Childhood-onset psoriasis: association with future cardiovascular and metabolic comorbidities

Abstract

SummaryBackground Psoriasis is associated with higher prevalences of cardiovascular and metabolic comorbidities in adults but the relationship of age at onset and those prevalences is unknown. Objective To evaluate whether the childhood onset of psoriasis (COP) is correlated with the frequency of cardiovascular and metabolic comorbidities in adulthood. Methods This noninterventional, cross-sectional, multicentre study of adults with psoriasis was conducted in 29 dermatology centres in France. Data on sex, age at onset of psoriasis and its clinical characteristics, and cardiovascular risk factors, including weight, body mass index, waist circumference, dyslipidaemia, diabetes, hypertension, smoking, and personal/familial major adverse cardiovascular events (MACE) were systematically recorded. Results Two thousand two hundred and one patients with psoriasis (male: 56%; mean age: 49 years; 25% with COP) were included consecutively in the study. Univariate analysis showed that COP was associated with lower frequencies of obesity, high waist circumference, diabetes, dyslipidaemia, hypertension, familial cardiovascular disease, MACE and metabolic syndrome, but more frequent active smoking. Multivariate analysis retained age as being associated with frequency of cardiovascular and metabolic comorbidities, and sex with smoking, but not age at the onset of psoriasis. Psoriasis severity was associated with higher frequencies of obesity and psoriatic arthritis. Conclusion Our results showed that COP does not seem to be an additional risk factor for higher frequencies of cardiovascular and metabolic comorbidities during adulthood.

The Prevalence of Nonalcoholic Fatty Liver Disease and Related Metabolic Comorbidities Was Associated with Age at Onset of Moderate to Severe Plaque Psoriasis: A Cross-Sectional Study

“…Recent studies have examined the association between childhood and very late onset psoriasis and metabolic and cardiovascular comorbidities[7,8]. Age at onset was not found to be an independent risk factor for comorbidities in patients with childhood onset psoriasis.…”

Clinical Characterisation at Onset of Childhood Psoriasis – A Cross Sectional Study in Sweden

“…Studies of the paediatric and adolescent populations also suggest an increased risk for metabolic dysfunction (7)(8)(9)(10), but with no evidence that onset in childhood per se would predispose for overweight and cardio-metabolic comorbidity in adulthood (11,12). However, the difficult issue of causality has not been clarified and studies of body mass index (BMI) and lipoprotein profiles at onset of disease are lacking.…”

Clinical profile of childhood-onset psoriasis and prevalence of HLA-Cw6: a hospital-based study from India

“…The study focused on COP, and the number of adults with COP was small. Thus, comparison of the ACOP subgroup in our study with other cohorts4 was not feasible because of small numbers. The study was also limited by the inability to assess the prevalence of the HLA-Cw6 allele in a control group without psoriasis.…”

“…Patients with exclusive palmoplantar involvement (which was difficult to differentiate from eczema) and those unwilling to participate were excluded. We categorised patients as children (current age ≤18 years) with COP (CCOP) and adults (currently >18 years) whose disease onset was in childhood as adults with COP (ACOP) based on a study published by Mahe et al 4. The clinical characteristics were compared between CCOP and ACOP.…”

“…Psoriasis, being a systemic inflammatory disease, is associated with comorbidities such as obesity, hypertension, diabetes, dyslipidaemia, metabolic syndrome (MetS) and cardiovascular disease. Although some studies have shown that childhood-onset psoriasis (COP) is associated with a higher risk of cardiovascular and metabolic complications,2 3 a recent multicentre cross-sectional study from France4 did not demonstrate this association.…”