Prevalence of Metabolic Syndrome in Chinese Patients With Erythrodermic Psoriasis: A Case-Control Study

Abstract

Erythroderma psoriasis (EP) is a rare and severe form of psoriasis, which is a chronic inflammatory skin disease that usually occurs simultaneously with cardiovascular disease (CVD). Metabolic syndrome (MetS) is a significant precursor of CVD. This study was to investigate the association between EP and MetS in the Chinese population. We conducted a retrospective study on 86 consecutive patients with EP and 100 healthy controls from Huashan Hospital between 2013 and 2018. Demographic, biochemical parameters for MetS, and other relevant data including the severity of EP, family history of EP, age of onset, and treatment history involved in those individuals were recorded. The prevalence of MetS in erythrodermic psoriatic patients was 88.37%, which was significantly higher than that of controls (P < 0.0001). Erythrodermic psoriatic patients also had a higher prevalence of MetS components, including abdominal obesity, dyslipidemia and hypertension, whereas hyperglycemia was similar. Adjusted for confounding factors, MetS, abdominal obesity, hypertension, smoking and alcohol use were positive independent predictors of EP (odds ratio > 1, P < 0.05). The area under the receiver operating characteristic curve calculated from determined risk factors for predicting the EP’s incidence was 0.934 (95% CI 0.902-0.966). There was no correlation between the severity of EP and the prevalence of MetS. Compared with patients with mild EP, patients with moderate-to-severe EP had higher body mass index, waist circumstance and blood pressure (P < 0.05). We concluded that the prevalence of MetS and its components was higher in patients with EP. MetS an independent predictor of EP, which can favor CVD and should be encouraged to correct these cardiovascular risk factors aggressively for managing EP.

Association between metabolic syndrome and prevalent skin diseases: A systematic review and meta‐analysis of case‐control studies

“…All studies had an average age range between 35 and 53 years old, except one study in which children with an average age of 13 years old were under investigation 48 . Ninteen of 21 studies recorded that psoriasis patients are greatly more affected by MetS 29–32,35–49 . Howbeit, statistical analysis results, following the removal of adjusted variables in one study, were altered.…”

Phenotypes of Psoriasis in Patients in Need of Systemic Treatment, and Correlation with Personal Habits, Treatment History and Comorbidities: A Cross-sectional Latent Class Analysis of Data from the Italian PsoReal Registry

“…This is in concordance with the low prevalence of generalized-erythrodermic PsO in clinical series, where it represents 1–6% of all PsO patients ( 6 ). In LC5 there was a male predominance and 31% of patients could be classified as having erythrodermic features, defined by skin involvement of at least 80–90% ( 7 ). The severity and extent of disease in this class, as well as the high rate of severe pruritus, the higher number of comorbidities and the longer disease duration could explain the reported higher number of previous systemic treatments, especially biologics, in this class compared with the others.…”

“…PsA, hypertension and kidney disease were remarkably more prevalent in LC5 compared with other classes. Arterial hypertension is known to be more prevalent in erythrodermic PsO ( 7 ). Comorbidities may be partially explained by lifestyle factors, such as drinking alcohol and smoking, that were more prevalent in patients with generalized erythrodermic PsO ( 7 ).…”

“…Arterial hypertension is known to be more prevalent in erythrodermic PsO ( 7 ). Comorbidities may be partially explained by lifestyle factors, such as drinking alcohol and smoking, that were more prevalent in patients with generalized erythrodermic PsO ( 7 ). The relationship between smoking and severity of PsO as well as treatment resistance is already well known ( 10 ).…”

A Bibliometric Analysis of Global Research Trends in Psoriasis and Metabolic Syndrome

“…61 Interestingly, the study found no correlation between the severity of erythrodermic psoriasis and the prevalence of MetS. 61 A case-control study conducted in Thailand reported that there was no significant variation in the severity of psoriasis between the MetS group and the non-MetS group in Southeast Asia. 62 An increasing number of studies have substantiated that psoriasis is not merely an inflammation of the skin, but also affects the whole-body system.…”