"312","author":"Akdogan","year":"2020","journal-title":"Arch. Dermatol. Res."},{"doi-asserted-by":"crossref","unstructured":"Aspera-Werz, R.H., M\u00fcck, J., Linnemann, C., Herbst, M., Ihle, C., Histing, T., Nussler, A.K., and Ehnert, S. (2022). Nicotine and Cotinine Induce Neutrophil Extracellular Trap Formation-Potential Risk for Impaired Wound Healing in Smokers. Antioxidants, 11.","key":"ref_26","DOI":"10.3390\/antiox11122424"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"268","DOI":"10.7326\/0003-4819-45-2-268","article-title":"Chronic obstructive pulmonary emphysema; a disease of smokers","volume":"45","author":"Franklin","year":"1956","journal-title":"Ann. Intern. Med."},{"doi-asserted-by":"crossref","unstructured":"Zhang, C., Qin, S., Qin, L., Liu, L., Sun, W., Li, X., Li, N., Wu, R., and Wang, X. (2016). Cigarette smoke extract-induced p120-mediated NF-\u03baB activation in human epithelial cells is dependent on the RhoA\/ROCK pathway. Sci. Rep., 6.","key":"ref_28","DOI":"10.1038\/srep23131"},{"doi-asserted-by":"crossref","unstructured":"Wang, H., Chen, H., Fu, Y., Liu, M., Zhang, J., Han, S., Tian, Y., Hou, H., and Hu, Q. (2022). Effects of Smoking on Inflammatory-Related Cytokine Levels in Human Serum. Molecules, 27.","key":"ref_29","DOI":"10.3390\/molecules27123715"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2313","DOI":"10.1007\/s10753-024-02191-3","article-title":"Nicotine-Induced Transient Activation of Monocytes Facilitates Immunosuppressive Macrophage Polarization that Restrains T Helper 17 Cell Expansion","volume":"48","author":"Zhan","year":"2024","journal-title":"Inflammation"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1023\/A:1006867423715","article-title":"Nicotinic and muscarinic components in acetylcholine stimulation of porcine adrenal medullary cells","volume":"169","author":"Luxoro","year":"1997","journal-title":"Mol. Cell. Biochem."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.sjbs.2019.11.001","article-title":"Tobacco smoking causes secondary polycythemia and a mild leukocytosis among heavy smokers in Taif City in Saudi Arabia","volume":"27","author":"Alkhedaide","year":"2020","journal-title":"Saudi J. Biol. Sci."},{"doi-asserted-by":"crossref","unstructured":"Nowak-Liduk, A., Kitala, D., Ocha\u0142a-Gierek, G., \u0141abu\u015b, W., Bergler-Czop, B., Pietrauszka, K., Niemiec, P., Szyluk, K., and Gierek, M. (2023). Hidradenitis Suppurativa: An Interdisciplinary Problem in Dermatology, Gynecology, and Surgery-Pathogenesis, Comorbidities, and Current Treatments. Life, 13.","key":"ref_33","DOI":"10.3390\/life13091895"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/1758-5996-6-79","article-title":"Cigarette smoking worsens systemic inflammation in persons with metabolic syndrome","volume":"6","author":"Jamal","year":"2014","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1007\/s11883-023-01132-z","article-title":"Hypertension and Dyslipidemia: The Two Partners in Endothelium-Related Crime","volume":"25","author":"Narkiewicz","year":"2023","journal-title":"Curr. Atheroscler. Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1001\/jamadermatol.2015.6264","article-title":"Risk of Major Adverse Cardiovascular Events and All-Cause Mortality in Patients With Hidradenitis Suppurativa","volume":"152","author":"Egeberg","year":"2016","journal-title":"JAMA Dermatol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"359","DOI":"10.4103\/ijd.ijd_245_22","article-title":"Hidradenitis Suppurativa and Risk of Coronary Artery Disease: A Systematic Review and Meta-Analysis","volume":"68","author":"Worapongsatitaya","year":"2023","journal-title":"Indian J. Dermatol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1161\/ATVBAHA.113.300156","article-title":"Smoking and cardiovascular disease: Mechanisms of endothelial dysfunction and early atherogenesis","volume":"34","author":"Messner","year":"2014","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.mvr.2014.03.001","article-title":"Impact of long-term exposure to cigarette smoking on skin microvascular function","volume":"93","author":"Rossi","year":"2014","journal-title":"Microvasc. