Metabolic Syndrome In Psoriatic Patients Research Articles

Correlation between psoriasis area severity index score and metabolic syndrome in psoriatic patients in Menoufia University

Objective This study was to assess the association between psoriasis and metabolic syndrome (MBS) and to determine if there is an association between psoriasis severity and MBS. Background Background: Psoriasis is a chronic inflammatory disease that affects not only the skin but also other organs. Genetic factors play an important role in individual predisposition. Lately, a positive association has been confirmed between psoriasis and MBS, in Western as well as in Middle Eastern countries. Patients and methods This case–control study was conducted at the Dermatology, Andrology and Sexually Transmitted Disease and Medical Biochemistry and Molecular Biology Departments, Faculty of Medicine, Menoufia University. It included 120 patients: 60 psoriatic patients and 60 age-matched and gender-matched healthy controls. Patients were collected from Dermatology Outpatient Clinics, Menoufia University Hospitals. Clinical, biometric, and necessary laboratory evaluations were performed. Statistical analysis was performed by using the Statistical Package for the Social Sciences (SPSS version 16.0). Results The patients with psoriasis were two times more likely to have MBS as compared with controls (38.3 vs 18.0%, P < 0.001) with an odds ratio of 2.4. All components of MBS were more prevalent in psoriasis patients than in controls. The psoriasis area severity index score was greater in patients with MBS than those without MBS (10.5 11.5 vs 7.0 8.1, P = 0.05). MBS prevalence tended to be higher in the inverse type than in others (52.2 vs 32.3%; P = 0.06) and in patients with nail pitting versus those without (45.3 vs 28.2%; P = 0.03). Conclusion This study concluded that there is an association between psoriasis and MBS.

SuPAR, a potential inflammatory mediator in psoriasis pathogenesis.

Psoriasis is an inflammatory skin disorder that is strongly associated with the metabolic syndrome. The sole reliance on clinical examination to guide prognostication and treatment is insufficient at best; accurate diagnostic and prognostic psoriatic molecular biomarkers are needed. Soluble urokinase plasminogen activator receptor (suPAR) has been implicated in inflammation. The aim of this study is to determine whether suPAR plays a role in the pathogenesis of psoriasis and whether an association exists between suPAR levels, disease severity, and other variables like insulin, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). This study also compares the pattern of uPAR staining in healthy vs psoriatic skin: 39 psoriatic and 30 control subjects were included. Two biopsies (affected and unaffected skin) and one biopsy were taken from psoriasis patients and healthy controls, respectively, with uPAR staining of all skin biopsies. Blood samples from all subjects were obtained to determine suPAR, ESR, CRP, and fasting insulin levels. uPAR staining was prominent in unaffected skin from psoriasis patients and healthy individuals vs weak/absent uPAR staining in psoriatic skin. CRP, ESR and suPAR levels were not significantly elevated in the mild psoriasis group compared to healthy controls. The loss of epidermal uPAR is suggestive of its tentative role in the pathogenesis of psoriasis. Patients with mild-moderate psoriasis possibly lack the powerful association attributed to metabolic syndrome in psoriatic patients. Further studies on larger cohorts are needed to ascertain the validity of the mentioned conclusions.

