DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20193230

A clinical study of prevalence of metabolic syndrome in psoriasis patients: a prospective cross-sectional observational study at a tertiary care centre in South India

Reshma R., Navakumar Manickam, Kannan Gopalan, Muthusamy Kandasamy

Abstract


Background: Metabolic syndrome (MS) is a constellation of risk factors like central obesity, atherogenic dyslipidemia, hypertension and glucose intolerance.Psoriasis is associated with MS and this may be contributed by various inflammatory mediators like interleukin 6 and tumor necrosis factor α which are increased in psoriasis. Aim of the study is to assess the prevalence and risk factors associated with metabolic syndrome in psoriasis patients and to find association between metabolic syndrome and severity of psoriasis using PASI score.

Methods: A hospital based prospective observational cross sectional study was conducted in Vinayaka Missions Medical College and Hospital, Salem over a period of one year (June 2017 – June 2018) involving 100 psoriasis patients, included based on the inclusion and exclusion criteria. Patients were analyzed based on a standard proforma and metabolic syndrome was diagnosed with the South Asian Modified National Cholesterol Education Program Adult Panel III (SAM- NCEP ATP III).

Results: In the present study, prevalence of metabolic syndrome was 54%. The risk factors noted were female gender (p=0.015), nail involvement (p=0.249), joint involvement (p=0.007) and increasing PASI score (p=0.194).There was no significant association between type of psoriasis and metabolic syndrome. Among the different components of metabolic syndrome, majority of psoriasis patients were having raised fasting blood sugar.

Conclusions: The occurrence of metabolic syndrome is high in Indian population. Therefore apart from getting treated for psoriasis, patients should be screened for components of MS and should be followed up regularly for onset of components of MS.


Keywords


Psoriasis, Metabolic syndrome, PASI score, Fasting blood glucose

Full Text:

PDF

References


Gisondi P, Tessari G, Conti A, Piaserico S, Schianchi S, Peserico A, et al. Prevalence of metabolic syndrome in patients with psoriasis: A hospital-based case-control study. Br J Dermatol. 2007;157:68-73.

Kourosh AS, Miner A, Menter A. Psoriasis as the marker of underlying systemic disease. Skin Therapy Le. 2008;13:1-5.

Nijsten T, Wakkee M. Complexity of the association between psoriasis and comorbidities. J Invest Dermatol. 2009;129:1601-3.

Enas E, Mohan V, Deepa M, Farooq S, Pazhoor S, Chennikara H.The metabolic syndrome and dyslipidemia among Asian Indians: A population with high rates of diabetes and premature coronary artery disease. J Cardio Metabol Syndrome. 2007;2(4):267-75.

Ninomiya JK, L′Italien G, Criqui MH, Whyte JL, Gamst A, Chen RS. Association of metabolic syndrome with history of myocardial infarction and stroke in the Third National Health and Nutrition Examination Survey. Circulation. 2004;109:42-6

Praveenkumar U, Ganguly S, Ray L, Nanda SK, Kuruvila S. Prevalence of metabolic syndrome in psoriasis patients and its relation to disease duration: A hospital based case control study. J Clin Diagn Res. 2016;10(2):WC01–05.

Lunawat D, Bubna AK, Sankarasubramaniam A, Veeraraghavan M, Rangarajan S, Swaminathan A. Prevalence of metabolic syndrome in patients with psoriasis: A prospective, observational, descriptive study from a tertiary health-care centre in South India. Muller J Med Sci Res. 2017;8:31-5.

Pandit K, Goswami S, Ghosh S, Mukhopadhyay P, Chowdhury S. Metabolic syndrome in South Asians. Indian J Endocrinol Metab. 2012;16:44–55.

Lakshmi S, Nath AK, Udayashankar C. Metabolic syndrome in patients with psoriasis: A comparative study. Indian Dermatol Online J. 2014;5:132–7.

Das SK, Nath T, Ghosal A, Mondal RK, Jana CK. Relation between metabolic syndrome and psoriasis: A multicenter, hospital-based, case-control study from West Bengal, India. J Obes Metab Res. 2014;1:225-9.

Girisha BS, Thomas N. Metabolic Syndrome in Psoriasis among Urban South Indians: A Case Control Study Using SAM-NCEP Criteria. J Clin Diagn Res. 2017;11(2):1–4.

Sommer DM, Jenisch S, Suchan M, Christophers E, Weichenthal M, et al. Increased prevalence of the metabolic syndrome in patients with moderate to severe psoriasis. Arch Dermatol Res. 2006;298:321–8.

