A Comparison of Clinical Characteristics in Overweight/Obese and Normal Weight Patients with Psoriasis Vulgaris: A Bicentric Retrospective Observational Study

Abstract

Background Psoriasis is a chronic, inflammatory skin disease that is often accompanied by multiple comorbidities. Obesity is considered an independent risk factor for the development of psoriasis. However, most of the related data are derived from epidemiological studies conducted in the United States of America and Europe. This study aimed to compare the clinical characteristics of patients with psoriasis who are overweight/obese and patients with psoriasis with normal weight in China. Methods We reviewed the medical records of 208 patients with psoriasis. Based on their body mass index (BMI), the patients were divided into two groups: patients with psoriasis who were overweight/obese and patients with psoriasis with normal weight. Results The most patients enrolled in this study were men (77.40%). Patients with psoriasis who were overweight/obese had a higher mean age, longer disease duration, and significantly higher Psoriasis Area and Severity Index (PASI) values ( P =0.032). Additionally, the incidence of fatty liver, hyperlipidemia, hyperuricemia, and abnormal liver function was higher among patients with psoriasis who were overweight/obese ( P <0.05). Linear regression analysis revealed a linear relationship between PASI values and BMI ( P =0.016). Moreover, patients with psoriasis who were overweight/obese had significantly higher levels of serum alanine transaminase (ALT), aspartate transaminase (AST), uric acid (UC), total cholesterol (TC), low-density lipoprotein (LDL), and fasting plasma glucose (FPG) ( P <0.05) and lower serum high-density lipoprotein (HDL) levels and absolute lymphocyte count (ALC) ( P <0.05). Conclusion Patients with psoriasis who are overweight/obese have more severe psoriatic lesions and metabolic comorbidities. Detailed assessment of the BMI of patients with psoriasis revealed that weight loss may be necessary for patients who are overweight/obese to reduce the risk of metabolic disorders.

Metabolic dysfunction associated steatotic liver disease in patients with plaque psoriasis: a case–control study and serological comparison

“…These findings suggest that lean-type MASLD might cause less synergistic damage to plaque psoriasis than typical MASLD, pointing to weight management as a potential comprehensive strategy for treating patients with both plaque psoriasis and MASLD. A bicenter retrospective study published in 2023 also supports our perspective on the importance of weight management in psoriasis patients ( 50 ).…”

Relationship between body mass index and degree of adult psoriasis

“…An observational study conducted by Czarnecka et al (12) found no significant association between normal BMI (<25 kg/m 2 ) and psoriasis severity (r = -0.001. and p = 0.917), but found a statistically significant association between abnormal BMI (≥ 25 kg/m 2 ) and PASI score (r = 0.23, and p = 0.016). Li et al (24) observed that overweight or obese subjects with psoriasis had significantly more severe psoriatic lesions and metabolic comorbidities. Therefore the study results on the correlation of BMI with psoriasis severity are still inconsistent.…”

Insights into Nutritional Strategies in Psoriasis

“…The inflammatory milieu in PsA is attributed to adipose tissue, whose dysregulation maintains chronic low-grade systemic inflammation [ 14 ]. Therefore, in order to reduce the risk of developing metabolic complications, it is mandatory for Ps and PsA patients to control their BMI primarily through losing weight [ 15 ]. The most accessible strategy for lowering BMI and reducing adipose tissue in Ps patients is a low-calorie diet.…”