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The association they found between chronic inflammation in HS and metabolic changes was similar to the association between psoriasis and MS&#44; as recently analyzed&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">6</span></a> An earlier meta-analysis showed that patients with HS have a 2-fold higher risk for MS &#40;cumulative odds ratio &#91;OR&#93;&#44; 2&#46;22&#59; 95&#37; CI&#44; 1&#46;62&#8211;3&#46;06&#41;&#44; although the studies included at that time had not reported ORs adjusted for the influence of possible confounders and the meta-analysis had not considered heterogeneity and biases&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">8</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">These findings have important implications for therapy over the chronic&#44; relapsing course of the disease&#44; considering that standard approaches to treating HS are still suboptimal&#46; Alternative therapies may prove appropriate in HS&#59; for example&#44; one study found that metformin helped control HS symptoms with few adverse effects&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">9</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">We aimed to review the current literature to compare reported prevalence rates of MS in HS and assess the association between the 2 conditions&#46; We sought studies that had adjusted for possible confounders&#46;</p></span><span id="sec0910" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">This systematic review and meta-analysis followed the MOOSE guidelines &#40;Meta-analysis of Observational Studies in Epidemiology&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">10</span></a> The protocol was registered in the PROSPERO system &#40;CRD42017059937&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Inclusion Criteria</span><p id="par0035" class="elsevierStylePara elsevierViewall">We included observational studies with case&#8211;control and cross-sectional designs that described the association of HS and MS&#46; The studies could be either prospective or retrospective&#44; and the language of publication could be either English or Spanish&#46; Searches encompassed the time from inception of the databases until January 2016&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Study participants could be either children or adults with HS&#46; Control patients did not have HS&#46; Both sexes were included&#46; The studies had to assess the prevalence or incidence of MS&#44; as defined by any of the following groups&#58; the World Health Organization&#44;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">11</span></a> the National Cholesterol Education Program Adult Treatment Panel III &#40;ATP-III&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">12</span></a> the International Diabetes Federation&#44;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">13</span></a> and the Joint Scientific Statement &#40;of the American Heart Association among others&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">14</span></a> Each definition includes several clinical criteria based on physical examination as well as laboratory findings or patient-reported information in both the HS and control populations&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">After making a concerted attempt to contact the authors of articles with missing information&#44; we discarded any studies that still lacked crude or adjusted OR data&#46; If studies included overlapping data&#44; only the one with the larger number of cases was retained&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Sources and Search Strategy</span><p id="par0050" class="elsevierStylePara elsevierViewall">Searches were done in the following databases&#58; MEDLINE&#44; SCOPUS&#44; SCIELO&#44; Google Scholar&#44; Science Direct&#44; and LILACS&#46; A search strategy appropriate for each database was used&#46; We used Medical Subject Headings and the following free-text terms <span class="elsevierStyleItalic">hidradenitis suppurativa</span> &#40;Spanish&#44; <span class="elsevierStyleItalic">hidradenitis supurativa</span>&#41; and <span class="elsevierStyleItalic">metabolic syndrome</span> &#40;<span class="elsevierStyleItalic">s&#237;ndrome metab&#243;lico</span>&#41;&#46; &#40;See online supplementary material&#44; Appendix&#46;&#41; We also hand searched journals for relevant articles mentioned in reference lists&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Study Selection and Data Extraction</span><p id="par0055" class="elsevierStylePara elsevierViewall">Two researchers &#40;M&#46;J&#46;M&#46;R&#46;-Z&#46; and H&#46;A&#46;G&#46;-P&#46;&#41; independently read titles and abstracts to assess each study&#39;s relevance&#46; The selection criteria were then applied to full texts before articles were finally included&#46; Any disagreement between the readers was resolved by consulting the third author &#40;A&#46;G&#46;O&#46;-L&#46;&#41;&#46; The 2 readers then extracted data independently&#44; filling in a standardized questionnaire&#46; Both checked all entries and revised the data sheets at least twice to ensure completeness and accuracy&#46; The following information was extracted&#58; author&#44; year of publication&#44; country&#47;geographic location&#44; study design&#44; number and type of patient&#59; mean age&#44; prevalence or incidence of MS in HS and control groups&#59; and crude and adjusted ORs&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Definitions of Variables</span><p id="par0060" class="elsevierStylePara elsevierViewall">All the included studies applied the ATP-III criteria to define MS&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">12</span></a> Thus&#44; MS was diagnosed when a patient had at least 3 of the following conditions<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">1</span></a>&#58; fasting glucose levels of 100<span class="elsevierStyleHsp" style=""></span>mg&#47;dL &#40;or under treatment to lower blood sugar levels&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">2</span></a> blood