Cardiovascular comorbidities in childhood psoriasis

Abstract

Background: Psoriasis is a common, chronic, systemic inflammatory skin disease associated with numerous cardiovascular comorbidities. Much evidence of this association exists in the adult population, data available in childhood psoriasis is more limited. Objectives: To analyze the prevalence of excess adiposity, cardiovascular risk factors, metabolic syndrome and lipid profile in children with psoriasis comparing to control group with similar age and sex distribution. Materials & methods: A case-control study was conducted with children, 5-15 yearsold, with moderate-to-severe plaque-type psoriasis and a control group comprising children with other skin diseases without systemic inflammatory diseases. Results: Psoriatic children had a significantly higher prevalence and greater odds of excess adiposity compared to controls: BMI (≥85 th percentile; OR 4.4; 95%CI 1.2-15.6), waist circumference (>75 th percentile; OR 7.4; 95%CI 2.0-27.7) and waist-to-height ratio (>0.490; OR 4.6; 95%CI 1.3-17.0). A higher prevalence of metabolic syndrome was observed in children with psoriasis compared to controls (25% vs 3.7%; P = 0.07), and two components of the metabolic syndrome were significantly higher in the psoriasis group: waist circumference (75% vs 29.6%; P = 0.002) and the high blood pressure component (30% vs 3.7% P = 0.032). Finally, an altered and more atherogenic lipid profile was observed among psoriatic patients without excess adiposity. Conclusion: This study demonstrates that comorbidities known to be associated with adult psoriasis are also observed in childhood psoriasis, reinforcing the need for screening cardiovascular comorbidities in children with psoriasis and promoting healthy lifestyle choices in these patients. Moreover, it also suggests that its association with psoriasis may be in part genetically determined rather than uniquely acquired.

Association of metabolic syndrome with pediatric psoriasis: a case‐control study in Kabul, Afghanistan

“…(30.0% vs. 7.4%), and Torres et al . (25.0% vs. 3.7%) . The higher odds of metabolic syndrome in our study are likely because of the lower rate of metabolic syndrome among children without psoriasis.…”

“…Lower HDL cholesterol was more common among children with psoriasis (16.2%) than controls (6.7%) with OR 2.70. These findings are in line with Torres et al ., who found dyslipidemia 15.0% versus 7.4% in pediatric psoriasis and controls, respectively …”

“…Only one child in the control group had hypertension. Similar findings were identified by Kwa et al ., 4.2% versus 1.2%, and Torres et al ., 10.0% versus 3.7% …”

“…also found higher WtHR among children with psoriasis than controls. However, the last two studies used a cutoff point of ≤0.539 . The exact mechanism underlying this association is unknown but is most likely multifactorial.…”

“…However, the last two studies used a cutoff point of ≤0.539. 20,23 The exact mechanism underlying this association is unknown but is most likely multifactorial. Genetic and immune-mediated mechanisms and behavioral factors, such as low physical activity, most likely have an essential role in clarifying the relationship of obesity with psoriasis.…”