Skip to main content
SpringerLink
Log in

Metabolic Syndrome Prevalence in Psoriasis

A Cross-Sectional Study in the Italian Population

  • Short Communication
  • Published:
American Journal of Clinical Dermatology Aims and scope Submit manuscript

Abstract

Background

The pathogenesis of psoriasis is complex, with a significant role suggested for pro-inflammatory mediators. There is strong evidence of an association between psoriasis and the metabolic syndrome (MetS), a cluster of cardiovascular risk factors, which impose a substantial disease burden.

Objective

This study aimed to evaluate the prevalence of MetS and to examine the implications of disease severity, type 2 diabetes mellitus, and cardiovascular disease in a large cohort of Italian psoriatic patients representative of the whole population.

Methods

This was a cross-sectional study involving 13 dermatological clinics in Italy. The primary study endpoint was a comparison of the prevalence of MetS between psoriatic patients and a non-psoriatic control group; secondary endpoints included the influence of psoriasis severity on the prevalence of MetS, and the relative prevalence and risk of type 2 diabetes mellitus and cardiovascular disorders.

Results

A total of 720 patients were enrolled (n = 360 per group). The prevalence of MetS was 26.84 % in the psoriatic population and 15.16 % in the control population (p = 0.0001; adjusted odds ratio 1.96). MetS was associated with a greater degree of psoriasis severity, and the prevalence and risk of diabetes tended to be higher in psoriatic patients than in the control group.

Conclusion

In the Italian population, the prevalence of MetS and associated comorbidities is elevated in patients with psoriasis compared with non-psoriatic subjects, as has been demonstrated in other countries. Our findings reinforce the importance of considering the implications of metabolic comorbidities in treating patients with psoriasis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Schäfer T. Epidemiology of psoriasis. Review and the German perspective. Dermatology. 2006;212(4):327–37.

    Article  PubMed  Google Scholar 

  2. Icen M, Crowson CS, McEvoy MT, Dann FJ, Gabriel SE, Maradit Kremers H. Trends in incidence of adult-onset psoriasis over three decades: a population-based study. J Am Acad Dermatol. 2009;60(3):394–401.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Wilson FC, Icen M, Crowson CS, McEvoy MT, Gabriel SE, Kremers HM. Time trends in epidemiology and characteristics of psoriatic arthritis over 3 decades: a population-based study. J Rheumatol. 2009;36(2):361–7.

    Article  PubMed Central  PubMed  Google Scholar 

  4. Gelfand JM, Troxel AB, Lewis JD, Kurd SK, Shin DB, Wang X, et al. The risk of mortality in patients with psoriasis: results from a population-based study. Arch Dermatol. 2007;143(12):1493–9.

    Article  PubMed  Google Scholar 

  5. Nestle FO, Kaplan DH, Barker J. Psoriasis. N Engl J Med. 2009;361(5):496–509.

    Article  CAS  PubMed  Google Scholar 

  6. Farber EM, Nall ML. The natural history of psoriasis in 5,600 patients. Dermatologica. 1974;148(1):1–18.

    Article  CAS  PubMed  Google Scholar 

  7. Lønnberg AS, Skov L, Skytthe A, Kyvik KO, Pedersen OB, Thomsen SF. Heritability of psoriasis in a large twin sample. Br J Dermatol. 2013;169:412–6.

    Article  PubMed  Google Scholar 

  8. Schön MP, Boehncke WH. Psoriasis. N Engl J Med. 2005;352(18):1899–912.

    Article  PubMed  Google Scholar 

  9. Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. Lancet. 2005;365(9468):1415–28.

    Article  CAS  PubMed  Google Scholar 

  10. Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, et al. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA. 2002;288(21):2709–16.

    Article  PubMed  Google Scholar 

  11. Gisondi P, Ferrazzi A, Girolomoni G. Metabolic comorbidities and psoriasis. Acta Dermatovenerol Croat. 2010;18(4):297–304.

    PubMed  Google Scholar 

  12. National Cholesterol Education Program (NCEP) Expert Panel on Detection E, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143–421.

    Google Scholar 

  13. Kahn HS, Cheng YJ, Thompson TJ, Imperatore G, Gregg EW. Two risk-scoring systems for predicting incident diabetes mellitus in US adults age 45 to 64 years. Ann Intern Med. 2009;150(11):741–51.

    Article  PubMed  Google Scholar 

  14. Ridker PM, Buring JE, Rifai N, Cook NR. Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds Risk Score. JAMA. 2007;297(6):611–9.

    Article  CAS  PubMed  Google Scholar 

  15. Ridker PM, Paynter NP, Rifai N, Gaziano JM, Cook NR. C-reactive protein and parental history improve global cardiovascular risk prediction: the Reynolds Risk Score for men. Circulation. 2008;118(22):2243–51 (4p following 51).

