A Comparison of Clinical Characteristics in Overweight/Obese and Normal Weight Patients with Psoriasis Vulgaris: A Bicentric Retrospective Observational Study

Background Psoriasis is a chronic, inflammatory skin disease that is often accompanied by multiple comorbidities. Obesity is considered an independent risk factor for the development of psoriasis. However, most of the related data are derived from epidemiological studies conducted in the United States of America and Europe. This study aimed to compare the clinical characteristics of patients with psoriasis who are overweight/obese and patients with psoriasis with normal weight in China. Methods We reviewed the medical records of 208 patients with psoriasis. Based on their body mass index (BMI), the patients were divided into two groups: patients with psoriasis who were overweight/obese and patients with psoriasis with normal weight. Results The most patients enrolled in this study were men (77.40%). Patients with psoriasis who were overweight/obese had a higher mean age, longer disease duration, and significantly higher Psoriasis Area and Severity Index (PASI) values (P=0.032). Additionally, the incidence of fatty liver, hyperlipidemia, hyperuricemia, and abnormal liver function was higher among patients with psoriasis who were overweight/obese (P<0.05). Linear regression analysis revealed a linear relationship between PASI values and BMI (P=0.016). Moreover, patients with psoriasis who were overweight/obese had significantly higher levels of serum alanine transaminase (ALT), aspartate transaminase (AST), uric acid (UC), total cholesterol (TC), low-density lipoprotein (LDL), and fasting plasma glucose (FPG) (P<0.05) and lower serum high-density lipoprotein (HDL) levels and absolute lymphocyte count (ALC) (P<0.05). Conclusion Patients with psoriasis who are overweight/obese have more severe psoriatic lesions and metabolic comorbidities. Detailed assessment of the BMI of patients with psoriasis revealed that weight loss may be necessary for patients who are overweight/obese to reduce the risk of metabolic disorders.

[1]  Xue Gao,et al.  Association between nutrient patterns and hyperuricemia: mediation analysis involving obesity indicators in the NHANES , 2022, BMC Public Health.

[2]  Jan Krakowiak,et al.  Metabolic Syndrome, BMI, and Polymorphism of Estrogen Receptor-α in Peri- and Post-Menopausal Polish Women , 2022, Metabolites.

[3]  C. Peng,et al.  Serum lipids and risk of incident psoriasis: a prospective cohort study from the UK Biobank study and Mendelian randomization analysis. , 2022, The Journal of investigative dermatology.

[4]  Valmore Bermúdez,et al.  Exploring the Links between Obesity and Psoriasis: A Comprehensive Review , 2022, International journal of molecular sciences.

[5]  Jianzhong Zhang,et al.  Effects of secukinumab and adalimumab on serum uric acid level in patients with plaque psoriasis , 2022, Chinese medical journal.

[6]  P. Gisondi,et al.  Risk of non-alcoholic fatty liver disease in patients with chronic plaque psoriasis: an updated systematic review and meta-analysis of observational studies , 2022, Journal of Endocrinological Investigation.

[7]  C. Ramírez,et al.  Posttranscriptional Regulation of Insulin Resistance: Implications for Metabolic Diseases , 2022, Biomolecules.

[8]  L. Messer,et al.  Psoriatic arthritis with hyperuricemia: more peripheral, destructive, and challenging to treat , 2022, Clinical Rheumatology.

[9]  A. Garg,et al.  Risk of psoriasis according to body mass index: a retrospective cohort analysis. , 2021, Journal of the American Academy of Dermatology.

[10]  Yu-Huei Huang,et al.  Impact of previous biologic use and body weight on the effectiveness of guselkumab in moderate-to-severe plaque psoriasis: a real-world practice , 2021, Therapeutic advances in chronic disease.

[11]  W. Liu,et al.  Adipose-derived mesenchymal stem cells from obese mice prevent body weight gain and hyperglycemia , 2020, Stem Cell Research & Therapy.

[12]  M. Dalamaga,et al.  Deciphering the Association Between Psoriasis and Obesity: Current Evidence and Treatment Considerations , 2020, Current Obesity Reports.

[13]  H. Miot,et al.  Dietary patterns of patients with psoriasis at a public healthcare institution in Brazil , 2020, Anais brasileiros de dermatologia.

[14]  G. Castaldo,et al.  Aggressive weight-loss program with a ketogenic induction phase for the treatment of chronic plaque psoriasis: A proof-of-concept, single-arm, open-label clinical trial. , 2020, Nutrition.

[15]  H. Vidal,et al.  IL-17A contributes to propagation of inflammation but does not impair adipogenesis and/or insulin response, in adipose tissue of obese individuals. , 2020, Cytokine.

[16]  J. Barker,et al.  Does weight loss reduce the severity and incidence of psoriasis or psoriatic arthritis? A Critically Appraised Topic , 2019, The British journal of dermatology.

[17]  M. Dalamaga,et al.  Adherence to the Mediterranean diet is independently associated with psoriasis risk, severity, and quality of life: a cross‐sectional observational study , 2019, International journal of dermatology.

[18]  Tae Yoon Kim,et al.  Increased risk of psoriasis in subjects with abdominal obesity: A nationwide population‐based study , 2019, The Journal of dermatology.

[19]  J. Shan,et al.  Impact of obesity on the efficacy of different biologic agents in inflammatory diseases: A systematic review and meta-analysis. , 2019, Joint, bone, spine : revue du rhumatisme.

