Associations between cardiovascular risk factors and psoriasis in Iran

Association of serum lipid profiles and dietary intakes of vitamin E and fiber with psoriasis severity

Background:

Dyslipidemia has been reportedly associated with an increased risk of atherosclerosis among psoriatic patients. Dietary intake can be a key factor in the pathophysiology of psoriasis. Herein, we assessed serum lipid profile and dietary intake in psoriatic patients, in comparison with healthy subjects.

Methods:

In this case-control study, 45 psoriatic patients and 43 healthy controls were evaluated. We estimated the macro/micronutrient intakes and energy, using a food frequency questionnaire (FFQ). Anthropometric parameters and serum levels of triglyceride (TG), high-density lipoproteins (HDL), low-density lipoproteins (LDL), and very low-density lipoproteins were assessed. The case group was categorized by severity measured by PASI score (mild<10, moderate 10-20, severe >20). Diet plan 6.0 was used to analyze FFQs and data were analyzed in SPSS 16.0, with p<0.05 considered significant.

Results:

The case group had markedly higher body mass index (BMI), LDL, and cholesterol and significantly lower HDL compared with controls (p<0.05). Carbohydrate, energy, fat intakes were significantly higher in cases, while folate, fiber, and vitamin E intakes were significantly lower in the case group, compared with the control group (p<0.05). BMI, cholesterol, and triglyceride values and dietary intakes of fiber and vitamin E were significantly associated with severity of psoriasis (p<0.05).

Conclusion:

Serum lipid profile and dietary intake are substantially important in psoriasis severity. Therefore, close monitoring of lipid profile and BMI during admission and follow-up and dietary modification can improve the severity of psoriasis.

Smoking Cigarettes and Consuming Alcohol in Patients with Psoriasis

Introduction

Psoriasis is a chronic disease. Research shows the emergence of harmful habits such as cigarette smoking and alcohol consumption in people with psoriasis.

Aim

The aim of this study was to determine the frequency of habits, cigarette smoking and alcohol consumption in patients with psoriasis, sexual distribution, and the relationship of habits with the severity of the disease.

Methods

The prospective study included 129 subjects with psoriasis, of which 67 or 51,94% were women and 62 or 48,06% were men.

Results

The frequency of cigarette smoking was 41,09%, alcohol consumption 24,80%. The gender distribution of cigarette smoking was: 35,82% of women and 46,77% of men smoked cigarettes. The gender distribution of alcohol consumption is: women 5,97% and men 45,16%. The severity of psoriasis, that is PASI score and cigarette smoking were statistically significantly related (r=0,63), and PASI score and alcohol consumption were not statistically significantly related (r=0,32).

Conclusion

Cigarette smoking and alcohol consumption are present in psoriasis sufferers, cigarette smoking is associated with disease severity, and alcohol consumption is not. It takes knowledge of the habits of people with psoriasis and a multidisciplinary approach to get rid of harmful habits.

Metabolic Syndrome and Psoriasis: A Case-Control Study in Kabul, Afghanistan

BACKGROUND

Psoriasis is a chronic inflammatory disease that is not limited to the skin. Recently, numerous studies have shown a positive association between metabolic syndrome and psoriasis.

OBJECTIVE

The current study aimed to examine the association of metabolic syndrome with psoriasis in an Afghan population.

METHODS

This was a case- control study including 114 patients with psoriasis and 114 controls aged ≥18 years admitted to the dermatology department of Maiwand Teaching Hospital in Kabul, Afghanistan. Height, weight, blood pressure, and waist circumference were measured in all subjects. Blood glucose, triglyceride, cholesterol, and high-density lipoprotein cholesterol levels were tested following overnight fasting. The modified National Cholesterol Education Program - Adult Treatment Panel III criteria were used for the diagnosis of metabolic syndrome.

RESULTS

In total, 51.8% of the cases and 44.7% of the controls were male. The average age of participants was 33.4±13.1 years in the case group and 41.1±15.4 years in the control group. The average duration of disease for psoriasis was 4.2 years with 5.6 years SD. The average PASI was 10.8 with 5.1 SD. More than half of the cases (62.3%) had moderate to severe psoriasis and 37.7% had mild psoriasis. The prevalence of metabolic syndrome was higher among patients with psoriasis compared to controls (36.8% vs 21.1%) with OR of 2.18 (p=0.009). In addition, overweight/obesity was more prevalent among cases compared to controls (65.8% vs 41.2%) with OR of 2.74 (p<0.001), whereas the waist circumference was not significantly different between the two groups. Furthermore, the mean levels of total cholesterol, triglyceride, and fasting blood glucose were also higher among patients with psoriasis compared to controls.

CONCLUSION

The results of the study confirm the association between psoriasis and metabolic syndrome. Hence, screening psoriatic patients for metabolic syndrome should be considered.

Psoriasis and cardiovascular disorders: association or epiphenomenon? Meta-analysis of observational studies

