Risk factors for comorbidities in Czech psoriatic patients: Results of a hospital-based case-control study

Abstract

Background.Psoriasis is now known to be associated with multiple other diseases/comorbidities -including the metabolic syndrome, atherosclerosis and gastrointestinal diseases which are all significantly higher in psoriasis patients. Research results however are highly variable and the conclusions are ambiguous. As no similar study has been performed to date in Czech psoriatic patients, this study aimed at identifying risk factors and early stages of selected diseases/comorbidities in the patients. Methods and Results. The study was designed as a hospital-based case-control study. 131 patients with chronic plaque psoriasis formed the cases and 267 patients with other skin disorders formed the controls. A comparison was made of basic demographic and anthropometric indicators, metabolic parameters, the presence of specific antibodies (ASCA, AEP, p-ANCA, AGC, EMA, ARA, t-TG, AGA) and non-specific signs of gastrointestinal diseases. The chi squared, MWU tests and binary logistical model were used to evaluate the data. The results showed significant differences (P<0.05) for the following parameters: blood pressure, waist circumference, weight, BMI values, leucocytes values, HDL cholesterol level, glycemia and gliadine antibody IgA level. All differences were to the detriment of psoriasis patients. In the binary logistical model the following parameters were associated with psoriasis: diastolic blood pressure, leucocyte value and glycemia. For all variables included in the logistical model P≤0.001. Conclusions. The results were coherent and consistent with existing data. They indicate that psoriasis is interconnected with hypertension, higher BMI and a decreased level of HDL cholesterol. These parameters have been clearly demonstrated as risk factors for the development of cardiovascular diseases. Higher levels of gliadine IgA antibodies are one of the diagnostic markers of celiac disease. Higher values of leukocytes may be interpreted as a nonspecific indicator of gastrointestinal inflammatory diseases. The associations between psoriasis and diastolic blood pressure, BMI value and glycemia are statistically significant in the binary logistic regression model. Care for psoriatic patients should focus especially on secondary prevention of predisposing diseases.

Plaque Psoriasis: Understanding Risk Factors of This Inflammatory Skin Pathology

“…In one case-control study, Arias-Santiago et al found four times more carotid atheroma plaques in psoriatic patients than in controls [103]. Votrubova et al in a study conducted with 131 patients with chronic plaque psoriasis and 267 control patients with other skin disorders, observed relationships between psoriasis and risk factors for cardiovascular diseases such as hypertension, higher body mass index and reduced HDL cholesterol levels [104].…”

Evidence of a common causal relationship between body mass index and inflammatory skin disease: a Mendelian Randomization study

“…For both adults and children, the observed difference in BMI is equivalent to a 9% increase in the odds of psoriasis per 1 kg/m 2 increase in BMI. 19 other studies tested for an association between BMI or obesity traits and psoriasis using alternative models [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50]. These all reported a positive association, including two studies which reported the odds of psoriasis in adults per 1 kg/m 2 increase in BMI to be 1.09 (95% CI 1.04 to 1.16)[51] and 1.04 (95% CI 1.02 to 1.10) [52].…”