[20]  D. Mozaffarian,et al.  The obesity transition: stages of the global epidemic. , 2019, The lancet. Diabetes & endocrinology.

[21]  Samuel E. Jones,et al.  Evidence of a causal relationship between body mass index and psoriasis: A mendelian randomization study , 2019, PLoS medicine.

[22]  M. Lebwohl,et al.  Psoriasis: Which therapy for which patient: Psoriasis comorbidities and preferred systemic agents. , 2019, Journal of the American Academy of Dermatology.

[23]  S. Langan,et al.  Obesity, Waist Circumference, Weight Change, and Risk of Incident Psoriasis: Prospective Data from the HUNT Study. , 2017, The Journal of investigative dermatology.

[24]  M. Lynch,et al.  Adipokines, psoriasis, systemic inflammation, and endothelial dysfunction , 2017, International journal of dermatology.

[25]  F. Ginhoux,et al.  High fat diet exacerbates murine psoriatic dermatitis by increasing the number of IL-17-producing γδ T cells , 2017, Scientific Reports.

[26]  Katrina Taylor,et al.  High-intensity interval and moderate-intensity continuous training elicit similar enjoyment and adherence levels in overweight and obese adults , 2017, European journal of sport science.

[27]  H. Vidal,et al.  Pathogenic Role of IL-17-Producing Immune Cells in Obesity, and Related Inflammatory Diseases , 2017, Journal of clinical medicine.

[28]  L. Skov,et al.  Psoriasis and Obesity , 2017, Dermatology.

[29]  S. Doǧru-Abbasoǧlu,et al.  Serum Visfatin, Fetuin‐A, and Pentraxin 3 Levels in Patients With Psoriasis and Their Relation to Disease Severity , 2016, Journal of clinical laboratory analysis.

[30]  P. Scherer,et al.  Adiponectin, the past two decades. , 2016, Journal of molecular cell biology.

[31]  L. Pirola,et al.  Adipocytes, like their progenitors, contribute to inflammation of adipose tissues through promotion of Th-17 cells and activation of monocytes, in obese subjects , 2016, Adipocyte.

[32]  Mei-Ling Yeh,et al.  Lifestyle changes for treating psoriasis. , 2015, The Cochrane database of systematic reviews.

[33]  S. Beygi,et al.  Patients with psoriasis are at a higher risk of developing nonalcoholic fatty liver disease , 2015, Clinical and experimental dermatology.

[34]  R. Tokuyama,et al.  Leptin Promotes Wound Healing in the Skin , 2015, PloS one.

[35]  Paul Aveyard,et al.  Diet or Exercise Interventions vs Combined Behavioral Weight Management Programs: A Systematic Review and Meta-Analysis of Direct Comparisons , 2014, Journal of the Academy of Nutrition and Dietetics.

[36]  Y. Shoenfeld,et al.  Obesity in autoimmune diseases: not a passive bystander. , 2014, Autoimmunity reviews.

[37]  Ming Li,et al.  Leptin levels in patients with psoriasis: a meta‐analysis , 2013, Clinical and experimental dermatology.

[38]  Min Zhang,et al.  Leptin induces secretion of pro‐inflammatory cytokines by human keratinocytes in vitro – a possible reason for increased severity of psoriasis in patients with a high body mass index , 2013, Experimental dermatology.

[39]  A. Armstrong,et al.  The association between psoriasis and dyslipidaemia: a systematic review , 2013, The British journal of dermatology.

[40]  A. Armstrong,et al.  The association between psoriasis and obesity: a systematic review and meta-analysis of observational studies , 2012, Nutrition & Diabetes.

[41]  Xuefeng Yu,et al.  Th17 cells in type 1 diabetes. , 2012, Cellular immunology.

[42]  S. Watanabe,et al.  Visfatin enhances CXCL8, CXCL10, and CCL20 production in human keratinocytes. , 2011, Endocrinology.

[43]  W. Gulliver,et al.  Psoriasis Comorbidities , 2009, Journal of cutaneous medicine and surgery.

[44]  A. Gottlieb,et al.  Guidelines of care for the management of psoriasis and psoriatic arthritis: section 4. Guidelines of care for the management and treatment of psoriasis with traditional systemic agents. , 2009, Journal of the American Academy of Dermatology.

[45]  M. Komine,et al.  Serum high molecular weight adiponectin levels are decreased in psoriasis patients. , 2009, Journal of dermatological science.

[46]  Bryan K. Smith,et al.  American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. , 2009, Medicine and science in sports and exercise.

[47]  Hyon K. Choi,et al.  Obesity, waist circumference, weight change, and the risk of psoriasis in women: Nurses' Health Study II. , 2007, Archives of internal medicine.

[48]  J S Yudkin,et al.  Journal of Clinical Endocrinology and Metabolism Printed in U.S.A. Copyright © 1997 by The Endocrine Society Subcutaneous Adipose Tissue Releases Interleukin-6, But Not Tumor Necrosis Factor-�, in Vivo* , 2022 .

[49]  F. Lu,et al.  The guidelines for prevention and control of overweight and obesity in Chinese adults. , 2004, Biomedical and environmental sciences : BES.

[50]  A. G. Shaper,et al.  Obesity and cardiovascular disease. , 1996, Ciba Foundation symposium.