    Google Scholar 

  16. 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(1):68–73.

    Article  CAS  PubMed  Google Scholar 

  17. Armstrong AW, Harskamp CT, Armstrong EJ. Psoriasis and metabolic syndrome: a systematic review and meta-analysis of observational studies. J Am Acad Dermatol. 2013;68(4):654–62.

    Article  PubMed  Google Scholar 

  18. 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(4):419–24.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Gelfand JM, Yeung H. Metabolic syndrome in patients with psoriatic disease. J Rheumatol Suppl. 2012;89:24–8.

    Article  PubMed Central  PubMed  Google Scholar 

  20. 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(3 Pt 1):556–62.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Altobelli E, Petrocelli R, Maccarone M, Altomare G, Argenziano G, Giannetti A, et al. Risk factors of hypertension, diabetes and obesity in Italian psoriasis patients: a survey on socio-demographic characteristics, smoking habits and alcohol consumption. Eur J Dermatol. 2009;19(3):252–6.

    PubMed  Google Scholar 

  22. Duarte GV, Oliveira MdeF, Cardoso TM, Follador I, Silva TS, Cavalheiro CM, et al. Association between obesity measured by different parameters and severity of psoriasis. Int J Dermatol. 2013;52(2):177–81.

    Article  PubMed  Google Scholar 

  23. Naldi L, Rzany B. Chronic plaque psoriasis. Clin Evid. 2005;13:2070–98.

    PubMed  Google Scholar 

  24. Wolters M. Diet and psoriasis: experimental data and clinical evidence. Br J Dermatol. 2005;153(4):706–14.

    Article  CAS  PubMed  Google Scholar 

  25. Engeli S, Bohnke J, Gorzelniak K, Janke J, Schling P, Bader M, et al. Weight loss and the renin–angiotensin–aldosterone system. Hypertension. 2005;45(3):356–62.

    Article  CAS  PubMed  Google Scholar 

  26. Boehncke S, Thaci D, Beschmann H, Ludwig RJ, Ackermann H, Badenhoop K, et al. Psoriasis patients show signs of insulin resistance. Br J Dermatol. 2007;157(6):1249–51.

    Article  CAS  PubMed  Google Scholar 

  27. Davidovici BB, Sattar N, Prinz J, Puig L, Emery P, Barker JN, et al. Psoriasis and systemic inflammatory diseases: potential mechanistic links between skin disease and co-morbid conditions. J Invest Dermatol. 2010;130(7):1785–96.

    Article  CAS  PubMed  Google Scholar 

  28. Cohen AD, Dreiher J, Shapiro Y, Vidavsky L, Vardy DA, Davidovici B, et al. Psoriasis and diabetes: a population-based cross-sectional study. J Eur Acad Dermatol Venereol. 2008;22(5):585–9.

    Article  CAS  PubMed  Google Scholar 

  29. Binazzi M, Calandra P, Lisi P. Statistical association between psoriasis and diabetes: further results. Arch Dermatol Res. 1975;254(1):43–8.

    Article  CAS  PubMed  Google Scholar 

  30. Shapiro J, Cohen AD, David M, Hodak E, Chodik G, Viner A, et al. The association between psoriasis, diabetes mellitus, and atherosclerosis in Israel: a case–control study. J Am Acad Dermatol. 2007;56(4):629–34.

    Article  PubMed  Google Scholar 

  31. Armstrong AW, Harskamp CT, Armstrong EJ. Psoriasis and the risk of diabetes mellitus: a systematic review and meta-analysis. JAMA Dermatol. 2013;149(1):84–91.

    Article  PubMed  Google Scholar 

  32. Mallbris L, Ritchlin CT, Stahle M. Metabolic disorders in patients with psoriasis and psoriatic arthritis. Curr Rheumatol Rep. 2006;8(5):355–63.

    Article  CAS  PubMed  Google Scholar 

  33. Pietrzak A, Jastrzebska I, Krasowska D, et al. Serum pancreatic lipase activity, serumlipid profile and peripheral blood dendritic cell populations in normolipidemic males with psoriasis. J Mol Catal. 2006;40(3–4):144–54.

    Article  CAS  Google Scholar 

  34. Akkara Veetil BM, Matteson EL, Maradit-Kremers H, McEvoy MT, Crowson CS. Trends in lipid profiles in patients with psoriasis: a population-based analysis. BMC Dermatol. 2012;12:20.

    Article  PubMed Central  PubMed  Google Scholar 

  35. Mallbris L, Akre O, Granath F, Yin L, Lindelof B, Ekbom A, et al. Increased risk for cardiovascular mortality in psoriasis inpatients but not in outpatients. Eur J Epidemiol. 2004;19(3):225–30.

