Itani Salam, Arabi Asma, Harb Dana, Hamzeh Diana, Kibbi Abdul-Ghani
Department of Dermatology, American University of Beirut, Beirut, Lebanon.
Division of Endocrinology, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
Int J Dermatol. 2016 Apr;55(4):390-5. doi: 10.1111/ijd.12811. Epub 2016 Jan 8.
Psoriasis is a chronic inflammatory disease that affects not only the skin but also other organs as well. Genetic factors play an important role in individual predisposition. Lately, a positive association has been confirmed between psoriasis and metabolic syndrome (MBS), in western as well as in Middle Eastern countries.
Assess the prevalence of MBS in Lebanese patients with psoriasis and the differential effect according to types and disease severity.
This was a case-control study including 150 psoriasis patients and 150 age- and gender-matched controls admitted to the dermatology clinics at the American University of Beirut-Medical Center, a tertiary care center in Beirut. Psoriasis severity was assessed by the Psoriasis Area Severity Index (PASI). Blood samples were collected from fasting subjects and tested for glucose, HDL cholesterol, triglycerides, and C-reactive protein (CRP). Multivariate binary logistic regression models were built to assess the relationship between MBS and psoriasis, after adjustment for smoking as a possible confounding variable.
Patients with psoriasis were two times more likely to have MBS as compared to controls (35.3% vs 18.0%, P < 0.001) with an odds ratio (OR) of 2.4. All components of MBS were more prevalent in psoriasis patients than in controls. PASI score was greater in patients with MBS than those without MBS (10.5 ± 11.5 vs. 7.0 ± 8.1, P = 0.05). MBS prevalence tended to be higher in the inverse type than in others (52.2% versus 32.3%; P = 0.06) and in patients with nail pitting versus those without (45.3% vs. 28.2%; P = 0.03).
This was the first study to assess the prevalence of MBS in Lebanese subjects with psoriasis and, to our knowledge, the first study that showed a higher likelihood of MBS in patients with inverse psoriasis and with nail pitting.
银屑病是一种慢性炎症性疾病，不仅影响皮肤，还会累及其他器官。遗传因素在个体易感性中起重要作用。最近，在西方国家以及中东国家，银屑病与代谢综合征（MBS）之间的正相关关系已得到证实。
评估黎巴嫩银屑病患者中MBS的患病率以及根据类型和疾病严重程度的差异影响。
这是一项病例对照研究，纳入了150例银屑病患者和150例年龄及性别匹配的对照，这些患者均在贝鲁特美国大学医学中心（位于贝鲁特的三级医疗中心）的皮肤科门诊就诊。通过银屑病面积和严重程度指数（PASI）评估银屑病严重程度。采集空腹受试者的血样，检测血糖、高密度脂蛋白胆固醇、甘油三酯和C反应蛋白（CRP）。在将吸烟作为可能的混杂变量进行调整后，建立多变量二元逻辑回归模型以评估MBS与银屑病之间的关系。
与对照组相比，银屑病患者患MBS的可能性高出两倍（35.3%对18.0%，P<0.001），优势比（OR）为2.4。MBS的所有组成部分在银屑病患者中比在对照组中更为普遍。患有MBS的患者的PASI评分高于未患MBS的患者（10.5±11.5对7.0±8.1，P = 0.05）。反向型银屑病患者的MBS患病率往往高于其他类型（52.2%对32.3%；P = 0.06），有甲凹点的患者高于无甲凹点的患者（45.3%对28.2%；P = 0.03）。
这是第一项评估黎巴嫩银屑病患者中MBS患病率的研究，据我们所知，也是第一项显示反向型银屑病和有甲凹点的患者患MBS可能性更高的研究。