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1097\/WON.0000000000000057","article-title":"Smoking, chronic wound healing, and implications for evidence-based practice","volume":"41","author":"McDaniel","year":"2014","journal-title":"J. Wound Ostomy Continence Nurs."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/S0140-6736(24)02475-9","article-title":"Hidradenitis suppurativa","volume":"405","author":"Sabat","year":"2025","journal-title":"Lancet"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1093\/ced\/llae521","article-title":"The association of hidradenitis suppurativa with cigarette smoking and cannabis use: A cross-sectional study in the All of Us Research Program","volume":"50","author":"Chen","year":"2025","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"4778","DOI":"10.1096\/fj.12-206458","article-title":"General mechanisms of nicotine-induced fibrogenesis","volume":"26","author":"Jensen","year":"2012","journal-title":"FASEB J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.1016\/j.jaad.2015.07.045","article-title":"Pathophysiology of hidradenitis suppurativa: An update","volume":"73","author":"Prens","year":"2015","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1111\/j.1365-4632.2011.05205.x","article-title":"Smoking and the skin","volume":"51","author":"Ortiz","year":"2012","journal-title":"Int. J. Dermatol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1007\/s00011-017-1074-y","article-title":"The critical role of macrophages in the pathogenesis of hidradenitis suppurativa","volume":"66","author":"Shah","year":"2017","journal-title":"Inflamm. Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2214","DOI":"10.1016\/j.lfs.2007.02.007","article-title":"Functional significance of non-neuronal acetylcholine in skin epithelia","volume":"80","author":"Hana","year":"2007","journal-title":"Life Sci."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1161\/01.CIR.0000111245.75752.C6","article-title":"Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute\/American Heart Association conference on scientific issues related to definition","volume":"109","author":"Grundy","year":"2004","journal-title":"Circulation"},{"doi-asserted-by":"crossref","unstructured":"Edwardson, C.L., Gorely, T., Davies, M.J., Gray, L.J., Khunti, K., Wilmot, E.G., Yates, T., and Biddle, S.J.H. (2012). Association of sedentary behaviour with metabolic syndrome: A meta-analysis. PLoS ONE, 7.","key":"ref_49","DOI":"10.1371\/journal.pone.0034916"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"28","DOI":"10.14744\/SEMB.2024.40374","article-title":"Evaluation of the Psychosocial Burden of Hidradenitis Suppurativa and Relevant Factors: A Prospective Single-Center Study","volume":"59","author":"Altunay","year":"2025","journal-title":"Sisli Etfal Hastan. Tip Bul."},{"doi-asserted-by":"crossref","unstructured":"Rymaszewska, J.E., Krajewski, P.K., Matusiak, \u0141., Maj, J., and Szepietowski, J.C. (2023). Satisfaction with Life and Coping Strategies among Patients with Hidradenitis Suppurativa: A Cross-Sectional Study. J. Clin. Med., 12.","key":"ref_51","DOI":"10.3390\/jcm12082755"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"4729","DOI":"10.1210\/jc.2010-0322","article-title":"Cortisol is negatively associated with insulin sensitivity in overweight Latino youth","volume":"95","author":"Adam","year":"2010","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1007\/s00125-007-0629-9","article-title":"Cortisol clearance and associations with insulin sensitivity, body fat and fatty liver in middle-aged men","volume":"50","author":"Holt","year":"2007","journal-title":"Diabetologia"},{"doi-asserted-by":"crossref","unstructured":"Perski, O., Theodoraki, M., Cox, S., Kock, L., Shahab, L., and Brown, J. (2022). Associations between smoking to relieve stress, motivation to stop and quit attempts across the social spectrum: A population survey in England. PLoS ONE, 17.","key":"ref_54","DOI":"10.1371\/journal.pone.0268447"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1136\/tobaccocontrol-2019-055558","article-title":"Do people know that cigarette filters are mainly composed of synthetic material? A representative survey of the German population (the DEBRA study)","volume":"30","author":"Kotz","year":"2021","journal-title":"Tob. Control"},{"doi-asserted-by":"crossref","unstructured":"Seo, Y.