Skip to main content

Advertisement

SpringerLink
Log in

Increased prevalence of the metabolic syndrome in patients with moderate to severe psoriasis

  • Original Paper
  • Published:
Archives of Dermatological Research Aims and scope Submit manuscript

Abstract

The role of chronic inflammation causing metabolic and vascular disorders is increasingly recognized. It is hypothesized that proinflammatory cytokines contribute to atherogenesis, peripheral insulin resistance, and the development of hypertension and type II diabetes. Psoriasis as a chronic inflammatory skin disorder is characterized by a variety of immunologic and inflammatory changes and may similarly predispose for those disorders. The objective of this study was to elucidate the association of psoriasis with chronic vascular and metabolic disorders. We investigated a total of 581 adult patients hospitalised for plaque type psoriasis as compared to 1,044 hospital-based controls. A distinct pattern of chronic disorders was found to be significantly associated with psoriasis, including diabetes mellitus type II [odds ratio (OR)=2.48], arterial hypertension (OR = 3.27), hyperlipedemia (OR = 2.09), and coronary heart disease (OR = 1.95). The combined presence of these conditions together with obesity, known as the metabolic syndrome, was clearly more prevalent in psoriasis patients (OR = 5.29). In addition, psoriasis patients were significantly more likely to be smokers (OR = 2.96) and to have a regular or heavy consumption of alcohol (OR = 3.33 and 3.61, respectively). In conclusion, psoriasis patients appear to be at higher risk for diabetes mellitus and cardiovascular disease. This could likely be due to the effects of chronic inflammatory changes, in particular the secretion of proinflammatory cytokines. The risk of late term cardiovascular complications might support the use of systemic treatment in 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

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Alberti KG, Zimmet PZ (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Part: 1 diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 15(7):539–553

    Article  PubMed  CAS  Google Scholar 

  2. Bloomgarden ZT (2004) Definitions of the insulin resistance syndrome: the 1st World Congress on the insulin resistance syndrome. Diabetes Care 27(3):824–830

    PubMed  Google Scholar 

  3. Choi HK, Hernan MA, Seeger JD, Robins JM, Wolfe F (2002) Methotrexate and mortality in patients with rheumatoid arthritis: a prospective study. Lancet 359(9313):1173–1177

    Article  PubMed  CAS  Google Scholar 

  4. Dessein PH, Joffe BI, Stanwix AE (2003) Inflammation, insulin resistance, and aberrant lipid metabolism as cardiovascular risk factors in rheumatoid arthritis. J Rheumatol 30(7):1403–1405

    PubMed  Google Scholar 

  5. Fernandez-Real JM, Ricart W (2003) Insulin resistance and chronic cardiovascular inflammatory syndrome. Endocr Rev 24(3):278–301

    Article  PubMed  CAS  Google Scholar 

  6. Gladman DD, Farewell VT, Rahman P, Schentag CT, Pellett F, Ng CM, Wade JA (2001) HLA-DRB1*04 alleles in psoriatic arthritis: comparison with rheumatoid arthritis and healthy controls. Hum Immunol 62(11):1239–1244

    Article  PubMed  CAS  Google Scholar 

  7. Grundy SM, Brewer HB Jr, Cleeman JI, Smith SC Jr, Lenfant C (2004) Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 109(3):433–438

    Article  PubMed  Google Scholar 

  8. Gudjonsson JE, Karason A, Antonsdottir AA, Runarsdottir EH, Gulcher JR, Stefansson K, Valdimarsson H (2002) HLA-Cw6-positive and HLA-Cw6-negative patients with psoriasis vulgaris have distinct clinical features. J Invest Dermatol 118(2):362–365

    Article  PubMed  Google Scholar 

  9. Henseler T, Christophers E (1995) Disease concomitance in psoriasis. J Am Acad Dermatol 32:982–986

    Article  PubMed  CAS  Google Scholar 

  10. Kendall DM, Sobel BE, Coulston AM, Peters Harmel AL, McLean BK, Peragallo-Dittko V, Buse JB, Fonseca VA, Hill JO, Nesto RW, Sunyer FX (2003) The insulin resistance syndrome and coronary artery disease. Coron Artery Dis 14(4):335–348

    Article  PubMed  Google Scholar 

  11. Kiortsis DN, Mavridis AK, Vasakos S, Nikas SN, Drosos AA (2005) Effects of infliximab treatment on insulin resistance in patients with rheumatoid arthritis and ankylosing spondylitis. Ann Rheum Dis 64(5):765–766

    Article  PubMed  CAS  Google Scholar 

  12. Lindegard B (1986) Diseases associated with psoriasis in a general population of 159,200 middle-aged, urban, native Swedes. Dermatologica 172:298–304

    Article  PubMed  CAS  Google Scholar 

  13. Mallbris L, Akre O, Granath F, Yin L, Lindelof B, Ekbom A, Stahle-Backdahl M (2004) Increased risk for cardiovascular mortality in psoriasis inpatients but not in outpatients. Eur J Epidemiol 19(3):225–230