Psoriasis is a chronic inflammatory disease believed to be correlated with numerous cardiovascular risk factors including increased blood pressure, elevated blood cholesterol level, diabetes, inactivity, high body mass index (obesity) and dyslipidaemia. The present meta-analysis intends to assess the association between psoriasis and cardiovascular risk factors. Three hundred and fifty articles were primarily screened using NCBI MEDLINE/PubMed and Cochrane library from its inception until June 30, 2018. Of these, 26 observational studies depending upon the inclusion and exclusion criteria were included in the study with 17,672 psoriasis patients and 66,407 non-psoriasis subjects. The psoriasis patients were found to be at significantly increased risk of systolic blood pressure (SBP) [ORs 2.31 (95% CI 1.12, 4.74)], diastolic blood pressure (DBP) [ORs 2.31 (95% CI 1.58, 3.38)], abdominal obesity [ORs 1.90 (95% CI 1.45, 2.50)] and triglycerides [ORs 1.80 (95% CI 1.29, 2.51)] as compared to non-psoriasis subjects. The subgroup analyses of studies based on the continents revealed that psoriasis patients from Middle East are prone to higher risk factors of CVD including increased levels of triglyceride, cholesterol, DBP, SBP, fasting blood sugar, body mass index and decreased HDL levels, whereas psoriasis patients from European population reported increased LDL-C and waist circumference. The present study supports a significant association between psoriasis and incidence of major adverse cardiovascular events. Contrary to the previous literature, our finding suggests that hypertension is a highly associative condition in psoriasis. The findings of this study could be validated amongst well-defined cohorts of patients with psoriasis individually in different regions to confirm the implication of the study.

Evaluation of serum lipid, lipoprotein, and apolipoprotein levels in psoriatic patients: a systematic review and meta-analysis of case-control studies

Introduction

Psoriasis is a T cell-mediated inflammatory skin disease in which fatty acids may be a link between psoriasis and its comorbidity.

Aim

The present meta-analysis aimed to evaluate lipid, lipoprotein, and apolipoprotein levels in the psoriatic patients compared with the control subjects.

Material and methods

Four databases, including Web of Science, Scopus, PubMed, and Cochrane Library were searched until July 2017. All records analysed were case-control studies. The quality of the questionnaires was evaluated using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was done by Rev Man 5.3 using mean difference (MD) and 95% confidence intervals (CIs).

Results

Out of 580 studies identified in four databases, 49 studies were included and analysed in this meta-analysis. The results showed that MD of total cholesterol, triglyceride, LDL, VLDL, HDL, Lp(a), Apo A1, and Apo B levels in the patients compared with the controls were (MD = 13.74 mg/dl; 95% CI: 7.72-19.75; p< 0.00001), (MD = 26.04 mg/dl; 95% CI: 20.77-31.31; p< 0.00001), (MD = 11.41 mg/dl; 95% CI: 6.26-16.57; p< 0.0001), (MD = 4.82 mg/dl; 95% CI: 3.63-6.00; p< 0.00001), (MD = -2.78 mg/dl; 95% CI: -4.53 - -1.03; p< 0.002), (MD = 8.51 mg/dl; 95% CI: 4.86-12.17; p< 0.0001), (MD = -6.60 mg/dl; 95% CI: -13.96 - 0.75; p< 0.08), and (MD = 9.70 mg/dl; 95% CI: 3.02-16.39; p< 0.004), respectively.

Conclusions

This meta-analysis identified abnormality of serum lipid, lipoprotein, and apolipoproteinprofiles in psoriatic patients compared with the controls as well as possibly a greater risk of atherosclerosis and cardiovascular (CV) accidents in the patients.

Body mass index, abdominal fatness, weight gain and the risk of psoriasis: a systematic review and dose-response meta-analysis of prospective studies

Greater body mass index (BMI) has been associated with increased risk of psoriasis in case–control and cross-sectional studies, however, the evidence from prospective studies has been limited. We conducted a systematic review and dose–response meta-analysis of different adiposity measures and the risk of psoriasis to provide a more robust summary of the evidence based on data from prospective studies. PubMed and Embase databases were searched for relevant studies up to August 8th 2017. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated using a random effects model. The summary relative risk (RR) for a 5 unit increment in BMI was 1.19 (95% CI 1.10–1.28, I² = 83%, n = 7). The association appeared to be stronger at higher compared to lower levels of BMI, p_nonlinearity < 0.0001, and the lowest risk was observed at a BMI around 20. The summary RR was 1.24 (95% CI 1.17–1.31, I² = 0%, p_{heterogeneity} = 0.72, n = 3) per 10 cm increase in waist circumference, 1.37 (95% CI 1.23–1.53, I² = 0%, p_{heterogeneity} = 0.93, n = 3) per 0.1 unit increase in waist-to-hip ratio, and 1.11 (95% CI 1.07–1.16, I² = 47%, p_{heterogeneity} = 0.15, n = 3) per 5 kg of weight gain. Adiposity as measured by BMI, waist circumference, waist-to-hip ratio, and weight gain is associated with increased risk of psoriasis.

Associations between body mass index and severity of psoriasis

Objective

Compared with healthy people, overweight and obesity are more commonly found among those suffering from skin conditions such as psoriasis. The present study was an attempt to survey the relationship between obesity and intensity of psoriasis.

Patients and methods

A total of 42 patients with psoriasis who were referred to Farshchian Hospital, Hamadan, participated in this cross-sectional descriptive–analytical study. Patients were classified into mild, moderate and severe based on the intensity of the disease measured by Psoriasis Area and Severity Index (PASI). Body mass index (BMI), waist size, age, gender, smoking and drinking habits of the participants were measured and compared.

Results

A total of 15 (35.07%) patients had mild psoriasis, 9 (21.4%) patients had moderate psoriasis and 18 (42.9%) patients suffered from severe psoriasis. Mean BMI of mild psoriasis patients was 25.86±5.93 kg/m², and this figure for the moderate and severe psoriasis patients was 30.85±3.77 kg/m² and 26.96±5.68 kg/m², respectively (P=0.096). Mean waist size of the mild psoriasis patients was 91.54±11.49 cm, and for moderate and severe patients, it was 99±8.39 cm and 92.17±10.73 cm, respectively (P=0.211).

Conclusion

The results of this study showed no significant difference between mean value of body mass index, waist size, age and gender in mild, moderate and severe groups of the psoriasis patients.