-S., Park, J.-M., Kim, J.-H., and Lee, M.-Y. (2023). Cigarette Smoke-Induced Reactive Oxygen Species Formation: A Concise Review. Antioxidants, 12.","key":"ref_56","DOI":"10.3390\/antiox12091732"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1111\/jdv.14599","article-title":"Low and high body mass index in hidradenitis suppurativa patients-different subtypes?","volume":"32","author":"Saunte","year":"2018","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"doi-asserted-by":"crossref","unstructured":"Cho, S.H., Jeong, S.H., Shin, J., Park, S., and Jang, S.-I. (2022). Short-term smoking increases the risk of insulin resistance. Sci. Rep., 12.","key":"ref_58","DOI":"10.1038\/s41598-022-07626-1"},{"key":"ref_59","first-page":"20","article-title":"Genetic Susceptibility to Hidradenitis Suppurativa and Predisposition to Cardiometabolic Disease","volume":"161","author":"Nielsen","year":"2024","journal-title":"JAMA Dermatol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1093\/bjd\/ljad305","article-title":"Metformin has anti-inflammatory effects and induces immunometabolic reprogramming via multiple mechanisms in hidradenitis suppurativa","volume":"189","author":"Petrasca","year":"2023","journal-title":"Br. J. Dermatol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1822","DOI":"10.25251\/skin.8.5.6","article-title":"Trends of Metformin Use in Patients with Hidradenitis Suppurativa, 2016\u20132021","volume":"8","author":"Stachowski","year":"2024","journal-title":"Ski. J. Cutan. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2559","DOI":"10.1111\/bcp.14077","article-title":"A sequence symmetry analysis of the interrelationships between statins, diabetes and skin infections","volume":"85","author":"Ko","year":"2019","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1159\/000514028","article-title":"Nicotine Dependency and Readiness to Quit Smoking among Patients with Hidradenitis Suppurativa","volume":"237","author":"Vossen","year":"2021","journal-title":"Dermatology"},{"key":"ref_64","first-page":"476","article-title":"Validation of Cardiovascular Risk Prediction by the Arriba Instrument","volume":"119","author":"Angelow","year":"2022","journal-title":"Dtsch. Arztebl. Int."},{"doi-asserted-by":"crossref","unstructured":"Hollands, G.J., Usher-Smith, J.A., Hasan, R., Alexander, F., Clarke, N., and Griffin, S.J. (2022). Visualising health risks with medical imaging for changing recipients\u2019 health behaviours and risk factors: Systematic review with meta-analysis. PLoS Med., 19.","key":"ref_65","DOI":"10.1371\/journal.pmed.1003920"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1093\/oxfordjournals.aje.a008997","article-title":"Longitudinal relation between smoking and white blood cells","volume":"144","author":"Sunyer","year":"1996","journal-title":"Am. J. Epidemiol."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/11\/1647\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T05:45:08Z","timestamp":1761198308000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/15\/11\/1647"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,22]]},"references-count":66,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["life15111647"],"URL":"https:\/\/doi.org\/10.3390\/life15111647","relation":{},"ISSN":["2075-1729"],"issn-type":[{"type":"electronic","value":"2075-1729"}],"subject":[],"published":{"date-parts":[[2025,10,22]]}}}