Nisa N, Qazi MA. Prevalence of metabolic syndrome in patients with psoriasis. Indian J Dermatol Venereol Leprol. 2010;76:662–5.

Madanagobalane S, Anandan S. Prevalence of metabolic syndrome in south indian patients with psoriasis vulgaris and the relation between disease severity and metabolic syndrome: A hospital based case control study. Indian J Dermatol. 2012;57(5):353–7.

Kutlu S, Ekmekci TR, Ucak S, Koslu A, Altuntas Y. Prevalence of metabolic syndrome in patients with psoriasis. Indian J Dermatol Venereol Leprol. 2011;77:193-4.

Singh S, Dogra S, Shafiq N, Bhansali A, Malhotra S. Prevalence of Metabolic Syndrome in Psoriasis and Levels of Interleukin-6 and Tumor Necrosis Factor-α in Psoriasis Patients with Metabolic Syndrome: Indian Tertiary Care Hospital Study. Int J Applied Basic Med Res. 2017;7(3):169-75.

Ferdinand KC, Rodriguez F, Nasser SA. Cardio-renal Metabolic Syndrome and Cardio-metabolic Risks in Minority Populations. Cardio-renal Med. 2014;4(1):1-11.

Ali NM, Kuruvila M, Unnikrishnan B. Psoriasis and metabolic syndrome: A case control study. Indian J Dermatol Venereol Leprol. 2014;80:255-7.

Raychaudhuri SK, Chatterjee S, Nguyen C, Kaur M, Jialal I, Raychaudhuri SP. Increased prevalence of the metabolic syndrome in patients with psoriatic arthritis. Metabol Syndrome Related Disorders. 2010;8:331-4.

Aruna C, Rao GV, Ramanamurthy P, Rambabu P. Prevalence of metabolic syndrome in patients with psoriasis: A hospital-based case control study from a tertiary care centre in Andhra Pradesh. J NTR Univ Health Sci. 2016;5:13-6.

Pereira R, Amladi S, Varthakavi P. A study of the prevalence of diabetes, insulin resistance, lipid abnormalities, and cardiovascular risk factors in patients with chronic plaque psoriasis. Indian J Dermatol. 2011;56(5):520–6.

Kothiwala SK, Khanna N, Tandon N, Naik N, Sharma VK, Sharma S, et al. Prevalence of metabolic syndrome and cardiovascular changes in patients with chronic plaque psoriasis and their correlation with disease severity: A hospital based cross-sectional study. Indian J Dermatol Venereol Leprol. 2016;82:510–8.

Khunger N, Gupta D, Ramesh V. Is psoriasis a new cutaneous marker for metabolic syndrome? A study in Indian patients. Indian J Dermatol. 2013;58:313-4.

Gangaiah N, Aysha Roshin NS, Thimmappa V, Shivanna R. Metabolic syndrome in patients with psoriasis: A hospital-based case–control study. Clin Dermatol Rev. 2018;2:64-8.

Das SK, Nath T, Ghosal A, Mondal RK, Jana CK. Relation between metabolic syndrome and psoriasis: A multicenter, hospital-based, case-control study from West Bengal, India. J Obes Metab Res. 2014;1:225-9.

Praveenkumar U, Ganguly S, Ray L, Nanda SK, Kuruvila S. Prevalence of metabolic syndrome in psoriasis patients and its relation to disease duration: A hospital based case-control study. J Clin Diagn Res. 2016;10(2):WC01–05.

Sommer DM, Jenisch S, Suchan M et al. Increased prevalence of the metabolic syndrome in patients with moderate to severe psoriasis. ArchDermatol Res 2006; 298: 321–328.

Chen YJ, Wu CY, ShenJL, ChuSY, Chen CK, Chang YT, et al. Psoriasis independently associated with hyperleptinemia contributing to metabolic syndrome. Arch Dermatol. 2008;144:1571-5.

Augustin M, Reich K, Glaeske G, Schaefer I and Radtke M. Co-morbidity and Age-related Prevalence of Psoriasis: Analysis of Health Insurance Data in Germany. Acta Derm Venereol. 2010;90:147–51.

Love T, Qureshi A, Karlson E, Gelfand J, Choi H. Prevalence of the metabolic syndrome in psoriasis. Arch Dermatol. 2011;147(4):419.

Kathirvel D, Dhandapani V, Baskaran R., Jennifer G H. Psoriasis and metabolic syndrome: hospital based cross sectional study of prevalence and correlation in a rural south Indian population. Int J Res Dermatol. 2016;2(3):49-54.