Patients diagnosed with psoriasis are often overweight, diabetic, or have high blood pressure and are resistant to psoriatic treatment in the presences of these conditions. However, research confirming the association between psoriasis and these factors—to help build-up protocols for the treating metabolic syndrome and improving patient outcomes—is lacking.
Researchers discovered an association between metabolic syndrome and psoriasis in previous meta-analyses, finding nearly twice- or thrice-increased risk for metabolic syndrome among patients with psoriasis. This increased risk for metabolic puts patients with psoriasis at increased risk for cardiovascular disease, including myocardial infarction and stroke. However, my colleagues and I observed that previous study authors combined observational studies that adjusted for covariates with those that did not. Therefore, we aimed to find a more exact measure of the relationship between psoriasis and metabolic syndrome
Upon a meta-analysis of 14 papers including more than 25,000 patients, we found that the relationship between psoriasis and metabolic syndrome was not as strong as it was previous results, with a mild odds ratio (OR) of 1.4 when compared with patients without psoriasis. Metabolic syndrome was present in 31.4% of patients with psoriasis. Those with systemic treatment had a lower risk than those without systemic treatment. We also found that Latin American and Middle Eastern patients with psoriasis had the highest risk for metabolic syndrome when compared with Europeans, whereas Asian patients had the lowest risk.
Patients with psoriasis represent a challenge for dermatologists, who are obligated to help them achieve the best quality of life possible. Efforts should be made to include the topic of metabolic syndrome in the treatment of these patients as part of their integral management.
Rodriguez-Zuniga M, García-Perdomo H. Systematic review and meta-analysis of the association between psoriasis and metabolic syndrome. J Am Acad Dermatol. October 2017; 657–666. Available at: http://www.jaad.org/article/S0190-9622(17)31666-3/fulltext.