The Association of Psoriasis and Elevated Blood Lipids in Overweight and Obese Children

Abstract

Objective-To investigate whether obesity and cardiovascular risk factors are associated with psoriasis in children and adolescents.Study design-For this population-based, cross-sectional study, measured weight and height, laboratory data, and psoriasis diagnoses were extracted from electronic medical records of 710,949 patients 2-19 y enrolled in an integrated health plan. Weight class was assigned based on body mass index-for-age.Results-The OR for psoriasis was 0.68, 1.00, 1.31, 1.39, and 1.78 (95%CI 1.49-2.14) for underweight, normal weight, overweight, moderately obese and extreme obese children, respectively (p for trend<0.001). The OR for psoriasis treated systemic therapy or phototherapy as indicator of severe or widespread psoriasis was 0.00, 1.00, 2.78, 2.93, and 4.19 (95%CI 1.81-9.68) for underweight, normal weight, overweight, moderately obese and extreme obese children, respectively (p for trend<0.003). In adolescents, mean total cholesterol, LDL cholesterol, triglycerides and ALT were significantly higher in children with psoriasis compared with children without psoriasis after adjustment for BMI.Conclusion-Overweight and obesity are associated with higher odds of psoriasis in youths. Independent of body weight, adolescent patients with psoriasis have higher blood lipids. These data suggest that pediatricians and dermatologists should screen youths with psoriasis for cardiovascular disease risk factors. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.The other authors declare no conflicts of interest. [5], and mortality [6]. In children, the rate of obesity has more than tripled in the past 30 years [7] with more and more children becoming extremely obese [8,9]. Like psoriasis, obesity is a condition characterized by chronic low-level inflammation in adults [10] and children [11]. The association between obesity and psoriasis has been well described in adults [12][13][14], including one prospective study suggesting that obesity is a risk factor for adult-onset psoriasis [15]. However, concerns of residualconfounding and lack of causality have been raised by others [16]. NIH Public AccessOne study has examined the association between obesity and psoriasis in children and found obesity to be 1.7 times higher in frequency in children with than without psoriasis [2].Results from that study also suggest that children with psoriasis have a higher prevalence of dyslipidemia and hypertension [2]. However, information on the degree of obesity is lacking in that study and the magnitude of the association cannot be quantified. Given the association of psoriasis ...

Cardiovascular Risk Factors in Children and Adolescents with Psoriasis: A Case-control Study

“…In addition, it has been demonstrated that there is a positive association between childhood psoriasis and overweight (5,6). A recent study by Koebnick et al (7) showed that obesity was associated with higher odds of psoriasis in children and adolescents. Other epidemiological data indicate that the greatest risk of myocardial infarction and incident diabetes mellitus is observed in young adult patients with severe psoriasis (8,9).…”

Childhood psoriasis

“…The risk profile for our younger patients is still under investigation, but a pattern linking psoriasis and the metabolic syndrome seems to be emerging [1,8,9,13,20,[28][29][30][31][32][33][34].…”

“…Multiple authors, including Au et al [31], Koebnick et al [32], and Volf et al [33], state that pediatric psoriasis patients should be monitored for cardiovascular risk factors and, if found at risk, should receive preventive interventions [34]. tywnie wpływa na jakość życia pozostałych członków rodziny [1,5,[24][25][26].…”

“…[31], Koebnick i wsp. [32], Volf i wsp. [33], uważa, że dzieci z łuszczycą powinny być monitorowane w celu identyfikacji czynników ryzyka wystąpienia chorób układu krążenia, a w przypadku ich wykrycia objęte profilaktyką i działaniami edukacyjnymi [34].…”

Pediatric Psoriasis

“…Pediatric psoriasis differs from adult onset psoriasis in types of environmental triggers, with trauma, stress, and bacterial infection being the most common pediatric disease triggers [ 1 , 3 ], while drug-reactions, smoking, alcohol use, and underlying HIV infection are triggers more common in adulthood [ 4 ]. Recently, obesity and the metabolic syndrome have been linked to both pediatric and adult psoriasis [ 5 ]. Treatment options are similar for adult and pediatric psoriasis patients, although therapy selection for pediatric psoriasis varies according to patient age and is limited by the fact that systemic treatments for pediatric psoriasis are off-label.…”