银屑病患者是否伴有代谢综合征伴发饮食障碍？一项初步研究的结果。
Do eating disorders accompany metabolic syndrome in psoriasis patients? Results of a preliminary study.
机构信息
Dermatology Department, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
出版信息
Clin Cosmet Investig Dermatol. 2011;4:139-43. doi: 10.2147/CCID.S24165. Epub 2011 Aug 29.
BACKGROUND
Metabolic syndrome (MBS) has been reported as a frequent comorbidity in psoriatic patients. The main pathogenesis is considered to be inflammation in this association. MBS has been investigated in eating disorders as well. While psoriasis has some psychiatric comorbidities, the link between psoriasis, MBS, and eating disorders (EDs) is unknown.
METHODS
The study was designed as a cross-sectional, randomized, and controlled trial. A total of 100 patients with psoriasis were included in the study. Sociodemographic data, clinical subtype of psoriasis, Psoriasis Area and Severity Index (PASI) scores, and associated diseases were registered for each patient. The criteria for diagnosis of MBS developed by the International Diabetes Foundation (IDF) was used. These are central obesity (waist circumference ≥94 cm in men or ≥80 cm in women), plus two of the following: elevated triglycerides (≥150 mg/dL), reduced high-desity lipoprotein cholesterol (>40 mg/dL for men; >50 mg/dL for women), elevated blood pressure (≥130 mmHg systolic or ≥85 mmHg diastolic), and elevated fasting blood glucose (≥100 mg/dL). Additionally, the Eating Attitude Test (EAT), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI), and psychiatric interview were performed for all patients.
RESULTS
There were 45 female and 55 male patients, aged between 18 and 85 years old (median 41.12 ± 16.01). MBS was present in 31% of the patients with psoriasis. There was no correlation between the severity of psoriasis and MBS. EAT scores were ≥30 in 7/100 patients. Four out of 31 patients with MBS (12.9%) had ED and 3/69 patients were without MBS (4.3%). Mean ED scores were compared statistically and the difference was significant (EAT = 17.9 ± 9.558 and 11.5 ± 7.204, P < 0.001).
CONCLUSION
Defining risk factors leading to comorbidities is important in psoriasis. EDs seem to have an impact on the development of MBS in psoriasis. Establishment and treatment of EDs in patients with psoriasis may prevent the onset of MBS and other comorbidities due to MBS.
背景
代谢综合征（MBS）已被报道为银屑病患者的常见合并症。其主要发病机制被认为是该关联中的炎症。代谢综合征也在饮食失调中进行了研究。虽然银屑病有一些精神共病，但银屑病、MBS 和饮食失调（EDs）之间的联系尚不清楚。
方法
该研究设计为横断面、随机和对照试验。共有 100 名银屑病患者纳入研究。为每位患者登记社会人口统计学数据、银屑病临床亚型、银屑病面积和严重程度指数（PASI）评分和相关疾病。使用国际糖尿病基金会（IDF）制定的 MBS 诊断标准。这些标准是中心性肥胖（男性腰围≥94cm，女性腰围≥80cm），加上以下两项中的两项：甘油三酯升高（≥150mg/dL）、高密度脂蛋白胆固醇降低（男性>40mg/dL；女性>50mg/dL）、血压升高（收缩压≥130mmHg 或舒张压≥85mmHg）和空腹血糖升高（≥100mg/dL）。此外，对所有患者进行了饮食态度测试（EAT）、贝克抑郁量表（BDI）、贝克焦虑量表（BAI）和精神科访谈。
结果
患者年龄 18-85 岁，中位数 41.12±16.01 岁，其中 45 例为女性，55 例为男性。银屑病患者中有 31%存在 MBS。银屑病的严重程度与 MBS 之间无相关性。100 例患者中有 7 例 EAT 评分≥30。31 例存在 MBS 的患者中有 4 例（12.9%）存在 ED，69 例无 MBS 的患者中有 3 例（4.3%）存在 ED。统计学比较 ED 评分，差异有统计学意义（EAT=17.9±9.558 和 11.5±7.204，P<0.001）。
结论
确定导致合并症的危险因素在银屑病中很重要。ED 似乎对银屑病中 MBS 的发展有影响。在银屑病患者中建立和治疗 ED 可能会预防 MBS 及其因 MBS 引起的其他合并症的发生。
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