Effect of eating and psychopathological traits in psoriatic patients

Background Psoriasis is a chronic inflammatory immune-mediated skin disease. Few studies have investigated the link between psychiatric disorders including eating disorders (EDs) and psoriasis. We hypothesized that EDs and the psychological effect of psoriasis contribute to the development of obesity and metabolic syndrome in psoriatic patients, who are frequently susceptible to psychiatric comorbidity. Objective The objective of this study was to evaluate the presence of EDs and psychological distress in patients affected by psoriasis compared with a control population and correlate these data with different features of the cutaneous disease and BMI. This was done to suggest the importance of a psychological support that could reduce the occurrence of loss of control over food and help psoriasis improvement. Patients and methods From September 2014 till February 2015, we enrolled 100 consecutive psoriatic outpatients and a control group of 100 selected nonpsoriatic outpatients, matched by age, sex, and BMI to the study group. The assessment utilities were composed by the Eating Disorder Inventory (EDI), the Symptom Checklist-90-Revised (SCL-90-R), and the Psoriasis Area Severity Index score. Results Regarding EDI and SCL-90-R subscales, psoriatic patients had higher scores for all EDI and SCL-90-R subscales than nonpsoriatic patients. According to the relation between BMI and SCL-90-R subscales in psoriatic patients, obese and overweight groups showed higher scores in all SCL-90-R subscales than the normal weight group. Conclusion In patients with psoriasis, EDs and severe psychiatric symptoms seem to be associated with overweight/obesity more frequently than in the general population.

The effect of subcutaneous methotrexate on markers of metabolic syndrome in psoriatic patients - preliminary report.

IntroductionMethotrexate (MTX) has anti-proliferative and anti-inflammatory effects in psoriasis. Moreover, low doses can reduce the risk of developing cardiovascular diseases. It turns out that psoriasis and atherosclerosis have a similar pathogenetic mechanism: the same pro-inflammatory cytokines, Th1 and Th17, are involved in both diseases.AimTo evaluate the effects of metabolic markers, protective cytokines (interleukin 10 (IL-10), transforming growth factor β (TGF-β)) and a marker of endothelial damage (endocan) in patients with plaque psoriasis.Material and methodsThe study included 24 patients aged 27–69 years (9 female, 15 male) with plaque psoriasis. The metabolic syndrome according to the International Diabetes Federation (IDF) was evaluated. The laboratory tests were performed under fasting conditions: C-reactive protein (CRP), glucose, total cholesterol, triglycerides, high-density lipoprotein (HDL), uric acid, endocan, IL-10, and TGF-β. After 12 weeks of treatment with MTX injections 15 mg/week, every patient was assessed with the same laboratory tests.ResultsAfter treatment we observed a statistically significant increase of endocan and IL-10, but no significant differences in the titer of TGF-β. C-reactive protein was reduced by approximately 54.7%. No improvement of lipid profile was observed, and even a significant increase in triglycerides was noted. Similarly, no significant difference was seen in the case of glucose and uric acid prior to and after treatment.ConclusionsMethotrexate in low doses in short-term treatment decreases CRP (anti-inflammatory effect) and increases endocan and IL-10 (potential protective role). Methotrexate is characterized by good efficacy and tolerability in therapy of patients with psoriasis.

Metabolic syndrome in patients with psoriasis: A hospital-based case–control study

Background: Psoriasis is a chronic inflammatory skin disease with an increased risk of cardiovascular disease. Metabolic syndrome (MS) increases the risk of cardiovascular diseases and type 2 diabetes mellitus. Previous studies indicate a higher prevalence of MS in psoriatic patients. Objectives: The objective of the study was to determine the frequency of occurrence of MS and its individual components in patients with psoriasis. Methodology: This study was a hospital-based, case–control study involving fifty adult patients with psoriasis and fifty age- and gender-matched controls. Blood pressure, body mass index, waist circumference, fasting lipid profile, and blood sugar were assessed in all subjects. MS was diagnosed by the presence of three or more of the South Asian Modified National Cholesterol Education Program's Adult Treatment Panel III criteria. Results: MS was significantly more common in psoriatic patients than in controls (38% vs. 22%, P = 0.043). Psoriatic patients had higher prevalence of raised fasting blood sugar (32% vs. 16%, P = 0.0334), hypertriglyceridemia (34% vs. 18%, P = 0.037), low high-density lipoprotein (50% vs. 20%, P = 0.00093), and hypertension (38% vs. 20%, P = 0.025). Raised values of waist circumference as a measure of central obesity though not statistically significant (P = 0.08) were found higher in psoriatic cases. The mean age of the psoriatic patients in years was 48 ± 17.1. Mean duration of the disease was 9.2 ± 8 years. There was no correlation between the severity and duration of psoriasis with MS. Conclusion: MS is frequent in patients with psoriasis. This highlights the need for screening of all psoriatic patients for early diagnosis and treatment of associated MS.