pressure of at least 130&#47;85<span class="elsevierStyleHsp" style=""></span>mmHg &#40;or on antihypertensive treatment&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">3</span></a> triglyceride concentration of 150<span class="elsevierStyleHsp" style=""></span>mg&#47;dL or more &#40;or on treatment&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">4</span></a> high density lipoprotein cholesterol &#60;40<span class="elsevierStyleHsp" style=""></span>mg&#47;dL in men or &#60;50<span class="elsevierStyleHsp" style=""></span>mg&#47;dL in women &#40;or on treatment&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">5</span></a> or a waist circumference over 102<span class="elsevierStyleHsp" style=""></span>cm in men or 88<span class="elsevierStyleHsp" style=""></span>cm in women&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The primary objective was to estimate the association between HS and MS in studies reporting ORs adjusted for confounders such as age&#44; sex&#44; and smoking&#46; Four secondary objectives were also set&#58; <span class="elsevierStyleItalic">1&#41;</span> to estimate the association between HS and MS based on reported crude ORs&#44; <span class="elsevierStyleItalic">2&#41;</span> to estimate the association in subgroups&#44; <span class="elsevierStyleItalic">3&#41;</span> to describe the characteristics of patients with HS &#40;age&#44; sex&#44; smoking habit&#44; etc&#46;&#41;&#44; and <span class="elsevierStyleItalic">4&#41;</span> to assess risk of bias in the included studies<span class="elsevierStyleItalic">&#46;</span></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Data Analysis</span><p id="par0070" class="elsevierStylePara elsevierViewall">We used adjusted ORs reported in the studies to calculate the cumulative OR&#46; This OR&#44; reported with its 95&#37; CI&#44; was the outcome measure for the primary objective&#46; Because we expected considerable heterogeneity&#44; the cumulative OR was calculated using a random effects meta-analysis&#44; which is the standard approach&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">15</span></a> Statistical heterogeneity was determined by the Q test&#44; which is based on the &#967;<span class="elsevierStyleSup">2</span> test and the I<span class="elsevierStyleSup">2</span> statistic&#44;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">16</span></a> which is considered high if over 50&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">17</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Descriptive data from clinical trials &#40;percentages and means&#41; were analyzed&#46; All analyses and meta-analyses were carried out with Stata13 software &#40;StataCorp&#41;&#46; Some images were created with Review Manager&#44; version 5&#46;1 &#40;Cochrane Collaboration&#41;&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Subgroup Analyses</span><p id="par0080" class="elsevierStylePara elsevierViewall">We compared results according to design &#40;cross-sectional vs case&#8211;control&#41;&#44; data collection methods &#40;prospective vs retrospective&#41;&#44; geographic location &#40;Europe vs other&#41;&#44; MS diagnostic criteria &#40;ATP-III vs other&#41;&#44; and patient type &#40;hospital vs another &#8220;general&#8221; source and adults vs children&#41;&#46; Forest plots were used to report the effect sizes and 95&#37; CIs&#46; These subgroup analyses were based on adjusted ORs whenever possible or on crude ORs if no adjusted ORs were reported&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Publication Bias</span><p id="par0085" class="elsevierStylePara elsevierViewall">Publication bias was assessed by inspecting funnel plots of study size against standard error&#46; A symmetrical plot indicates that publication bias is unlikely except when very small studies are included&#46; &#40;See online supplementary material&#44; Appendix&#46;&#41;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Quality Assessment</span><p id="par0090" class="elsevierStylePara elsevierViewall">We used the MINORS tool &#40;Methodological Index for Non-Randomized Studies&#41; to assess methodological quality&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">18</span></a> Two authors &#40;M&#46;J&#46;M&#46;R&#46;-Z&#46; and A&#46;G&#46;O&#46;-L&#46;&#41; completed their assessments independently&#46; Items were scored 0 if not reported&#44; 1 if reported but inadequately&#44; and 2 if reported adequately&#46; The ideal overall score for a comparative study was 24&#44; and we judged that the risk of bias was low if the score was at least 20&#46; &#40;See online supplementary material&#44; Appendix&#46;&#41; When the 2 independent raters differed on any of the items&#44; they attempted to reach agreement&#46; If they failed&#44; the third author &#40;H&#46;A&#46;G&#46;-P&#46;&#41; was consulted for an independent opinion&#46;</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Results</span><p id="par0095" class="elsevierStylePara elsevierViewall">From a total of 514 articles retrieved from searches we selected 5<span class="elsevierStyleHsp" style=""></span>studies after applying the inclusion criteria for this systematic review&#46; Three of the studies adjusted for confounding factors and were included in the meta-analysis to meet the primary objective&#46; All 5<span class="elsevierStyleHsp" style=""></span>studies reported crude ORs and were included in the meta-analysis to meet the secondary objective &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">All were retrospective or prospective case&#8211;control studies and had been carried out in Europe&#44; North America&#44; or the Middle East&#46; Patients with HS were identified in electronic databases or other hospital records&#46; Included patients were being treated in dermatology clinics located in tertiary referral hospitals or elsewhere &#40;termed &#8220;general&#8221;&#41;&#46; Two patient cohorts were analyzed in the study by Miller et al<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">19</span></a>&#58; one included hospital patients with HS and the other included