Rheumatology Department, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom.
Warwick Medical School, University of Warwick, Coventry, United Kingdom.
PLoS One. 2020 Aug 13;15(8):e0237598. doi: 10.1371/journal.pone.0237598. eCollection 2020.
Obesity is a leading comorbidity in psoriatic disease, including both psoriasis (PsO) and psoriatic arthritis (PsA), and is associated with adverse metabolic and cardiovascular (CV) outcomes. Anthropometric parameters, such as weight, body mass index (BMI) and waist-to-hip ratio, have been extensively reported in psoriatic disease. However, the associations of body composition and fat distribution with psoriasis have not yet been fully defined.
To identify whether patients with psoriatic disease, including psoriatic arthritis, have altered body composition compared with the general population, and to review existing modalities for the assessment of body composition.
Electronic searches of the literature were conducted in PubMed, Medline (Ovid®), Embase (Ovid®), Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar. Titles and abstracts were reviewed by two authors independently against a set of prespecified inclusion/exclusion criteria. The research question was answered with a systematic literature review and results were summarized narratively.
Twenty-five full text articles met the inclusion criteria and were included in the final narrative analysis. The studies were of heterogeneous design and used a range of objective measures to assess body composition, including simple anthropometric measures, bioimpedance analysis (BIA), dual energy X-ray absorptiometry (DXA) and computed tomography (CT). Few studies met all the quality assessment criteria. Clinical heterogeneity prevented meta-analysis.
Patients with psoriatic disease reveal defined body composition changes that are independent of obesity and the customary metabolic syndrome, including higher overall body fat, visceral fat and sarcopenia. These findings emphasize that patients with psoriatic disease should be screened for abnormal adipose effects beyond their weight and body mass index (BMI). Our findings show that the last decade has seen an exciting expansion of research interest in the development and validation of new modalities for the assessment of body composition. There is no consensus on the optimal assessment method of body composition for this diverse group; hence there is a need for validation of existing modalities and standardization of assessment tools.
肥胖是银屑病（PsO）和银屑病关节炎（PsA）等银屑病的主要合并症，与不良代谢和心血管（CV）结局相关。人体测量参数，如体重、体重指数（BMI）和腰臀比，在银屑病中已有广泛报道。然而，身体成分和脂肪分布与银屑病的关系尚未完全明确。
确定患有银屑病（包括银屑病关节炎）的患者与普通人群相比，其身体成分是否发生改变，并回顾现有的身体成分评估方法。
对PubMed、Medline（Ovid®）、Embase（Ovid®）、Cochrane 对照试验中心注册库（CENTRAL）和 Google Scholar 进行了文献电子检索。两名作者独立地根据一套预先设定的纳入/排除标准对标题和摘要进行了审查。该研究问题通过系统文献综述进行了回答，并以叙述性方式进行了总结。
25 篇全文文章符合纳入标准，并纳入最终的叙述性分析。这些研究设计各异，使用了多种客观指标来评估身体成分，包括简单的人体测量指标、生物阻抗分析（BIA）、双能 X 射线吸收法（DXA）和计算机断层扫描（CT）。很少有研究符合所有质量评估标准。临床异质性阻碍了荟萃分析的进行。
患有银屑病的患者表现出明确的身体成分变化，这些变化独立于肥胖和常见的代谢综合征，包括更高的总体体脂、内脏脂肪和肌肉减少症。这些发现强调，患有银屑病的患者除了体重和体重指数（BMI）外，还应筛查异常脂肪影响。我们的研究结果表明，过去十年，人们对评估身体成分的新方法的开发和验证产生了浓厚的研究兴趣。对于这个多样化的群体，还没有关于身体成分最佳评估方法的共识；因此，需要对现有的评估方法进行验证，并对评估工具进行标准化。
