The Department of Dermatology, Tufts Medical Center, Boston, MA, USA.
Am J Clin Dermatol. 2021 May;22(3):293-300. doi: 10.1007/s40257-021-00590-y. Epub 2021 Feb 15.
Psoriasis is a chronic inflammatory disease that affects 2-3% of the population worldwide. It is associated with plaques, psoriatic arthritis, and metabolic syndrome and its components, including obesity, diabetes, dyslipidemia, nonalcoholic fatty liver disease, and cardiovascular disease. In this review, we highlight the shared pathogenic pathways leading to the comorbid existence of both diseases and the impact of drugs used for psoriasis on metabolic syndrome and vice versa. Persistent inflammation is common to both diseases. They share increased inflammatory cytokines such as tumor necrosis factor (TNF)-α and interleukin-6. Biologics have revolutionized the treatment of plaque psoriasis and also have a positive impact on metabolic syndrome. There is some evidence that TNFα inhibitors decrease insulin resistance and improve glycemic indices. Some psoriasis treatments may result in decreased body weight. Lifestyle measures used in the management of metabolic syndrome, such as weight loss, exercise, and healthy diet, are beneficial in patients with psoriasis. Considering the association between metabolic syndrome and psoriasis, we recommend screening patients with psoriasis for metabolic syndrome with clinical examinations and laboratory tests. Patients with a co-diagnosis of these diseases deserve special attention for optimal treatment.
银屑病是一种慢性炎症性疾病，影响全球 2-3%的人口。它与斑块、银屑病关节炎和代谢综合征及其组成部分有关，包括肥胖、糖尿病、血脂异常、非酒精性脂肪性肝病和心血管疾病。在这篇综述中，我们强调了导致这两种疾病同时存在的共同发病途径，以及用于治疗银屑病的药物对代谢综合征的影响，反之亦然。持续的炎症是这两种疾病的共同特征。它们都有增加的炎症细胞因子，如肿瘤坏死因子 (TNF)-α 和白细胞介素-6。生物制剂彻底改变了斑块状银屑病的治疗方法，对代谢综合征也有积极影响。有一些证据表明 TNFα 抑制剂可以降低胰岛素抵抗并改善血糖指数。一些银屑病治疗可能会导致体重减轻。用于代谢综合征管理的生活方式措施，如减肥、运动和健康饮食，对银屑病患者有益。考虑到代谢综合征和银屑病之间的关联，我们建议对银屑病患者进行临床检查和实验室检查以筛查代谢综合征。对这些疾病同时诊断的患者应特别注意以获得最佳治疗效果。
