Metabolic Syndrome Screening and Nutritional Status of Patients with Psoriasis: A Scoping Review

Abstract

Background: Patients with plaque psoriasis have an increased risk of metabolic syndrome. However, no studies have assessed the nutritional status or screening methods of this population. Aims: This review aimed to identify and summarise metabolic syndrome screening criteria and the tools/methods used in nutrition assessment in patients with plaque psoriasis. Data synthesis: PubMed, Web of Science, Ovid and Scopus were searched from inception to March 2023, following the Arkensey and O’Malley framework, to identify articles that report nutritional assessment methods/tools and metabolic screening criteria. Twenty-one studies were identified. Overall, these studies used four different screening criteria to define metabolic syndrome. Patients with psoriasis had a high prevalence of metabolic syndrome and had a poor nutritional status compared to controls. However, only anthropometric measures such as weight, height and waist circumference were employed to determine the nutritional status. Only two studies assessed the vitamin D status. Conclusions: Patients with psoriasis have a poor nutritional status, and they are at risk of nutrient deficiencies. However, these health aspects are not routinely assessed and may increase the risk of malnutrition among these patients. Therefore, additional assessments, such as body composition and dietary assessment, are needed to determine the nutritional status to provide a suitable intervention.

Oxidative stress and metabolic biomarkers in patients with Psoriasis

“…Proinflammatory cytokines (e.g., TNF-a and IL-12/23) are shown to be related to renal inflammation and hemodynamics alterations, thus favoring sodium retention and hypertension. In addition, psoriasis is often accompanied with comorbidities such as obesity, insulin resistance, diabetes and NAFLD due to an increased levels of such proinflammatory cytokines (e.g., TNFa, IL-6 and IL-17) [1] [9] [10] .…”

“…In the current study the PCA extracted 4 factors consisted of metabolic and redox status parameters in a group of psoriasis patients as following: oxidative stress-inflammation related factor (i.e., HDL-c, CAT, AOPP and CRP), renal function related factor (i.e., creatinine and urea), metabolic related factor (i.e., glucose and TG) and oxidative stress-hepatic related factor (i.e., MDA, ALT). Indeed, previous data in literature have shown the evident interconnection between psoriasis and related comorbidities, such as dyslipidemia, insulin resistance, NAFLD, CKD (1,(9)(10)(11).…”

“…Like in many other chronic diseases (i.e., diabetes mellitus, hypertension, obesity, cardiovascular disease, etc.) [4] [5] [6] , oxidative stress and inflammation play the major role in the pathogenesis of psoriasis [7] [8] [9] . The impaired redox balance in favor of pro-oxidants [i.e., reactive oxygen species (ROS) and reactive nitrogen species (RNS)] leads to oxidative modifications and destruction of lipids, proteins and DNA structures in almost all cells and tissues [8] .…”

“…Given the fact that psoriasis is a systemic disease, biomolecules’ alterations related to cholesterol metabolism are correlated with comorbidities such as obesity, dyslipidemia, hypertension, insulin resistance, non-alcoholic fatty liver disease (NAFLD) and diabetes [1] [9] [10] . Patients with psoriasis are also at increased risk of chronic kidney disease (CKD) and end-stage renal disease since proinflammatory cytokines influence renal hemodynamics, favor the retention of sodium and lead to hypertension onset and renal injury [11] .…”