Gelfand Joel M, Yeung Howa
Department of Dermatology and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
J Rheumatol Suppl. 2012 Jul;89:24-8. doi: 10.3899/jrheum.120237.
Psoriasis is a common Th-1 and Th-17-mediated chronic inflammatory disease that has been associated with metabolic syndrome, a constellation of cardiovascular risk factors including obesity, hypertension, dyslipidemia, and insulin resistance. Overlapping inflammatory pathways and genetic susceptibility may be potential biologic links underlying this association. Multiple epidemiologic studies have consistently demonstrated higher prevalence of metabolic syndrome in patients with psoriasis. Dose-response relationships between more severe psoriasis and higher prevalence of metabolic syndrome components were recently established. This association has important clinical implications for the comprehensive management of psoriasis: Patients with psoriasis should be routinely screened for metabolic syndrome and treated accordingly to manage cardiometabolic risk, while clinicians should monitor potential effects on treatment efficacy and safety in patients with comorbid psoriasis and metabolic syndrome. Further research will be necessary to establish the directionality of this association and to explore the effect of treatment on these comorbid diseases.
银屑病是一种常见的由Th-1和Th-17介导的慢性炎症性疾病,它与代谢综合征相关,代谢综合征是一组心血管危险因素,包括肥胖、高血压、血脂异常和胰岛素抵抗。重叠的炎症途径和遗传易感性可能是这种关联潜在的生物学联系。多项流行病学研究一致表明,银屑病患者中代谢综合征的患病率更高。最近还确立了更严重的银屑病与代谢综合征各组分更高患病率之间的剂量反应关系。这种关联对银屑病的综合管理具有重要的临床意义:银屑病患者应常规筛查代谢综合征并相应治疗以控制心脏代谢风险,而临床医生应监测合并银屑病和代谢综合征患者治疗疗效和安全性的潜在影响。有必要进行进一步研究以确定这种关联的方向性,并探索治疗对这些合并疾病的影响。
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