Hidradenitis suppurativa is a chronic inflammatory skin disease of terminal follicular acroinfundibulum.This study aimed to evaluate serum irisin, plasma glucose, insulin, and lipid levels in hidradenitis suppurativa, and elucidate possible associations with disease activity, inflammatory, or metabolic parameters.This case-control study included 37 patients (M/F: 9/28) and 37 sex-, age- and body mass index -matched healthy controls (M/F: 11/26). Demographic data, Hurley stage of disease, fasting glucose, insulin, total cholesterol, high density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, C-reactive protein levels, erythrocyte sedimentation rate, hematologic parameters, and serum irisin were assessed.The hidradenitis suppurativa group had significantly higher waist circumference than controls (p<0.001). Insulin resistance, defined as a homeostatic model assessment for insulin resistance value greater than 2.5, was observed in 45.9% of patients and 8.1% of controls (p=0.003), whereas metabolic syndrome was observed in 32.4% of patients and 5.4% of controls (p<0.001). Furthermore, plasma triglycerids, glucose, and insulin levels were significantly higher in the hidradenitis suppurativa (p=0.013, p=0.001, and p=0.004), respectively. Mean irisin level was insignificantly higher in the hidradenitis suppurativa group (37.4±32.6) than in controls (26.2±24.7, p=0.217).Physical activity and the exercise levels of participants were not documented.This study indicates that hidradenitis suppurativa patients have higher serum irisin, fasting plasma glucose, insulin, and triglycerides levels than healthy controls. Thus, the authors suggest that hidradenitis suppurativa patients should be evaluated for insulin resistance and metabolic syndrome, and monitored accordingly.