The Relationship Between Sweat Response, BMI, and Physical Activity: Implications for Pilonidal Sinus Disease

Aim: Obesity has been suspected of influencing sweating and constituting a risk factor for pilonidal sinus disease (PSD), given the parallel rise in both obesity and PSD incidence in developed countries.This study, therefore, examined the relationship between sweating and body mass index (BMI).Methods: A total of 322 individuals from a large northern German cohort, all without PSD, were assessed.A questionnaire was designed to evaluate BMI and engagement in sports activities.Standardized pilocarpine iontophoresis sweat testing was performed in the glabella sacralis region, 5-10 cm cephalad to the intergluteal fold.Results: The normal BMI group had significantly higher sweat production (20.74±2.5 µl) than the high BMI group (17.10±2.8µl) (p<0.001).Individuals who regularly participated in sports more than twice a week exhibited significantly higher sweat production than those who did not exercise (27.2±2.9 µl vs. 24.4±1.6 µl, p<0.001).Conclusion: Increased BMI was not associated with increased pilocarpine iontophoresis-induced glabella sacralis sweat output.Engagement in sports increased sweat production in both normal and high BMI individuals.Increased sweating may play a protective role, potentially contributing to weight reduction and, consequently, a lower incidence of PSD through mechanisms yet to be elucidated.