Effect of Weight Loss on the Severity of Psoriasis

Jensen, Peter; Zachariae, Claus; Christensen, Robin; Geiker, Nina Rica Wium; Schaadt, Bente Krogsgaard; Stender, Steen; Hansen, Peter Riis; Astrup, Arne; Skov, Lone

doi:10.1001/jamadermatol.2013.722

Cited by 191 publications

(196 citation statements)

References 40 publications

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“…Also, Gisondi et al (29) showed an increased response to cyclosporine after weight loss in obese patients with psoriasis, and in 2013 we published the results of a randomized LED weight-loss trial with PASI as the primary endpoint (9); this provided the patients for the current extension study, which was designed to follow maintenance of weight loss. Our randomized study showed a trend in favor of a clinically important reduction in the severity of psoriasis measured by PASI and DLQI and also that certain components of the cardiovascular disease risk profile of obese patients with psoriasis could be significantly improved after weight loss (9,10). To our knowledge, there have been no studies on weight reduction in overweight patients with psoriasis with the severity of psoriasis as primary endpoint-and no such studies with extended follow-up periods.…”

Section: Discussionmentioning

confidence: 67%

“…In this 48-wk extension study of obese patients with psoriasis who underwent successful weight loss with a 16-wk LED, changes in the severity of psoriasis (PASI and DLQI) were maintained after 64 wk (9). In addition, marked improvements in plasma glucose and glycated hemoglobin amounts remained unchanged after the weight maintenance period, whereas cholesterol concentrations had returned to baseline values.…”

Section: Discussionmentioning

confidence: 88%

“…Psoriasis and obesity are accompanied by low-grade systemic inflammation, and in theory, obesity-derived proinflammatory mechanisms may worsen the severity of psoriasis in overweight individuals with psoriasis (8). Given the close association between psoriasis and adiposity, we recently reported a randomized study on the effects of weight reduction with a low-energy diet (LED) 10 on the severity of psoriasis (9). In the study, obese patients with psoriasis were followed for 16 wk, and the weight reduction resulted in a trend in favor of a clinically important reduction in the severity of psoriasis and a significant improvement in self-reported quality of life.…”

Section: Introductionmentioning

confidence: 99%

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Long-term effects of weight reduction on the severity of psoriasis in a cohort derived from a randomized trial: a prospective observational follow-up study

Jensen¹,

Christensen

Zachariae³

et al. 2016

The American Journal of Clinical Nutrition

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Background: Weight reduction may reduce the severity of psoriasis, but little is known about the long-term effects. Objective: We aimed to investigate long-term effects of weight reduction in psoriasis. Design: We previously conducted a randomized trial (n = 60) involving patients with psoriasis who were allocated to a control group or a low-energy diet (LED) group. Here we followed the participants for an additional 48-wk period. In total, 56 patients with psoriasis [mean 6 SD body mass index (in kg/m 2 ): 34.4 6 5.3] underwent a 64-wk weight-loss program consisting of an initial 16-wk randomized phase with an LED for 8 wk and 8 wk of normal food intake combined with 2 LED products/d, followed by a 48-wk period of weight maintenance with the latter diet. After the randomization phase, the control group received the same 8 + 8-wk LED intervention, and all patients were then followed for 48 wk while on the weight-loss maintenance diet. The main outcome was the Psoriasis Area and Severity Index (PASI), and secondary outcome was the Dermatology Life Quality Index (DLQI). Results: For the present study, 56 patients were eligible, 38 agreed to participate, and 32 completed. After the 16-wk LED-only period, the mean weight loss was 215.0 kg (95% CI: 216.6, 213.4 kg), and PASI and DLQI were reduced by 22.3 (95% CI: 23.1, 21.5) and 22.3 (95% CI: 23.2, 21.4), respectively. At week 64, the mean weight loss compared with baseline was 210.1 kg (95% CI: 212.0, 28.1 kg), and PASI and DLQI were maintained at 22.9 (95% CI: 23.9, 21.9) and 21.9 (95% CI: 23.0, 20.9), respectively. Conclusion: Long-term weight loss in patients with psoriasis has long-lasting positive effects on the severity of psoriasis. This trial was registered at clinicaltrials.gov as NCT01137188.Am J Clin Nutr 2016;104:259-65.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

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Long-term effects of weight reduction on the severity of psoriasis in a cohort derived from a randomized trial: a prospective observational follow-up study

Jensen¹,

Christensen

Zachariae³

et al. 2016

The American Journal of Clinical Nutrition

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“…Furthermore, a prospective randomized trial reported that diet-induced weight loss for 8 weeks reduced the disease severity in 60 overweight patients with psoriasis 16 . With regard to the metabolic disturbance observed in patients with psoriasis, previous studies have consistently shown a significantly positive association between psoriasis and metabolic disorders, and suggested that psoriasis may induce metabolic disorders via a proinflammatory milieu and subsequent insulin resistance 17 .…”

