Supervisors info:
Παπαδαυΐδ Ευαγγελία, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Κατούλης Αλέξανδρος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Νταλαμάγκα Μαρία, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Background: Psoriasis is an inflammatory skin disease, which is characterized by abnormal differentiation of keratinocytes. It affects approximately 1-3% of worldwide population and it causes high morbidity. Moreover, mild to severe psoriasis is often related to many metabolic disorders, such as obesity, diabetes, dyslipidemia, fat liver disease and metabolic syndrome (MetS). MetS represents a cluster of cardiometabolic risk factors, such as obesity, insulin resistance, dyslipidaemia, hypertension. During the last decades the incidence of Mets has been increased worldwide, probably due to the increase of obese people, so, it is crucial to prevent and deal with this problem. Recent studies show a relationship between psoriasis and Mets. It seems that they share common risk factors, pathophysiology, and genetic background. The prevalence of MetS among patients with psoriasis is estimated between 20-50%, according to studies from different countries around the world. In addition, the association of psoriasis with MS, but also with obesity, hypertriglyceridemia and hyperglycemia, is increasing with the increasing severity of the disease, independent of other metabolic syndrome factors. The relationship between psoriasis and metabolic syndrome also has important clinical implications and dermatologists should pay particular attention to early recognition of coexisting metabolic disorders and administrate appropriate treatment.
Objective: The objective of this study is to estimate the prevalence of metabolic syndrome in patients with psoriasis, according to IDF criteria.
Method: The sample included 157 patients with psoriasis, 93 men (59.2%) and 64 women (40.8%) who came to the Psoriasis Dermatology Clinic in the first quarter of 2018. Patients were examined clinically and laboratory in order to determine who meets the IDF criteria for metabolic syndrome.
Results: 29.2% of patients met the IDF criteria. Of these patients, 71.7% were male and 28.3% female (p = 0.02). The mean age of patients with MetS was 63.17 (± 10.71) years, while those without MetS were 51.34 (± 13.62) (p <0.001). The mean age of onset of psoriasis for patients with MetS was 44.77 (± 16.11) years, versus 31.09 (± 15.55) of psoriatic patients without MetS (p <0.001). Moreover, 41.3% of patients with MetS had late onset of psoriasis, compared to 13.5% for patients without MetS (p <0.001). In contrast, 65.7% of patients without MetS had early onset of psoriasis, compared to 34.7% for patients with MetS (p <0.001). No correlation was found between MetS and duration of psoriasis, severity of psoriasis, and smoking.
Limitations: 1. Most of our patients have a pre-existing psoriasis and other comorbidities and they are under treatment with biologics or other systemic therapy. 2. Small sample of patients 3. No control group
Conclusion: Metabolic syndrome seems to have a high prevalence among patients with psoriasis and patients with psoriasis have an increased chance of developing metabolic syndrome compared to the general population. It is important all patients with psoriasis to be screened regularly for cardiovascular risk factors such as hypertension, dyslipidaemia, insulin resistance and type 2 Diabetes Mellitus, as well as to follow a balanced diet and exercise regularly to prevent obesity and MetS.