Role of high-mobility group box-1 as a marker of disease severity and diagnosis of metabolic syndrome in psoriatic patients

Background Psoriasis is a chronic inflammatory disease with systemic immunological disturbance. Suggested pathophysiology linking psoriasis and metabolic syndrome involves overlapping inflammatory and genetic pathways. High-mobility group box-1 (HMGB1) is a nuclear transcriptional protein, which is released extracellularly to function as a proinflammatory mediator. Elevated HMGB1 was reported in autoimmune and inflammatory disorders. However, its role in inflammatory dermatological conditions such as psoriasis is under investigation. Objectives The goals of this study were to evaluate the serum level of HMGB1 in psoriasis patients and its relation to disease severity. In addition, the study aimed to compare its level between psoriatic patients with and without metabolic syndrome with assessment of its prognostic potential to diagnose metabolic syndrome in the psoriatic population. Patients and methods Fifty psoriatic patients and 20 healthy controls were included. Serum level of HMGB1 was measured using enzyme-linked immunosorbent assay and its relation to disease severity and duration using psoriasis area and severity index. Metabolic syndrome was identified among psoriatic patients, using International Diabetes Foundation. Receiver operating characteristic analysis was employed to calculate the area under the curve for HMGB1 to find the best cutoff value capable of diagnosis of metabolic syndrome in psoriasis. Results Significantly higher HMGB1 level in psoriasis patients than in controls was detected (P=0.037) and was correlated with disease severity. A higher HMGB1 level among psoriatic patients with metabolic syndrome than that among patients without metabolic syndrome was reported (P=0.007). At receiver operating characteristic analysis, HMGB1 showed 80% sensitivity and 50.43% specificity in detecting metabolic syndrome in psoriasis. Conclusion HMGB1 may be considered as a useful marker of psoriasis severity in addition to its predicting potential for metabolic syndrome in psoriatic patients.

Prevalence of metabolic syndrome in psoriasis vulgaris: a cross sectional study from a tertiary care hospital of South-East Rajasthan

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Psoriasis, a common skin disorder is now considered as systemic inflammatory disease. Its chronic inflammatory state is thought to predispose patients to metabolic syndrome (MetS), which is a significant predictor of cardiovascular events. The objective of the study is to investigate the prevalence of metabolic syndrome in psoriatic patients with only cutaneous involvement and to evaluate the correlation between presence of MetS and psoriasis severity&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; We performed hospital based, cross-sectional study on 100 adult patients with psoriasis vulgaris and equi-numbered age and sex matched controls. MetS was diagnosed by revised National Cholesterol Education Program’s Adult Panel III criteria.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; A higher prevalence of metabolic syndrome was found in psoriasis patients as compared to controls [28 (28%) vs 9 (9%), P value=0.0005].Impaired fasting glucose level, hypertension, hypertriglyceridemia and abdominal obesity were more prevalent in psoriasis group. No statistically significant difference was found between prevalence of low levels of HDL and presence of metabolic syndrome. Presence of metabolic syndrome was not associated with severity and duration of psoriasis. Female patients with psoriasis were more frequently having metabolic syndrome.&lt;/p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Prevalence of metabolic syndrome is higher in patients with psoriasis irrespective of its duration and severity. This stresses on the need of regular evaluation for the presence of MetS or any of its components in psoriasis patients so as to allow early detection and management.