persons with HS from general sources &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">The systematic review encompassed a total of 25<span class="elsevierStyleHsp" style=""></span>597 participants&#44; of whom 3950 with HS had a mean age of 44&#46;5 years&#46; Both sexes and both children and adults were included &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; The overall prevalence of MS was 9&#46;64&#37; among the HS patients&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">A total of 24<span class="elsevierStyleHsp" style=""></span>952 participants entered the meta-analysis of studies that adjusted for confounding factors &#40;primary objective&#41;&#59; 3627 were patients with HS &#40;cases&#41; and 21<span class="elsevierStyleHsp" style=""></span>325 were controls without HS&#46; MS was present in 226 cases and 3279 controls&#44; giving a cumulative OR for MS of 1&#46;82 &#40;95&#37; CI&#44; 1&#46;39&#8211;2&#46;25&#59; I<span class="elsevierStyleSup">2</span>&#61;30&#37;&#41; for the cases &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>A&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">Hospital patients were at higher risk of presenting MS &#40;OR&#44; 2&#46;82&#59; 95&#37; CI&#44; 0&#46;58&#8211;5&#46;06&#59; I<span class="elsevierStyleSup">2</span> &#61; 2&#37;&#41; than others &#40;OR&#44; 1&#46;78&#59; 95&#37; CI&#44; 1&#46;34&#8211;2&#46;22&#59; I<span class="elsevierStyleSup">2</span> &#61; 57&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>A&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">Studies done in Europe &#40;Denmark&#44; Germany&#44; and Spain&#41; found that patients with HS had significant risk of presenting MS &#40;OR&#44; 2&#46;12&#59; 95&#37; CI&#44; 1&#46;60&#8211;2&#46;65&#59; I<span class="elsevierStyleSup">2</span> &#61; 0&#37;&#41;&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">The meta-analysis of studies reporting crude ORs showed that 381 HS patients and 6551 controls had MS&#44; giving a cumulative OR of 1&#46;98 &#40;95&#37; CI&#44; 1&#46;58&#8211;2&#46;38&#59; I<span class="elsevierStyleSup">2</span> &#61; 12&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>B&#41;&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Patient subgroup analyses&#44; using data from studies reporting crude ORs&#44; showed that hospital HS patients had a slightly higher risk of presenting MS &#40;OR&#44; 2&#46;61&#59; 95&#37; CI&#44; 1&#46;79&#8211;3&#46;34&#59; I<span class="elsevierStyleSup">2</span> &#61; 0&#37;&#41; than other &#40;general&#41; patients &#40;OR&#44; 1&#46;80&#59; 95&#37; CI&#44; 1&#46;44&#8211;2&#46;15&#59; I<span class="elsevierStyleSup">2</span> &#61; 0&#37;&#41; <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>B&#41;&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Analysis by age groups using data from studies that included pediatric patients showed that they had a 2-fold higher risk of having MS &#40;OR&#44; 2&#46;10&#59; 95&#37; CI&#44; 1&#46;58&#8211;2&#46;62&#59; I<span class="elsevierStyleSup">2</span> &#61; 0&#37;&#41;&#46; The association was similar in studies that included only adults &#40;OR&#44; 2&#46;46&#59; 95&#37; CI&#44; 1&#46;14&#8211;3&#46;79&#59; I<span class="elsevierStyleSup">2</span> &#61; 33&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall">A total of 6156 participants &#40;cases and controls&#41; were smokers&#58; 40&#37; were HS patients and 20&#37; were controls&#46; HS patients who smoked had a 2-fold higher risk of presenting MS than controls &#40;OR&#44; 1&#46;85&#59; 95&#37; CI&#44; 1&#46;70&#8211;2&#46;00&#59; I<span class="elsevierStyleSup">2</span> &#61; 96&#37;&#41;&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">When the data was subjected to metaregression analysis of characteristics &#40;age and type of participant&#41;&#44; the strength of the association between HS and the presence of MS did not reach significance in studies adjusting for confounding factors &#40;<span class="elsevierStyleItalic">P</span>&#61;0&#46;336&#41;&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">In addition&#44; the funnel plots &#40;online supplementary material&#44; Appendix&#41; and the Egger test of asymmetry &#40;coefficient of bias<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;74&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;000&#41; suggested the presence of publication bias&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Discussion</span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">HS&#8211;MS Association in Studies With Adjusted vs Crude ORs</span><p id="par0155" class="elsevierStylePara elsevierViewall">The meta-analysis included studies with ORs adjusted for confounding factors as well as crude ORs&#46; The 2 types of data were analyzed separately&#46; The primary objective was met by analyzing only studies reporting adjusted ORs&#44; in keeping with Cochrane recommendations&#46;<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">20</span></a> Our analysis showed that HS patients had approximately 80&#37; higher risk of MS compared to control patients&#46; This result was similar to the findings of an earlier meta-analysis&#44; which reported a cumulative OR of 2&#46;22 &#40;95&#37; CI&#44; 1&#46;62&#8211;3&#46;06&#59; I<span class="elsevierStyleSup">2</span> &#61; 77&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">7</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">Observational studies generally suffer from a higher likelihood of bias from confounding factors&#46; Therefore&#44; and because the observational studies we included had different designs&#44; we preferred adjusted ORs in order to reduce effects of bias and heterogeneity&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">8</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">However&#44; we did analyze crude ORs for our secondary objectives&#44; following a method similar to that of an earlier meta-analysis&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">7</span></a> Our results with crude ORs similarly showed that HS patients had a 2-fold higher risk for MS&#46; It is