Curcó Neus, Barriendos Nuria, Barahona Maria José, Arteaga Carmen, García Mercedes, Yordanov Stanislav, De La Barrera Olimpia, Prat Carolina, Vives Pere, Giménez Nuria
Department of Dermatology, Hospital Universitari Mútua Terrassa, Barcelona, Spain.
Department of Endocrinology, Hospital Universitari Mútua Terrassa, Barcelona, Spain.
Australas J Dermatol. 2018 May;59(2):e93-e98. doi: 10.1111/ajd.12577. Epub 2017 Feb 27.
Psoriasis has been associated with metabolic syndrome and with an increased cardiovascular risk especially in patients with severe disease. The goal of this study was to estimate the prevalence of metabolic syndrome and other cardiovascular risk factors and its association with the psoriasis severity, sex and age.
Consecutive patients with psoriasis were enrolled in a prospective study over a 1-year period. Blood samples were collected. Psoriasis area and severity index (PASI) and body surface area scores and two dermatology quality of life (DQOL) questionnaires were used to evaluate psoriasis severity and the impact of the disease.
Altogether 178 patients were included, of whom 44% had moderate-severe psoriasis. The overall prevalence of metabolic syndrome was 30% (men 34%, women 26%) without significant differences between patients with severe and mild disease. Age and menopause appeared to increase the risk for metabolic syndrome. Patients with severe psoriasis smoked more heavily, were more likely to have diabetes or insulin resistance and had higher homocysteine and lower high density lipoprotein cholesterol (HDL-C) levels than patients with mild psoriasis (P < 0.05). In women, a higher waist circumference was observed. Women had higher HDL-C levels and lower smoking and alcohol consumption rates. In accordance with the systematic coronary risk evaluation system, 18% of the patients had a high 10-year risk of fatal cardiovascular disease.
Psoriasis severity was associated with diabetes, insulin-resistance, smoking habit and higher cardiovascular risk. Metabolic syndrome was related to age and menopause but not to psoriasis severity.
银屑病与代谢综合征相关，且心血管疾病风险增加，尤其是在重症患者中。本研究的目的是评估代谢综合征及其他心血管危险因素的患病率及其与银屑病严重程度、性别和年龄的关系。
连续纳入银屑病患者进行为期1年的前瞻性研究。采集血样。采用银屑病面积和严重程度指数（PASI）、体表面积评分以及两份皮肤病生活质量（DQOL）问卷来评估银屑病严重程度及疾病影响。
共纳入178例患者，其中44%患有中度至重度银屑病。代谢综合征的总体患病率为30%（男性34%，女性26%），重度和轻度疾病患者之间无显著差异。年龄和绝经似乎会增加代谢综合征的风险。重度银屑病患者比轻度银屑病患者吸烟更严重，更易患糖尿病或胰岛素抵抗，且同型半胱氨酸水平更高，高密度脂蛋白胆固醇（HDL-C）水平更低（P < 0.05）。在女性中，观察到腰围更大。女性的HDL-C水平更高，吸烟和饮酒率更低。根据系统性冠状动脉风险评估系统，18%的患者有10年致命心血管疾病的高风险。
银屑病严重程度与糖尿病、胰岛素抵抗、吸烟习惯及更高的心血管风险相关。代谢综合征与年龄和绝经有关，但与银屑病严重程度无关。