Prevalence of Metabolic Syndrome in Psoriasis Patients and its Relation to Disease Duration: A Hospital Based Case-Control Study

Previous studies indicate a higher prevalence of metabolic syndrome in psoriatic patients. This study aimed to investigate the association of metabolic syndrome and its components with psoriasis. It also studied the relation between presence of metabolic syndrome and disease duration in psoriasis patients. This was a hospital-based, case-control study conducted with 30 clinically diagnosed patients of chronic plaque psoriasis and 30 age- and sex-matched control subjects. Height, weight, BMI, blood pressure and waist circumference were assessed in all the subjects. Fasting levels of serum glucose, serum triglycerides and serum HDL were estimated by automated clinical chemistry analyser. Metabolic syndrome was diagnosed by the presence of at least 3 criteria of NCEP ATP III with Asian modification for waist circumference. Metabolic syndrome was more common in psoriatic patients than in controls but the difference was statistically insignificant (60% vs. 40%, p-value=0.12). The psoriasis group had a higher prevalence of elevated blood glucose levels and higher waist circumference compared to controls. Psoriasis patients had a higher prevalence of high triglyceride levels than controls, the difference being statistically insignificant (40% vs. 30%, p-value = 0.41). The prevalence of low HDL levels was significantly higher in cases compared to controls (86.7% vs. 60%, p-value = 0.02). There was no relation between presence of metabolic syndrome and duration of psoriasis. Our findings suggest that metabolic syndrome as well as dyslipidaemia is commoner in psoriasis patients. This underlines the need for screening of all psoriasis patients for early diagnosis and treatment of associated metabolic syndrome to reduce the high burden of morbidity and mortality.

Risk factors for cardiovascular diseases and metabolic syndrome in psoriatic patients: case - control study

Background: Psoriasis has an increased likelihood of comorbidities compared with healthy controls such as cardiovascular diseases and metabolic syndrome. Objectives: To investigate the risk factors that increases the incidence of cardiovascular diseases and metabolic syndrome in Iraqi patients with psoriasis. Patients & methods: a case- control prospective study enrolled 80 patients with psoriasis and 80 normal individuals as a control group. Psoriasis severity was assessed using PASI(psoriasis area severity index) score, in both groups, blood pressure, BMI(body mass index) & waist circumference were measured, laboratory tests including fasting blood sugar & lipid profile were done. For comparison between the 2 groups, Fisher s exact test were performed. Results: In psoriatic group, calculation of (BMI), showed that 19 (23.8%) were obese, 34 (42.5%) over weight, 27 (38.8%) normal weight. Thirty four patients (42.5%) had an elevated blood pressure, both were significantly correlated with the severity of psoriasis.44 (55%) have abnormal lipid profile, 17 (21.3%) elevated cholesterol, 17(21.3%) had raised LDL & 32 (40%) had low HDL. These were correlated with the severity of psoriasis. Eight (10%) patients had elevated VLDL & 13 (16.3 %) had elevated TG. Twelve (15%) patients had elevated FBS.33 (41.25%) patients were having Metabolic syndrome and the risk was increased with the duration of psoriasis. Comparing with the control group, psoriatic patients were at risk of developing hyperglycemia & hyperlipidemia with statistically significant elevation of fasting blood sugar, cholesterol, LDL, & reduced HDL. Conclusions: Compared with the control group, psoriatic patients in our population had an atherogenic lipid profile with increased prevalence of risk factors for cardiovascular diseases & metabolic syndrome & this was directly correlated with the severity and duration of the disease.

Metabolic syndrome in Iraqi patients with psoriasis: A comparative study

Background: Psoriasis patients are at increased risk of developing the metabolic syndrome (MS). Proinflammatory cytokines such as tumor necrosis factor-α, interleukin-6, interleukin-23, interleukin-17 that are increased in the psoriatic plaques are known to contribute to features of MS such as hypertension, dyslipidemia and insulin resistance.Aims: (1) To study the prevalence of MS in patients with psoriasis. (2) To study the effect of duration of psoriasis on prevalence of MS.Materials and Methods: A hospital based comparative study was conducted involving 40 adult patients withpsoriasis and 40 age and sex-matched controls. All participants were evaluated for components of MS.Results: Both groups included 29 males and 11 females. The mean age of the cases and controls were 39.5 years and 38.85 years, respectively. MS was present in 18 out of 40 (45%) patients with psoriasis and 14 out of 40 (35%) controls; odds ratio (OR= 1.519 CI 0.61 to 3.73 p value =0.362). Higher age and female gender correlated with the presence of MS in psoriasis patients. Psoriasis cases with MS are older and had longer disease duration compared with psoriatic patient without MS. The difference was statistically significant.Conclusion: There is higher prevalence of MS in psoriatic patients. However, the duration of psoriasis correlatedclosely with prevalence of metabolic syndrome.

