Azfar Rahat S, Gelfand Joel M
Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Curr Opin Rheumatol. 2008 Jul;20(4):416-22. doi: 10.1097/BOR.0b013e3283031c99.
The scientific literature linking psoriasis to metabolic syndrome, and its components, as well as atherosclerosis and myocardial infarction has rapidly expanded. Increasingly, epidemiological studies are establishing the directionality of these associations and psoriasis' role as an independent risk factor in developing these outcomes.
Psoriasis is associated with metabolic syndrome, and its components, such as obesity, diabetes, and hypertension. Obesity has been shown to be an independent risk factor for the development of psoriasis, and is also associated with more severe psoriasis. Psoriasis is associated with diabetes, coronary artery disease, and an increased risk for myocardial infarction independent of traditional risk factors for these disorders. These phenotypically diverse conditions share similar pathologic changes such as chronic inflammation, angiogenesis, oxidative stress, and selected susceptibility genes and loci.
The broad literature linking psoriasis to metabolic disorders has led to changes in standard of care recommendations for patients with psoriasis. In particular, practitioners are encouraged to screen psoriasis patients, especially when disease is severe, for metabolic disorders and cardiovascular risk factors and institute appropriate prevention strategies. Additional studies investigating the role of psoriasis activity and severity as an independent risk factor for developing metabolic disorders, atherosclerosis, and myocardial infarction and the role of psoriasis treatment in altering the risk of developing these serious morbidities are urgently needed.
将银屑病与代谢综合征及其组成部分，以及动脉粥样硬化和心肌梗死联系起来的科学文献迅速增加。越来越多的流行病学研究正在确定这些关联的方向性以及银屑病在导致这些结果中作为独立危险因素的作用。
银屑病与代谢综合征及其组成部分相关，如肥胖、糖尿病和高血压。肥胖已被证明是银屑病发病的独立危险因素，并且还与更严重的银屑病相关。银屑病与糖尿病、冠状动脉疾病以及独立于这些疾病传统危险因素的心肌梗死风险增加相关。这些表型多样的病症具有相似的病理变化，如慢性炎症、血管生成、氧化应激以及特定的易感基因和基因座。
将银屑病与代谢紊乱联系起来的广泛文献已导致银屑病患者护理标准建议的改变。特别是，鼓励从业者对银屑病患者进行筛查，尤其是在疾病严重时，筛查代谢紊乱和心血管危险因素，并制定适当的预防策略。迫切需要进一步研究银屑病活动和严重程度作为发生代谢紊乱、动脉粥样硬化和心肌梗死的独立危险因素的作用，以及银屑病治疗在改变发生这些严重疾病风险方面的作用。