believed that the similarity between adjusted and crude ORs is attributable to the small number of published studies&#46; However&#44; the similarity does suggest there is an association between HS and MS&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">The HS&#8211;MS association is related to a shared origin in chronic inflammation&#46; As in psoriasis&#44;<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">21&#8211;23</span></a> chronic inflammation in HS leads to insulin resistance and&#44; subsequently&#44; endothelial cell dysfunction&#44; promoting cardiovascular disease&#46; Although there is no consensus about which cytokines and immune pathways are responsible for inflammation in HS&#44; studies have demonstrated the presence of increased concentrations of interleukin &#40;IL&#41; 17&#44; IL-1b&#44; IL-10&#44; tumor necrosis factor&#44; and IL-23&#44; which are considered the main cytokines involved&#46;<a class="elsevierStyleCrossRefs" href="#bib0335"><span class="elsevierStyleSup">24&#44;25</span></a></p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">HS&#8211;MS Association in Tertiary Care Hospital Dermatology Clinics vs General Cases</span><p id="par0175" class="elsevierStylePara elsevierViewall">We also found a stronger association between HS and MS in hospital-treated patients versus &#8220;general&#8221; patients&#46; These findings reflect diagnostic bias between these 2 groups&#46; However&#44; we believe that tertiary care hospital clinics are more likely to be treating HS patients with more severe symptoms&#44; such as a larger number of lesions or highly inflamed lesions&#44; which would have a greater impact on quality of life&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">This indirect indicator of disease severity is reflected in studies reporting that patients with more severe forms of HS seek care in dermatology clinics&#44; increasing the burden on the health care system&#46;<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">26&#44;27</span></a> Hence&#44; we believe this pattern explains the stronger HS&#8211;MS association in groups with more severe disease<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">7&#44;28</span></a> mediated by a higher degree of inflammation in severe HS&#46;<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">29</span></a> Hessam<span class="elsevierStyleHsp" style=""></span>et<span class="elsevierStyleHsp" style=""></span>al<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">30</span></a> found that HS severity correlated positively with higher concentrations of serum markers of inflammation such as C-reactive protein and neutrophils&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Each component of MS &#40;arterial hypertension&#44; obesity&#44; dyslipidemia&#44; and diabetes mellitus&#41; will also show an association with HS&#46; A higher body mass index has been linked to greater severity in HS symptoms&#44;<a class="elsevierStyleCrossRefs" href="#bib0370"><span class="elsevierStyleSup">31&#44;32</span></a> and a significant correlation between HS and obesity in contrast with overweight has been reported &#40;OR&#44; 4&#46;4 vs 2&#46;1&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">28</span></a> The prevalence of obesity in patients with HS &#40;70&#37;&#41; was even higher than in patients with psoriasis &#40;50&#37;&#41; in one study&#46;<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">33</span></a></p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">HS&#8211;MS Association in Smokers and Nonsmokers</span><p id="par0190" class="elsevierStylePara elsevierViewall">Patients with HS were 2-fold more likely than control patients to be smokers&#46; There is considerable epidemiologic evidence for a link between HS and smoking&#44;<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">32</span></a> and it is important to remember that smoking will contribute considerably to inflammation in MS&#44; exacerbating and accelerating atherogenesis&#46;<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">34</span></a> Nonsmoking patients with HS have also been reported to improve with treatment more than smokers&#46;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">35</span></a> Our findings support the notion that smoking addiction is a common concomitant condition among patients with HS&#46; Thus&#44; physicians should encourage these patients to quit smoking in order to improve both their HS symptoms and their metabolic profile&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">HS&#8211;MS Association in Children and Adults</span><p id="par0195" class="elsevierStylePara elsevierViewall">HS symptoms&#44; which usually appear after puberty and are less common during childhood&#44;<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">36</span></a> can nevertheless develop at young ages&#46;<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">37</span></a> Our analysis shows that there is a significant association between HS and MS in studies that include pediatric patients as well as adults&#46; However&#44; there is scarce literature on the relationship between obesity and MS in children with HS&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Deckers et al<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">38</span></a> found that the body mass indexes of patients whose HS symptoms developed after the age of 30 years were similar to those whose symptoms appeared earlier&#46; When Shalom<span class="elsevierStyleHsp" style=""></span>et<span class="elsevierStyleHsp" style=""></span>al<span class="elsevierStyleSup">39</span> analyzed their results by age groups in a study comparing age- and sex-matched patients with HS&#44; the prevalence of obesity was significantly higher in HS patients under the age of 20 years &#40;20&#37;&#41; than in older patients &#40;12&#37;&#41; &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;005&#41;&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">Finally&#44; current guidelines state that the possibility of endocrine disorders and obesity should be borne in mind