Metabolic syndrome in patients with chronic plaque psoriatic disease: a case-control study from western Uttar Pradesh, India
Keywords:Fasting glucose, Hypertension, Lipid profile, Metabolic syndrome, Waist circumference
Background: Various studies on psoriasis and metabolic syndrome have shown a large variation in their results. An increasing frequency is imposing a substantial burden on the overall health of psoriasis patients that needs to be appropriately foreseen and addressed. Aim of this study was to study various aspects of metabolic syndrome in patients with chronic plaque psoriatic disease in northern Indian region.
Methods: A cohort of patients registering for treatment of chronic plaque psoriasis at Dermatology outpatients’ department formed the study population. Detailed history was captured. General physical examination was carried out. A thorough cutaneous examination was undertaken which captured details on type, distribution and arrangement of primary lesions and secondary changes in patients. After overnight fasting, venous blood samples were collected from the subjects and were analysed for serum glucose, triglyceride and HDL-cholesterol.
Results: Metabolic syndrome in psoriasis was associated with higher age. Gender wise male preponderance was observed. Among the psoriasis cases, 64% had metabolic syndrome whereas among the control subjects 48% had the condition (p-value 0.158). The mean for serum triglyceride level for psoriasis patients (159.42 mg/dL) was higher than controls (144.25 mg/dL). Forty six percent of cases fulfilled elevated triglycerides ≥150 mg/dl as a criterion of metabolic syndrome, compared to 40% of controls.
Conclusions: We observed a higher frequency of metabolic syndrome among psoriasis cases in a northern Indian population. An association of dyslipidemia with psoriasis was also noted. Routine screening of the condition to facilitate early diagnosis and treatment should be undertaken.
Gisondi P, Tessari G, Conti A, Piaserico S, Schianchi S, Peserico A, et al. Prevalence of metabolic syndrome in patients with psoriasis: a hospital-based case-control study. Br J Dermatol. 2007;157:68-73.
Schön MP, Boehncke WH. Psoriasis. N Engl J Med. 2005;352:1899-912.
Myers WA, Gottlieb AB, Mease P. Psoriasis and psoriatic arthritis: clinical features and disease mechanisms. Clin Dermatol. 2006;24:438-47.
Gottlieb AB, Chao C, Dann F. Psoriasis comorbidities. J Dermatolog Treat. 2008;19:5-21.
Mallbris L, Ritchlin CT, Ståhle M. Metabolic disorders in patients with psoriasis and psoriatic arthritis. Current Rheumatol Rep. 2006;8(5):355-63.
Zindancı I, Albayrak O, Kavala M. Prevalence of metabolic syndrome in patients with psoriasis. Sci World J. 2012;2012:312463.
Bhor U, Pande S. Scoring systems in dermatology. Indian J Dermatol Venereol Leprol. 2006;72:315-21.
Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circ. 2009;120:1640-5.
Madanagobalane S, Anandan S. Prevalence of metabolic syndrome in South Indian patients with psoriasis vulgaris and the relation between disease severity and metabolic syndrome: a hospital-based case-control study. Indian J Dermatol. 2012;57:353-7.
Lakshmi S, Nath AK, Udayashankar C. Metabolic syndrome in patients with psoriasis: A comparative study. Indian Dermatol Online J. 2014;5:132-7.
Love TJ, Qureshi AA, Karlson EW, Gelfand JM, Choi HK. Prevalence of the metabolic syndrome in psoriasis: results from the National Health and Nutrition Examination Survey, 2003-2006. Arch Dermatol. 2011;147:419-24.
Langan SM, Seminara NM, Shin DB, Troxel AB, Kimmel SE, Mehta NN, et al. Prevalence of metabolic syndrome in patients with psoriasis: a population-based study in the United Kingdom. J Invest Dermatol. 2012;132:556-62.
Kim GW, Park HJ, Kim HS, Kim SH, Ko HC, Kim BS, et al. Analysis of cardiovascular risk factors and metabolic syndrome in Korean patients with psoriasis. Ann Dermatol. 2012;24:11-5.
Praveenkumar U, Ganguly S, Ray L, Nanda SK, Kuruvila S. Prevalence of metabolic syndrome in psoriasis patients and its relation to disease duration: a hospital-based case-control study. JCDR. 2016;10(2):WC01.
Gupta R, Sharma KK, Gupta A, Agrawal A, Mohan I, Gupta VP, et al. Persistent high prevalence of cardiovascular risk factors in the urban middle class in India: Jaipur heart watch-5. J Assoc Phy India. 2012;60:11-6.
Nisa N, Qazi MA. Prevalence of metabolic syndrome in patients with psoriasis. Indian J Dermatol Venereol Leprol. 2010;76:662-5.
Pereira RR, Amladi ST, Varthakavi PK. A study of the prevalence of diabetes, insulin resistance, lipid abnormalities, and cardiovascular risk factors in patients with chronic plaque psoriasis. Indian J Dermatol. 2011;56:520-6.
Dreiher J, Weitzman D, Davidovici B, Shapiro J, Cohen AD. Psoriasis and dyslipidaemia: a population-based study. Acta Derm Venereol. 2008;88:561-5.