Metabolic comorbidities of psoriasis (Review)

Abstract

Psoriasis is a chronic inf lammatory and immune-mediated condition, which is no longer considered as being limited to the skin, but may affect the entire body. Epidemiological studies have shown that certain disorders, including obesity, diabetes, liver abnormalities, elevated lipid levels in the blood and metabolic syndrome, may occur more frequently in patients with psoriasis compared with the general population. As psoriasis is a chronic disease, the frequently associated comorbidities must be identified early to ensure timely treatment and, possibly, their prevention. Comorbidities often manifest clinically 1-2 years after the onset of psoriasis and are commonly seen in patients with severe forms of the disease. The association between psoriasis and its comorbidities is not coincidental, but rather based on common pathophysiological mechanisms and risk factors that underlie the increased frequency of comorbidities in patients with psoriasis. The aim of the present review was to emphasize the important role of dermatologists in the early recognition of comorbidities in patients with psoriasis, with a focus on metabolic comorbidities, precisely because the dermatologists are usually the first medical contact due to the predominance of skin lesions. Therefore, these specialists have the responsibility to inform patients on the association between psoriasis and possible multiple comorbidities, devise prevention and treatment plans, or even redirect patients to other specialists. Contents 1. Introduction 2. Metabolic comorbidities of psoriasis 3. Management of metabolic comorbidities in psoriasis 4. Conclusions

The Role of Transcription Factor PPAR-γ in the Pathogenesis of Psoriasis, Skin Cells, and Immune Cells

“…Compared to healthy individuals, psoriasis patients have an increased risk of developing comorbidities, including cardiovascular disease, hypertension, obesity, and diabetes mellitus (rev. in [ 2 , 3 ]). A higher risk of cardiovascular, metabolic, and other disorders suggest that psoriasis is systemic, and in addition to the skin, it also damages other tissues and organs.…”

The Effect of Metformin and Biological Therapy on Insulin Resistance in Iraqi Psoriatic Patients

“…Such a multisystem chronic disease is usually associated with comorbidities such as obesity, diabetes, metabolic syndrome and arthritis. 19 The disorder has a pathophysiological basis, and serum TNF, IFN-, IL-6, IL-8, IL-12, IL-17, and IL-18 levels were considerably higher in patients with psoriasis. 10,15 Also, oxidative stress is majorly involved in disease development.…”

“…10,15 Also, oxidative stress is majorly involved in disease development. 16,[19][20][21] Metformin is used as a first-line antidiabetic medication in the treatment of diabetes mellitus (DM). It does not produce hypoglycemia; instead, it lowers serum glucose level by inhibiting hepatic glucose synthesis and improving peripheral tissue sensitivity to insulin.…”

Knowledge Mapping and Research Hotspots of Comorbidities in Psoriasis: A Bibliometric Analysis from 2004 to 2022

“…Similarly, patients with diabetes have a higher prevalence of psoriasis, which may be associated with insulin use, and DPP-4 inhibitor, a drug used for diabetes, has been shown to ameliorate psoriasis [ 29 , 30 ]. Moreover, several studies have confirmed that patients with psoriasis, especially severe psoriasis, suffer from an increased risk of metabolic diseases, such as obesity, diabetes and its complications, hypertension, dyslipidemia, metabolic syndrome, and gout [ 31 , 32 , 33 ]. Improvement in psoriasis is usually accompanied by the remission of insulin resistance and a decrease in leptin levels [ 34 ].…”