when treating young patients with HS&#46;<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">40</span></a> MS&#44; which is a condition that includes diabetes mellitus&#44; hypertension&#44; and dyslipidemia among its components&#44; does not have specific criteria for making the diagnosis in children&#46;<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">41</span></a> Studies specifically in pediatric cohorts should be carried out to confirm the association between HS and pediatric metabolic disorders&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Limitations</span><p id="par0210" class="elsevierStylePara elsevierViewall">The funnel plots we constructed suggest the presence of publication bias&#46; &#40;See online supplementary material&#44; Appendix&#46;&#41; This detection of probable bias contrasts with an earlier meta-analysis&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">7</span></a> However&#44; heterogeneity among the studies we included was low&#44; as reflected in the consistency of their findings&#46; Likewise&#44; the risk of bias was low in a considerable number of the individual studies &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figs&#46; 2</a>A and 2B&#41;&#44; supporting the validity of our findings&#46; These results should nevertheless be interpreted cautiously&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">In addition&#44; we found few studies about HS and MS and were unable to obtain missing data from authors in spite of repeated attempts to reach them&#46; Finally&#44; potentially eligible studies may have been left out because we restricted our search to English and Spanish&#44; leaving out such languages as German and Chinese&#46;</p></span></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0175">Conclusion</span><p id="par0220" class="elsevierStylePara elsevierViewall">This meta-analysis detected an association between HS and MS in both adult and pediatric patients&#46; We also saw a relation between MS and severity of HS&#46; These findings underline the need to screen HS patients for MS&#46; Smoking should also be discouraged in HS&#46; We suggest carrying out more studies to assess the clinical significance of the HS&#8211;MS association in order to investigate the possible efficacy and safety of medications used in MS as treatments for HS&#46; Trials should be designed to determine whether these treatments might have an effect on the metabolic profile of these patients as well as improve their HS symptoms&#46;</p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0180">Conflicts of Interest</span><p id="par0225" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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          "identificador" => "xpalclavsec1107571"
          "titulo" => "Palabras clave"
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        5 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        6 => array:3 [
          "identificador" => "sec0910"
          "titulo" => "Methods"
          "secciones" => array:8 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Inclusion Criteria"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Sources and Search Strategy"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Study Selection and Data Extraction"
            ]
            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Definitions of Variables"
            ]
            4 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Data Analysis"
            ]
            5 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Subgroup Analyses"
            ]
            6 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Publication Bias"
            ]
            7 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Quality Assessment"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Results"
        ]
        8 => array:3 [
          "identificador" => "sec0060"
          "titulo" => "Discussion"
          "secciones" => array:5 [
            0 => array:2 [
              "identificador" => "sec0065"
              "titulo" => "HS&#8211;MS Association in Studies With Adjusted vs Crude ORs"
            ]
            1 => array:2 [
              "identificador" => "sec0070"
              "titulo" => "HS&#8211;MS Association in Tertiary Care Hospital Dermatology Clinics vs General Cases"
            ]
            2 => array:2 [
              "identificador" => "sec0075"
              "titulo" => "HS&#8211;MS Association in Smokers and Nonsmokers"
            ]
            3 => array:2 [
              "identificador" => "sec0080"
              "titulo" => "HS&#8211;MS Association in Children and Adults"
            ]
            4 => array:2 [
              "identificador" => "sec0085"
              "titulo" => "Limitations"
            ]
          ]
        ]
        9 => array:2 [
          "identificador" => "sec0090"
          "titulo" => "Conclusion"
        ]
        10 => array:2 [
          "identificador" => "sec0095"
          "titulo" => "Conflicts of Interest"
        ]
        11 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2018-04-05"
    "fechaAceptado" => "2018-10-21"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1107570"
          "palabras" => array:7 [
            0 => "Hidradenitis suppurativa"
            1 => "Meta-analisis"
            2 => "Systematic review"
            3 => "Metabolic syndrome"
            4 => "Epidemiology"
            5 => "Psoriasis"
            6 => "Cardiovascular disease"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1107571"
          "palabras" => array:7 [
            0 => "Hidradenitis supurativa"
            1 => "Metaan&#225;lisis"
            2 => "Revisi&#243;n sistem&#225;tica"
            3 => "S&#237;ndrome metab&#243;lico"
            4 => "Epidemiolog&#237;a"
            5 => "Psoriasis"
