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成年银屑病患者代谢综合征和心血管疾病的评估与治疗

Evaluation and treatment of metabolic syndrome and cardiovascular disease in adult patients with psoriasis.

作者信息

Palmer Victoria, Cornier Marc-André, Waring Ashley, Valdebran Manuel

机构信息

Department of Medicine, Richmond University Medical Center, Staten Island, NY, USA.

Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, Medical University of South Caroline, Charleston, SC, USA.

出版信息

Int J Dermatol. 2023 Dec;62(12):1437-1446. doi: 10.1111/ijd.16873. Epub 2023 Oct 16.

Abstract

Psoriasis is strongly associated with cardiovascular disease (CVD) and metabolic syndrome, with patients having an approximately twofold increased risk of each compared to the general population. This increased risk is based on shared underlying genetic and cytokine profiles, as well as similar environmental risks. Many screening guidelines do not address the development of CVD and metabolic syndrome in these predisposed patients. These deficits are evidenced by the exclusion of psoriasis as a risk factor in validated 10-year CVD risk calculators for adult patients with chronic inflammatory diseases, as well as insufficient screening guidelines for insulin resistance in patients with psoriasis. This manuscript aims to discuss and propose allopathic and lifestyle recommendations for the screening and management of the aforementioned comorbidities in adult patients with psoriasis.

摘要

银屑病与心血管疾病(CVD)和代谢综合征密切相关,与普通人群相比,银屑病患者患这两种疾病的风险大约增加了一倍。这种风险增加是基于共同的潜在基因和细胞因子谱,以及相似的环境风险。许多筛查指南并未涉及这些易感患者中CVD和代谢综合征的发生情况。在针对患有慢性炎症性疾病的成年患者的经过验证的10年CVD风险计算器中,将银屑病排除为风险因素,以及银屑病患者胰岛素抵抗的筛查指南不足,都证明了这些缺陷。本手稿旨在讨论并提出针对成年银屑病患者上述合并症的筛查和管理的对抗疗法及生活方式建议。

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