Metabolic Syndrome, Obesity Hasten Psoriasis Development
July 16, 2019 (healio.com) – Korean adults with metabolic syndrome are more likely to be diagnosed with psoriasis — especially if they also have obesity — compared with metabolically healthy individuals, according to findings published in Metabolism.
“In spite of the relatively low prevalence of psoriasis, psoriasis has major effects on life since it … not only results in functional and social morbidities with socioeconomic cost, but [is] also associated with an increased risk of various accompanying disease[s],” Yong Gyu Park, PhD, of the department of biostatistics in the college of medicine at the Catholic University of Korea in Seoul, and colleagues wrote. “Thus, psoriasis has become a medical concern, and finding the related factors as predictors of psoriasis is important.”
Park and colleagues conducted a prospective study in which they identified 2,595,878 adults with metabolic syndrome (mean age, 54.7 years; 45.9% women) and 7,122,713 adults without the condition (mean age, 44.3 years; 45.1% women) in the Korean National Health Insurance Service database. The researchers evaluated psoriasis development in both cohorts between 2009 and 2017.
The researchers found that more participants with metabolic syndrome had psoriasis by the end of the study period compared with those without the syndrome (2.45% vs. 2.01%; P < .001). In addition, even with adjustments for age, sex, smoking status, alcohol use, exercise frequency, income and BMI, those with metabolic syndrome were 1.05 times more likely to develop psoriasis compared with those without the syndrome (aHR = 1.05; 95% CI, 1.04-1.06).
Psoriasis was also more likely to be diagnosed in participants with metabolic syndrome who had at least three components of the syndrome (aHR = 1.02; 95% CI, 1.01-1.04), which include a waist circumference of at least 90 cm for men and at least 85 cm for women, triglyceride levels of at least 150 mg/dL, HDL cholesterol of less than 40 mg/dL in men or less than 50 mg/dL in women, systolic blood pressure of 130 mm Hg or more, diastolic BP of 85 mm Hg or more and a fasting glucose level of at least 100 mg/dL, according to the researchers. Participant with four (aHR = 1.06; 95% CI, 1.04-1.08) or five metabolic syndrome components (aHR = 1.09; 95% CI, 1.06-1.12) were even more likely to develop psoriasis.
“[Metabolic syndrome] management considering the severity of the condition might reduce the incidence of psoriasis,” the researchers wrote.
In terms of BMI status, the chances of psoriasis development were increased by 1.06 times for those with obesity, which the researchers defined as a BMI between 25 kg/m2 and 29.9 kg/m2 (aHR = 1.06; 95% CI, 1.04-1.07), and by 1.12 times for those with severe obesity, which the researchers defined as a BMI of 30 kg/m2 (aHR = 1.12; 95% CI, 1.09-1.15), compared with those with a BMI of between 18.5 kg/m2 and 23 kg/m2, which the researchers defined as normal weight. Participants with a BMI between 23 kg/m2 and 24.9 kg/m2 also had heightened odds for psoriasis (aHR = 1.02; 95% CI, 1.01-1.03) vs. those with normal weight.
“We found that obese individuals were not only likely to develop psoriasis, but also that the risk increased as the number of [metabolic syndrome] components increased, consistent with previous studies,” the researchers wrote. “Obese patients require careful management of both obesity per se and [metabolic syndrome] components and should be screened for psoriasis even before [metabolic syndrome] diagnosis.”
Source: Kim HN, et al. Metabolism. 2019;doi:10.1016/j.metabol.2019.07.001.