Ismail Ali Mohamed Ali, Saad Ahmad Elsayed, Draz Ramy Salama
Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt.
Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Giza, Egypt.
Reumatologia. 2023;61(2):116-122. doi: 10.5114/reum/162995. Epub 2023 May 10.
Chronic-plaque psoriasis is a chronic inflammatory dermatological disease. Obesity comorbidities, including non-alcoholic fatty liver disease, are highly prevalent in patients with chronic-plaque psoriasis. Recently, weight loss has been a highly recommended intervention to improve the severity of psoriatic symptoms, psoriasis-induced chronic systemic inflammation, psoriasis-associated cardiovascular risk factors, quality of life, and the efficacy of anti-psoriatic drugs. This study was designed to assess the effect of a 12-week low-calorie-diet intervention on aspartate transaminase, psoriasis severity (assessed via Psoriasis Area and Severity Index - PASI), alanine transaminase, quality of life (assessed via Dermatology Life Quality Index - DLQI), triglycerides, waist circumference (WC), and body mass index (BMI) in class I obese men with chronic-plaque and non-alcoholic fatty liver disease.
Sixty men with age ≥ 18 years with class I obesity and with chronic plaque psoriasis and non-alcoholic fatty liver disease were included in the study. All participants were randomly assigned to one of two groups: the first group as the low-calorie-diet group (30 men received immunosuppressive drugs, followed a low-calorie diet, and increased their energy expenditure through a daily 15,000-step outdoor walking program for 12 weeks) and the second as the control group (30 men received immunosuppressive drugs only). The primary outcome consisted of the results of the area and severity index. Weight, BMI, WC, laboratory results such as triglycerides, liver enzymes (alanine transaminase and aspartate transaminase) as well as DLQI were considered as secondary outcomes.
While no significant improvements were achieved in the measured variables of the control group, the low-calorie-diet group demonstrated significant improvement in all the measured variables.
The results of the present study confirmed that 12-week low-calorie-diet intervention controls BMI, increases the response of psoriasis to pharmacological agents and improves the quality of life. Diet interventions significantly control the elevated hepatic enzymes (aspartate and alanine transaminases) and triglycerides in male patients with chronic-plaque psoriasis and non-alcoholic fatty liver disease.
慢性斑块状银屑病是一种慢性炎症性皮肤病。肥胖合并症，包括非酒精性脂肪性肝病，在慢性斑块状银屑病患者中非常普遍。最近，减肥已成为一项备受推荐的干预措施，以改善银屑病症状的严重程度、银屑病引发的慢性全身炎症、银屑病相关的心血管危险因素、生活质量以及抗银屑病药物的疗效。本研究旨在评估为期12周的低热量饮食干预对伴有慢性斑块状银屑病和非酒精性脂肪性肝病的I类肥胖男性的天冬氨酸转氨酶、银屑病严重程度（通过银屑病面积和严重程度指数 - PASI评估）、丙氨酸转氨酶、生活质量（通过皮肤病生活质量指数 - DLQI评估）、甘油三酯、腰围（WC）和体重指数（BMI）的影响。
60名年龄≥18岁、患有I类肥胖症且伴有慢性斑块状银屑病和非酒精性脂肪性肝病的男性被纳入研究。所有参与者被随机分为两组：第一组为低热量饮食组（30名男性接受免疫抑制药物治疗，遵循低热量饮食，并通过每日15000步的户外步行计划增加能量消耗，持续12周），第二组为对照组（30名男性仅接受免疫抑制药物治疗）。主要结局包括面积和严重程度指数的结果。体重、BMI、WC、甘油三酯等实验室检查结果、肝酶（丙氨酸转氨酶和天冬氨酸转氨酶）以及DLQI被视为次要结局。
虽然对照组的测量变量没有显著改善，但低热量饮食组在所有测量变量上均有显著改善。
本研究结果证实，为期12周的低热量饮食干预可控制BMI，增强银屑病对药物治疗的反应，并改善生活质量。饮食干预可显著控制伴有慢性斑块状银屑病和非酒精性脂肪性肝病的男性患者中升高的肝酶（天冬氨酸和丙氨酸转氨酶）及甘油三酯。
