Abstract
BackgroundWestern dietary pattern is included among the environmental dietary factors involved in the pathogenesis of psoriasis. Nutritional data collection methods and gender differences might affect the association between diet and psoriasis. The 7-day food records is considered the “gold standard” of self-administered food frequency questionnaires. In this study, we evaluated the differences in the dietary intake, anthropometric measurements and cardio-metabolic risk profile in a group of psoriatic patients compared with an age and Body Mass Index (BMI)-matched control group. In addition, in the group of psoriatic patients we investigated the association between the dietary intake and clinical severity of psoriasis.MethodsCross-sectional case control observational study. A total of 82 adult males, 41 treatment-naïve patients with psoriasis and 41 healthy subjects matched for age and BMI were included in the study. The clinical severity of psoriasis was by assessed by Psoriasis Area and Severity Index (PASI) score. The dietary interview data were collected by a 7-day food records. Anthropometric measures, glucose and lipid profile, liver function tests and C-reactive protein levels were measured. Homeostasis Model Assessment of Insulin Resistance (HoMA-IR), Visceral Adiposity Index (VAI) and the Fatty Liver Index (FLI) were calculated.ResultsPsoriatic patients consumed a higher percentage of total and simple carbohydrates, total fat, polyunsaturated fatty acid (PUFA) and n-6/n-3 PUFAs ratio, and cholesterol, while the consumption of protein, complex carbohydrates, monounsaturated fatty acid (MUFA), n-3 PUFA and fiber was lower than in the control group. In addition, psoriatic patients presented altered anthropometric measurements, glucose and lipid profile, liver function tests, and elevated values of HoMA-IR, VAI and FLI. PASI score well correlated with anthropometric measures, glucose and lipid profile, liver function tests, cardio-metabolic indices, and the dietary components, except for protein and total carbohydrates. At logistic regression analysis between PASI score and MUFA, MetS presence was well predicted only by higher PASI score (OR = 1.794; p = 0.002; CI 1.242–2.591). At multiple regression analysis, MUFA was the best predictor of PASI score (r2 = 0.387, β = −0.635, t = −5.127, p < 0.001).ConclusionDifferences in dietary intake were observed in adult male psoriatic patients compared with the controls. These differences were associated to the severity of the psoriasis and cardio-metabolic risk. FLI represented an early indicator of the cardio-metabolic risk profile in psoriatic patients, and dietary MUFA were major predictor of the clinical severity of psoriasis, while the association between psoriasis and metabolic syndrome appeared to be independent of MUFA intake. The low MUFA consumption might act as a possible adjunctive mechanism in increasing the inflammation milieu of psoriatic patients.
Highlights
Western dietary pattern is included among the environmental dietary factors involved in the pathogenesis of psoriasis
Psoriasis is a common chronic inflammatory skin disease associated with obesity and serious comorbidities, such as type 2 diabetes mellitus, hypertension, metabolic syndrome [1], and hepatic steatosis (HS) [2], a major feature associated with the non-alcoholic fat liver disease (NAFLD) and the hepatic manifestation of metabolic syndrome [3]
Socio-demographic characteristics and participation in physical activity were not significantly different in both groups, while the metabolic risk factors and liver function tests were significantly higher in psoriatic patients than in control group
Summary
Western dietary pattern is included among the environmental dietary factors involved in the pathogenesis of psoriasis. In the group of psoriatic patients we investigated the association between the dietary intake and clinical severity of psoriasis. Besides basic gender differences in weight concern and body self-perception, adults males consume more energy, saturated fat acid (SFA), and cholesterol but less complex carbohydrates and fibre than females. Specific macronutrient, such as simple carbohydrates, SFA and n-6 polyunsaturated fatty acid (n-6 PUFA) may contribute to a proinflammatory state, while others, including fiber, monounsaturated fat acid (MUFA), n-3 polyunsaturated fatty acid (n-3 PUFA), are associated with reduced levels of inflammatory [9]
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