Psoriasis and the metabolic syndrome

Abstract

Psoriasis is an inflammatory, immune-mediated cutaneous disorder that has recently been recognized as systemic disease that is associated with multiple comorbidities such as depression, obesity, and the metabolic syndrome. The metabolic syndrome is the constellation of abdominal obesity, dyslipidemia, hypertension and insulin resistance, and presence of the metabolic syndrome significantly increases a patient's risk for cardiovascular disease, stroke and type 2 diabetes. Recent studies have found that psoriasis patients are at increased risk for metabolic syndrome as well as the individual components of metabolic syndrome, and the two diseases appear linked through a common mechanism of inflammation. Speculation exists as to whether this association is causative or whether it is the result of other habits seen in psoriasis patients, such as increased rates of smoking, alcohol consumption, and sedentary lifestyle, which add to the complexity of the association between psoriasis and the metabolic syndrome. However, psoriasis treatments have been shown to reduce the risk of developing metabolic syndrome components and comorbidities. Future studies are needed to better understand the nature of this relationship and the implications this could have for management and treatment of patients with psoriasis.

Biochemical markers of psoriasis as a metabolic disease

“…Researchers have focused their attention on comorbidities in psoriasis including: type 2 diabetes, atherosclerosis, hypertension, myocardial infarction, depression and obesity. Hyperuricemia in patients with psoriasis has been noted [1,3,[41][42][43][44][45]. It seems that metabolic syndrome, for which the coexistence of well-known cardiovascular disease risk factors is characteristic, may be the connection between cardiovascular complications and type 2 diabetes in patients with psoriasis [1].…”

“…Psoriasis is an immune mediated inflammatory skin disease characterized by epidermal hyperproliferation, impaired differentiation of keratinocytes, excessive angiogenesis and immunological dysfunction [1][2][3]. The immunologic cells engaged in the pathogenesis of psoriasis which have been the focus of attention in recent years include not only lymphocytes Th1, but also Th17, Th22 and regulatory T lymphocytes (Treg).…”

“…A growing number of new cases of psoriasis are reported [37,38]. Recently, psoriasis has been recognized as a systemic disease associated with multiple comorbidities [1,3]. The lipid disturbances in the course of psoriasis have been analyzed since 1924 [39,40].…”

El síndrome metabólico en dermatología

“…La importancia del SM radica en el incremento del riesgo de sufrir otras comorbilidades, fundamentalmente enfermedad arterial coronaria, infarto de miocardio, ictus y diabetes mellitus de tipo 2 3 . El SM se caracteriza por un incremento de la actividad de las células TH1, lo que sugiere que, en determinadas enfermedades inflamatorias, como la psoriasis, estarían unidas por la misma desregulación de las vías de la inflamación 4 .…”

Psoriasis, a Systemic Disease Beyond the Skin, as Evidenced by Psoriatic Arthritis and Many Comorbities – Clinical Remission with a Leishmania Amastigotes Vaccine, a Serendipity Finding

“…Recent studies have found that psoriasis patients are at increased risk for metabolic syndrome as well as the individual components of metabolic syndrome, and the two diseases appear linked through a common mechanism of inflammation. Psoriasis treatments have been shown to reduce the risk of developing metabolic syndrome components and comorbidities (Alsufyani et al, 2010). The prevalence of obesity in psoriatic patients within the "Utah Psoriasis Initiative" (UPI) population was higher than that in the general Utah population.…”