Prevalence of cardiovascular disease risk factors, and metabolic syndrome and its components in patients with psoriasis aged 30 to 49 years.

IntroductionSome studies show that metabolic syndrome (MS) is more common in psoriatic patients.AimTo evaluate the prevalence of MS and its components as cardiovascular disease (CVD) risk factors in psoriatic patients compared to the general Polish population.Material and methodsIn 62 patients, aged 30 to 49 years with a mild to severe course of psoriasis, the features of MS have been assessed by IDF definition and compared to the results obtained in the NATPOL 2011 study.ResultsAnalysis of CVD risk factors in patients with a severe course of psoriasis showed a correlation with waist circumference (0.38, p < 0.05), hypertension (0.40, p < 0.05) and a negative correlation with HDL (0.29, p < 0.05). The prevalence of MS in psoriatic patients was 25.81%, and for the control group – 21.02% (p > 0.05), the mean HOMA-IR was 1.93 and 1.94 (p > 0.05), respectively. There were differences in the prevalence of abdominal obesity (53.6% vs. 40.3%, p < 0.05). In lipid parameters, except for HDL, the compared groups did not differ significantly (triglycerides, ApoA-I and B). Criteria for MS concerning blood pressure (> 130/85 mm Hg) and hypertension were more frequent in men with psoriasis than in the control group (38.2% vs. 11.1%, p < 0.05).ConclusionsSevere psoriasis is associated with a significantly higher prevalence of risk factors for CVD. The prevalence of MS, insulin resistance and lipid abnormalities in patients with psoriasis aged 30 to 49 years is similar to the general Polish population. Abdominal obesity is more common in psoriatic patients and hypertension in men with psoriasis.

Circulating levels of lipocalin-2 and retinol-binding protein-4 are increased in psoriatic patients and correlated with baseline PASI

Psoriasis has been related to metabolic syndrome (MS). Adipocytokines produced by white adipose tissue may be involved in the pathogenesis of psoriasis and its association with MS. Our objectives were to characterize the profile of a number of different inflammatory and atherogenic markers, vitamins, adipokines and cytokines and their potential involvement in MS in patients with moderate-to-severe psoriasis without joint involvement compared to anthropometrically matched controls, and to evaluate correlation with severity of the skin disease and changes after narrow-band UVB (NB-UVB) phototherapy. We designed a prospective cross-sectional study. Baseline waist circumference, body fat composition, lipid, carbohydrate and calcium metabolism profile, inflammation markers, homocysteine and vitamins D, B6, B12 and folic acid, leptin, resistin, omentin, lipocalin-2, adipocyte fatty acid-binding protein, retinol-binding protein-4 (RBP-4), interleukin-6, soluble tumour necrosis factor receptor 1 (sTNFR1) and interleukin-17 of 50 psoriasis patients and 50 gender, age and body mass index-matched controls were recorded, then evaluated after NB-UVB in the patients. The patients had higher baseline serum concentrations of leptin, RBP-4, lipocalin-2 and sTNFR1. Baseline psoriasis area and severity index correlated with serum concentrations of RBP-4 and lipocalin-2 only. Principal components analysis disclosed a component including vitamins B12, B6, folic acid, calcidiol and HDL-cholesterol that was only present in healthy controls and opposed to a cluster of variables which promote MS. This component was absent in the patients. Our results point to lipocalin-2 and RBP-4 as relevant mediators of the trend towards MS in psoriatic patients.