            6 => "Enfermedad cardiovascular"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Background</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Recent studies have shown a relationship between hidradenitis suppurativa &#40;HS&#41; and metabolic syndrome &#40;MS&#41;&#44; but the literature offers no meta-analysis restricted to studies that have been adjusted for confounders&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Objective</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">To determine the association between HS and MS&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Methods</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A systematic review and meta-analysis of observational studies on HS and MS in adults&#46; We searched MEDLINE&#44; SCOPUS&#44; SCIELO&#44; Google Scholar&#44; Science Direct and LILACS from the inception of the databases to January 2016&#46; We performed a random effects model meta-analysis for studies reporting adjusted and crude odds ratios &#40;ORs&#41; with 95&#37; CIs&#46; A subgroup analysis was related to the type of HS patient &#40;general patients vs hospital patients&#41; and age group &#40;adults vs children and adults&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Results</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Five studies including 3950 HS patients were analyzed&#46; We found that MS was present in 9&#46;64&#37; of HS patients &#40;OR&#44; 1&#46;82&#59; 95&#37; CI&#44; 1&#46;39&#8211;2&#46;25&#41;&#46; Studies from tertiary care hospital dermatology clinics &#40;OR&#44; 2&#46;82&#59; 95&#37; CI&#44; 0&#46;58&#8211;5&#46;06&#41; reported a greater risk for MS than studies carried out in patients treated outside hospitals &#40;OR&#44; 1&#46;78&#59; 95&#37; CI&#44; 1&#46;34&#8211;2&#46;22&#41;&#46; Studies that included pediatric populations reported a significant association &#40;OR&#44; 2&#46;10&#59; 95&#37; CI&#44; 1&#46;58&#8211;2&#46;62&#41;&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Limitation</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Few of the included studies reported adjusted ORs&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusions</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">HS patients have an increased risk for MS&#46; Clinicians should consider screening HS patients for metabolic risk factors&#46;</p></span>"
        "secciones" => array:6 [
          0 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Background"
          ]
          1 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Objective"
          ]
          2 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Methods"
          ]
          3 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Results"
          ]
          4 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Limitation"
          ]
          5 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Introducci&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">En recientes estudios se ha demostrado la existencia de una relaci&#243;n entre la hidradenitis supurativa &#40;HS&#41; y el s&#237;ndrome metab&#243;lico &#40;SM&#41;&#44; sin embargo&#44; hasta el momento no se ha realizado ning&#250;n metaan&#225;lisis que incluya estudios ajustados seg&#250;n variables de confusi&#243;n&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Objetivos</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Determinar la asociaci&#243;n entre la HS y el SM&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Metodolog&#237;a</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Se realiz&#243; una revisi&#243;n sistem&#225;tica y un metaan&#225;lisis&#44; donde se incluyeron estudios observacionales acerca de la HS y el SM en pacientes adultos&#44; localizados en MEDLINE&#44; SCOPUS&#44; SCIELO&#44; GOOGLE SCHOLAR&#44; SCIENCE DIRECT y LILACS&#44; y que fueron publicados en un periodo comprendido entre el inicio de la base de datos hasta enero del 2016&#46; De esta manera&#44; se realiz&#243; un metaan&#225;lisis&#44; para el cual se sigui&#243; el modelo de efectos aleatorios bas&#225;ndose en aquellos estudios con odds ratios &#40;OR&#41; ajustadas y crudas y que adem&#225;s presentaban un intervalo de confianza &#40;IC&#41; del 95&#37;&#46; El subgrupo analizado se correlacion&#243; posteriormente con el tipo de poblaci&#243;n con HS &#40;poblaci&#243;n general con HS vs&#46; poblaci&#243;n hospitalaria con HS&#41; y con el grupo de edad &#40;adultos vs&#46; ni&#241;os y adultos&#41;&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Resultados</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Cinco estudios&#44; incluyendo 3&#46;950 pacientes con HS fueron analizados&#46; Se encontr&#243; que el SM estaba presente en el 9&#44;64&#37; de los pacientes con HS &#40;OR 1&#44;82&#44; IC del 95&#37;&#44; 1&#44;39-2&#44;25&#41;&#46; Estudios realizados en centros dermatol&#243;gicos hospitalarios de tercer nivel &#40;OR 2&#44;82&#44; IC del 95&#37;&#44; 0&#44;58-5&#44;06&#41; mostraron una mayor asociaci&#243;n al SM si comparados con estudios realizados en la poblaci&#243;n general &#40;OR 1&#44;78&#44; IC del 95&#37;&#44; 1&#44;34-2&#44;22&#41;&#46; Los estudios que incluyeron una poblaci&#243;n pedi&#225;trica registraron as&#237; mismo una asociaci&#243;n significativa al SM &#40;OR 2&#44;10&#44; IC del 95&#37;&#44; 1&#44;58-2&#44;62&#41;&#46;</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Limitaci&#243;n</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Se cont&#243; con escasos estudios ajustados a las variables de confusi&#243;n&#46;</p></span> <span id="abst0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conclusi&#243;n</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Los pacientes con HS tendr&#225;n un riesgo incrementado de presentar SM&#46; Se deber&#237;a considerar la realizaci&#243;n de un cribado de factores de riesgo metab&#243;licos en todos los pacientes con HS&#46;</p></span>"
        "secciones" => array:6 [
          0 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Objetivos"
          ]
          2 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Metodolog&#237;a"
          ]
          3 => array:2 [
            "identificador" => "abst0055"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0060"
            "titulo" => "Limitaci&#243;n"
          ]
          5 => array:2 [