    Article  PubMed  Google Scholar 

  36. Reich K. The concept of psoriasis as a systemic inflammation: implications for disease management. J Eur Acad Dermatol Venereol. 2012;26(Suppl 2):3–11.

    Article  PubMed  Google Scholar 

  37. Ludwig RJ, Herzog C, Rostock A, Ochsendorf FR, Zollner TM, Thaci D, et al. Psoriasis: a possible risk factor for development of coronary artery calcification. Br J Dermatol. 2007;156(2):271–6.

    Article  CAS  PubMed  Google Scholar 

  38. Prodanovich S, Kirsner RS, Kravetz JD, Ma F, Martinez L, Federman DG. Association of psoriasis with coronary artery, cerebrovascular, and peripheral vascular diseases and mortality. Arch Dermatol. 2009;145(6):700–3.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank Annalisa Arcese and Raffaella Ceschini for their contribution to the study; and Ray Hill, an independent medical writer, who provided copy editing and journal styling prior to submission on behalf of Springer Healthcare. Sheridan Henness, PhD, of Springer Healthcare Communications, provided post-submission medical writing assistance. All medical writing assistance was funded by Pfizer Italy.

Nicola Aste received support for travel to meetings and honoraria for participation in review activities, such as data monitoring boards, from Pfizer. Aurora Parodi received grants, consulting fees, and payment for lectures from AbbVie, Galderma, Janssen-Cilag, Leo Pharma, Merck Sharp & Dohme, Novartis, Pfizer, and Shire; support for travel to meetings from AbbVie, Galderma, Janssen-Cilag, Leo Pharma, Merck Sharp & Dohme, Novartis, and Pfizer; and honoraria for participation in review activities, such as data monitoring boards, from AbbVie, Janssen-Cilag, Leo Pharma, Merck Sharp & Dohme, Novartis, and Pfizer. Concetta Potenza received grants from AbbVie and Janssen-Cilag and payment for lectures from AbbVie. All other authors declare that they have no competing interests.

Author information

Authors and Affiliations

  1. Dermatological Clinic, ‘Sapienza’ University of Rome, Rome, Italy

    Franca Cantoresi, Antonio Richetta & Stefano Calvieri

  2. Dermatology Department, University of Cagliari, Cagliari, Italy

    Nicola Aste

  3. Cardiology, Department of Clinical and Molecular Medicine, School of Medicine and Psychology, ‘Sapienza’ University of Rome, AO Sant’Andrea, Rome, Italy

    Camilla Calvieri

  4. NESMOS Department, ‘Sapienza’ University of Rome, AO Sant’Andrea, Rome, Italy

    Marta Carlesimo

  5. Section of Dermatology, Department of Medical and Surgical Critical Care, University of Florence, Florence, Italy

    Paolo Fabbri

  6. Dermatology Unit, A. Murri Hospital, Jesi, Italy

    Giorgio Filosa

  7. Dermatological Unit, Sacro Cuore di Gesù Fatebenefratelli Hospital, Benevento, Italy

    Antonia Galluccio

  8. Dermatological Clinic, University of Perugia, Perugia, Italy

    Paolo Lisi

  9. Dermatological Clinic, University of Catania, Catania, Italy

    Giuseppe Micali

  10. Section of Dermatology, Dipartimento di Scienze della Salute (DISSAL), University of Genoa and S. Martino University Hospital, Genoa, Italy

    Aurora Parodi

  11. Dermatological Unit, Polo Pontino, ‘Sapienza’ University of Rome, Rome, Italy

    Concetta Potenza

  12. Dermatological Unit, Macerata Hospital, Macerata, Italy

    Marco Simonacci

  13. Dermatological Clinic, University of Trieste, Trieste, Italy

    Piergiusto Trevisan

  14. U.O. Dermatology of Catanzaro, Catanzaro, Italy

    Giancarlo Valenti

  15. U.O. di Dermatologia, Az. Policlinico Umberto I, viale del Policlinico 155, 00161, Rome, Italy

    Stefano Calvieri

Authors
  1. Aurora Parodi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nicola Aste
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Camilla Calvieri
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Franca Cantoresi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marta Carlesimo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Paolo Fabbri
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Giorgio Filosa
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Antonia Galluccio
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Paolo Lisi
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Giuseppe Micali
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Concetta Potenza
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Antonio Richetta
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Marco Simonacci
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Piergiusto Trevisan
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Giancarlo Valenti
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Stefano Calvieri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stefano Calvieri.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Parodi, A., Aste, N., Calvieri, C. et al. Metabolic Syndrome Prevalence in Psoriasis. Am J Clin Dermatol 15, 371–377 (2014). https://doi.org/10.1007/s40257-014-0074-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40257-014-0074-8

Keywords

Search

Navigation