    Article  PubMed  Google Scholar 

  14. Mallbris L, Granath F, Hamsten A, Stahle M (2006) Psoriasis is associated with lipid abnormalities at the onset of skin disease. J Am Acad Dermatol 54(4):614–621

    Article  PubMed  Google Scholar 

  15. McDonald CJ (1989) Cardiovascular disease in psoriasis. J Invest Dermatol 92:646–647

    Article  PubMed  CAS  Google Scholar 

  16. McDonald CJ, Calabresi P (1978) Psoriasis and occlusive vascular disease. Br J Dermatol 99(5):469–475

    Article  PubMed  CAS  Google Scholar 

  17. Moll JM, Wright V (1973) Psoriatic arthritis. Semin Arthritis Rheum 3(1):55–78

    Article  PubMed  CAS  Google Scholar 

  18. Montagnani A, Tosti A, Patrizi A, Salardi S, Cacciari E (1985) Diabetes mellitus and skin diseases in childhood. Dermatologica 170:65–68

    Article  PubMed  CAS  Google Scholar 

  19. Naldi L, Parazzini F, Brevi A, Peserico A, Veller Fornasa C, Grosso G, Rossi E, Marinaro P, Polenghi MM, Finzi A et al (1992) Family history, smoking habits, alcohol consumption and risk of psoriasis. Br J Dermatol 127:212–217

    Article  PubMed  CAS  Google Scholar 

  20. Offidani A, Cellini A, Valeri G, Giovagnoni A (1998) Subclinical joint involvement in psoriasis: magnetic resonance imaging and x-ray findings. Acta Derm Venereol 78:463–465

    Article  PubMed  CAS  Google Scholar 

  21. Poikolainen K, Reunala T, Karvonen J, Lauharanta J, Karkkainen P (1990) Alcohol intake: a risk factor for psoriasis in young and middle aged men? BMJ 300:780–783

    Article  PubMed  CAS  Google Scholar 

  22. Prodanowich S, Ma F, Taylor JR, Pezon C, Fasihi T, Kirsner RS (2005) Methotrexate reduces incidence of vascular diseases in veterans with psoriasis or rheumatoid arthritis. J Am Acad Dermatol 52(2):262–267

    Article  PubMed  Google Scholar 

  23. Rotter V, Nagaev I, Smith U (2003) Interleukin-6 (IL-6) induces insulin resistance in 3T3-L1 adipocytes and is, like IL-8 and tumor necrosis factor-alpha, overexpressed in human fat cells from insulin-resistant subjects. J Biol Chem 278(46):45777–45784

    Article  PubMed  CAS  Google Scholar 

  24. Sattar N, McCarey DW, Capell H, McInnes IB (2003) Explaining how “high-grade” systemic inflammation accelerates vascular risk in rheumatoid arthritis. Circulation 108(24):2957–2963

    Article  PubMed  Google Scholar 

  25. Stern RS, Lange R (1988) Cardiovascular disease, cancer, and cause of death in patients with psoriasis: 10 years prospective experience in a cohort of 1,380 patients. J Invest Dermatol 91:197–201

    Article  PubMed  CAS  Google Scholar 

  26. Vasku V, Kankova K, Vasku A, Muzik J, Izakovicova Holla L, Semradova V, Vacha J (2002) Gene polymorphisms (G82S, 1704G/T, 2184A/G and 2245G/A) of the receptor of advanced glycation end products (RAGE) in plaque psoriasis. Arch Dermatol Res 294(3):127–130

    Article  PubMed  CAS  Google Scholar 

  27. Winchester R (1993) Psoriatic arthritis. In: Fitzpatrick TB, Eisen AZ, Wolff K, Freedberg IM, Austen KF (eds) Dermatology in general medicine, 4th edn. McGraw-Hill Book Company, New York, pp 515–527

    Google Scholar 

  28. Zachariae H (2003) Prevalence of joint disease in patients with psoriasis: implications for therapy. Am J Clin Dermatol 4(7):441–447

    Article  PubMed  Google Scholar 

  29. Zachariae H, Zachariae R, Blomqvist K, Davidsson S, Molin L, Mork C, Sigurgeirsson B (2002) Quality of life and prevalence of arthritis reported by 5,795 members of the Nordic Psoriasis Associations. Data from the Nordic Quality of Life Study. Acta Derm Venereol 82(2):108–113

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

This work was supported by a German National Genome Research Network Grant (BMFT 01 GS 0171).

Author information

Authors and Affiliations

  1. Department of Dermatology, University of Kiel, Schittenhelmstr. 7, 24105, Kiel, Germany

    Dorothea M. Sommer, Michael Suchan, Enno Christophers & Michael Weichenthal

  2. Department of Immunology, University of Kiel, Kiel, Germany

    Stefan Jenisch

Authors
  1. Dorothea M. Sommer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stefan Jenisch
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael Suchan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Enno Christophers
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael Weichenthal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael Weichenthal.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sommer, D.M., Jenisch, S., Suchan, M. et al. Increased prevalence of the metabolic syndrome in patients with moderate to severe psoriasis. Arch Dermatol Res 298, 321–328 (2007). https://doi.org/10.1007/s00403-006-0703-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00403-006-0703-z

Keywords

Search

Navigation