The Association of Metabolic Syndrome and Psoriasis: A Systematic Review and Meta-Analysis of Observational Study

Abstract

Background: Metabolic syndrome worsens complications in psoriasis patients by predisposing them to cardiovascular diseases. Psoriasis has been widely associated with metabolic syndrome; however, it has still not been proven owing to a limited number of studies and some of those reporting conflicting results. Objective: Psoriasis has reportedly been associated with metabolic syndrome; however, it has yet not been established beyond doubt owing to conflicting literature. The present meta-analysis of observational studies aims to evaluate the prevalence of metabolic syndrome in psoriasis patients and establish an inferring point that psoriasis patients are certainly susceptible to metabolic syndrome. The study will benefit clinicians to assess and monitor psoriasis patients for several associated comorbid conditions and in its treatment. Methods: A systematic web search for ‘Psoriasis’, ‘Metabolic Syndrome’, ‘Hypertension’, ‘Plasma Glucose’, ‘Dyslipidaemia’, ‘Waist Circumference’ was performed, collecting all original observational studies on humans up to April 30, 2018. Depending on the inclusion and exclusion criteria, articles were screened for eligibility. Due to the presence of significant heterogeneity, the Odds Ratio (OR) was calculated using a random-effect model with Der-Simonian and Laird method. The statistical heterogeneity was determined using I2 statistics. Comprehensive Meta-Analysis Software, Version 3 was used to perform all the analysis. Results: Sixty-three studies encompassing 15,939 psoriasis patients and 103,984 controls were included in this meta-analysis. Among them, 30.29 % of psoriasis patients were reported with metabolic syndrome in comparison to 21.70 % of subjects in the control group. The present study clearly indicates an increased prevalence of metabolic syndrome among psoriasis patients (OR: 2.077 [95% CI, 1.84 - 2.34]). Conclusions: The findings support the fact that psoriasis patients have a higher incidence of metabolic syndrome. Our study also recommends that psoriasis patients should be regularly monitored for metabolic syndrome complications and its associated risk factors such as hypertension, raised triglyceride, lowered HDL Cholesterol, increased fasting plasma glucose, and waist circumference.

Psoriasis and Cardiovascular Risk: A Comprehensive Review

“…A recent meta-analysis (63 studies encompassing 15,939 psoriasis patients and 103,984 controls) showed that 30.3% of psoriasis patients were reported with MetS compared with 21.7% subjects in the control group [OR 2.18 (95% CI 1.84-2.34)] [22]. Similarly, another meta-analysis showed that the association between psoriasis and MetS is high in Latin America [23].…”

Review of the Prevalence of Cardiovascular and Metabolic Comorbidities of Psoriasis

“…By the end of the followup period (median of just over 5 years), the hypertension prevalence rose to 24.72% (mild psoriasis) and 31.62% (severe psoriasis), and 31.6% among controls. 5 Other studies found outcomes in similar prevalence ranges of 30%, 18 32.8%, 19 32%, 17 34.3%, 10 and 35%, 13 respectively. In the Brigham study the prevalence was reports at 45%.…”

Psoriasis: Comorbidities

“…Psoriasis increases the incidence of these diseases and is considered to represent an aggravating factor by itself. A systematic review of the risk of CVD risk factors in psoriasis and recent findings from a meta‐analysis are summarized in Table 1 20,44‐54 …”