Section: Discussionmentioning

confidence: 99%

Impact of metabolic status on the incidence of psoriasis: A Korean nationwide cohort study

Kim¹,

Kim²,

Moon³

et al. 2016

Diabetes Research and Clinical Practice

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“…Cytokines such as tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, leptin, resistin, plasminogen activating inhibitor released from adipose tissue, are considered to induce psoriasis 15 . Although there are studies showing reduced Psoriasis Area Severity Index (PASI) scores and increased quality of life scores following diet with low calories and gastric bypass surgery in overweight/obese patients scores, there are also studies indicating disease exacerbation following weight loss and surgery [16][17][18] . Obesity negatively affects the effect of treatment.…”

Section: Obesitymentioning

confidence: 99%

Comorbidities in psoriasis: The recognition of psoriasis as a systemic disease and current management

Kalkan¹

2017

TURKDERM

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©Copyright 2017 by Turkish Society of Dermatology and Venereology Turkderm-Turkish Archives of Dermatology and Venereology published by Galenos Yayınevi. Öz IntroductionPsoriasis, with a worldwide prevalence of 2-3%, is now assumed as a systemic chronic inflammatory disease accompanied by comorbidities while it was accepted as a disease limited only to the skin in the past 1 . Psoriasis and its comorbidities were the main focused topic at several sessions of the 73 rd Annual Meeting of the American Academy of Dermatology and, especially, systemic disease concept was emphasized 2 . Therefore, recent publications suggest that the term psoriatic disease would be a better nomination instead of psoriasis 3 . In this review, learning screening recommendations developed for early detection and treatment of comorbidities as well as integrated, multidisciplinary approach for disease management have been targeted by reviewing psoriasis and accompanying comorbidities. Comorbidities are more frequently seen in 15% of psoriasis patients who have moderate to severe psoriasis due to increased inflammatory impact and common pathogenesis. Consistent monitoring and systemic treatment are required to prevent development of comorbidities. There are several Tüm dünyada %2-3 oranında görülme sıklığına sahip psoriazis, geçmişte sadece deriye sınırlı kabul edilirken, günümüzde birçok komorbiditenin eşlik ettiği kronik sistemik enflamatuvar bir hastalık olarak ele alınmaktadır. Orta-şiddetli düzeyde psoriazisi olanlarda daha sık görülen komorbiditelerle ilgili çeşitli sınıflamalar mevcuttur. Basit olarak klasik, kronik sistemik enflamasyonla ilişkili, yaşam tarzı ile ilgili ve tedavi ile ilgili olarak sınıflanabileceği gibi medikal komorbiditeler, psikiyatrik/psikolojik komorbiditeler ve komorbiditelere katkı yapan durumlar şeklinde de sınıflanabilmektedir. Bu derlemede psoriazis ve eşlik eden komorbiditelerin gözden geçirilmesiyle; komorbiditelerin erken tanı ve tedavisini sağlama, komorbiditilerin erken tespitine yönelik geliştirilen tarama önerilerini öğrenme ve hastalığın yönetiminde entegre, multidisipliner yaklaşım ile uzun dönem hastalık kontrolü ve hayat kalitesinde düzelme sağlamak hedeflenmektedir. Anahtar Kelimeler: Psoriazis, komorbidite, sistemik hastalık Psoriasis, with a worldwide prevalence of 2-3%, is now assumed as a systemic chronic inflammatory disease accompanied by comorbidities while it was accepted as a disease limited only to the skin in the past. There are several classifications of the comorbidities which are more common in patients with moderate to severe psoriasis. Simply, comorbidities can be classified as classic, emerging, related to lifestyle, related to treatment. They can also be categorized as medical comorbidities, psychiatric/psychologic comorbidities, and behaviors contributing to medical and psychiatric comorbidities. In this review, providing early diagnosis and treatment of comorbidities, learning screening recommendations for early detection and long-term disease control and improvemen...

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Effect of Weight Loss on the Severity of Psoriasis

Abstract: clinicaltrials.gov Identifier: NCT01137188.

Cited by 191 publications

References 40 publications

Long-term effects of weight reduction on the severity of psoriasis in a cohort derived from a randomized trial: a prospective observational follow-up study

Long-term effects of weight reduction on the severity of psoriasis in a cohort derived from a randomized trial: a prospective observational follow-up study

Impact of metabolic status on the incidence of psoriasis: A Korean nationwide cohort study

Comorbidities in psoriasis: The recognition of psoriasis as a systemic disease and current management

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