            "identificador" => "abst0065"
            "titulo" => "Conclusi&#243;n"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0910">Please cite this article as&#58; Rodr&#237;guez-Zu&#241;iga MJM&#44; Garc&#237;a-Perdomo HA&#44; Ortega-Loayza AG&#46; Asociaci&#243;n entre la hidradenitis supurativa y el s&#237;ndrome metab&#243;lico&#58; revisi&#243;n sistem&#225;tica y metaan&#225;lisis&#46; Actas Dermosifiliogr&#46; 2019&#59;110&#58;279&#8211;288&#46;</p>"
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par9120" class="elsevierStylePara elsevierViewall">The following are the supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia><elsevierMultimedia ident="upi0010"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
            "identificador" => "sec0010"
          ]
        ]
      ]
    ]
    "multimedia" => array:9 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2889
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Flow chart of study exclusions and inclusions&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 2870
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            "Tamanyo" => 311623
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">A&#44; Meta-analysis results for the primary objective showed an association between hidradenitis suppurativa &#40;HS&#41; and metabolic syndrome &#40;MS&#41;&#46; B&#44; Meta-analysis results for the secondary objective showed an association between HS and MS based on crude odds ratios &#40;ORs&#41;&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 3183
            "Ancho" => 2132
            "Tamanyo" => 380603
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">A&#44; Meta-analysis of data from studies reporting adjusted odds ratios &#40;ORs&#41; showed an association between hidradenitis suppurativa &#40;HS&#41; and metabolic syndrome &#40;MS&#41; B&#44; Meta-analysis of studies reporting crude ORs also showed an association between HS and MS&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "fig0020"
        "etiqueta" => "Figure 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1212
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            "Tamanyo" => 143868
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Meta-analysis results showing the association between hidradenitis suppurativa and metabolic syndrome according to age range &#40;adults only vs adults and children together&#41;&#46; All these studies reported only crude odds ratios&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; Both&#44; pediatric and adult patients&#59; ATP-III&#44; National Cholesterol Education Program Adult Treatment Panel III diagnostic criteria for MS&#59; C&#8211;C&#44; case&#8211;control&#59; DB&#44; electronic database&#59; HS&#44; hidradenitis suppurative&#59; aOR&#44; adjusted odds ratio&#59; cOR&#44; crude odds ratio&#59; Hosp&#44; hospital HS patients&#59; Gen&#44; &#8220;general&#8221; population HS cases&#59; Pro&#44; prospective&#59; Retro&#44; retrospective&#59; MS&#44; metabolic syndrome&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Author&#47;Year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Country&#47;Region&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Design&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">HS Case Type&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Age Group&#47;Mean Age&#44; y&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mean Age&#44; y</th><th class="td" title="table-head  " align="left" valign="top" scope="col">HS Data Source&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">MS Criteria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Control&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sabat et al&#44;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">5</span></a> 2012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Germany&#47;Europe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&#8211;C&#47;Pro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Hosp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Adults&#47;40&#46;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Case history&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ATP-III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gold et al&#44;<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">42</span></a> 2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">USA&#47;North America&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&#8211;C&#47;Retro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Hosp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Both&#47;43&#46;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Case history&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ATP-III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Miller et al&#44;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">19</span></a> 2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Denmark&#47;Europe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&#8211;C&#47;Pro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Gen&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Adults&#47;51&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">DB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ATP-III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Miller et al&#44;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">19</span></a> 2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Denmark&#47;Europe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&#8211;C&#47;Pro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Hosp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Adults&#47;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Case history&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ATP-III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Shalom et al&#44;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">39</span></a> 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Israel&#47;Middle East&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&#8211;C&#47;Retro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Gen&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Both&#47;39&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">39&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">39&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">DB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ATP-III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pascual et al&#44;<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">43</span></a> 2016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Spain&#47;Europe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&#8211;C&#47;Pro&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Hosp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Adults&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Case history&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ATP-III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "leyenda" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; HS&#44; hidradenitis suppurative&#59; aOR&#44; adjusted odds ratio&#59; cOR&#44; crude odds ratio&#59; MS&#44; metabolic syndrome&#59; NA&#44; not applicable&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="table-head ; entry_with_role_rowhead " align="left" valign="top" scope="col">Author&#47;Year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No&#46; of Participants</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Women&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Smokers&#44; n &#40;&#37;&#41;</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MS&#44; n &#40;&#37;&#41;</th><th class="td" title="table-head  " align="left" valign="top" scope="col">aOR <a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">cOR <a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a> &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Controls&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Controls&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">HS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Controls&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sabat et al&#44;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">5</span></a> 2012&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">180&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">99 &#40;55&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">45 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32 &#40;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#46;46 &#40;2&#46;02&#8211;9&#46;96&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gold et al&#44;<a class="elsevierStyleCrossRef" href="#bib0425"><span class="elsevierStyleSup">42</span></a> 2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">465&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">243&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">222&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">366 &#40;78&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">190 &#40;40&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">123 &#40;50&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">67 &#40;30&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;37 &#40;1&#46;62&#8211;3&#46;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Miller et al&#44;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">19</span></a> 2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">15177&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">326&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14851&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8308 &#40;54&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2696 &#40;17&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;4&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2683 &#40;18&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3297 &#40;21&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">105 &#40;32&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3192 &#40;21&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#46;08 &#40;1&#46;61&#8211;2&#46;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;71 &#40;1&#46;33&#8211;2&#46;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Miller et al&#44;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">19</span></a> 2014&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14883&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14851&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8115 &#40;54&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2700 &#40;18&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;53&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2683 &#40;18&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3209 &#40;21&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;53&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3192 &#40;21&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;89 &#40;1&#46;9&#8211;7&#46;98&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#46;04 &#40;1&#46;52&#8211;6&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Shalom et al&#44;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">39</span></a> 2015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9619&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3207&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6412&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5923 &#40;61&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3443 &#40;35&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1520 &#40;47&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1923 &#40;30&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">162 &#40;1&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">80 &#40;2&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">82 &#40;1&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;61 &#40;1&#46;36&#8211;1&#46;89&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#46;98 &#40;1&#46;45&#8211;2&#46;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pascual et al&#44;<a class="elsevierStyleCrossRef" href="#bib0430"><span class="elsevierStyleSup">43</span></a> 2016&nbsp;\t\t\t\t\t\t\n
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