PREVALENCE OF METABOLIC SYNDROME AND ITS COMPONENTS IN PATIENTS WITH CHRONIC PLAQUE PSORIASIS: A HOSPITAL BASED CASE-CONTROL STUDY

Abstract

Study Background: Chronic plaque Psoriasis (PS) is a systemic, immune-mediated, inflammatory recurrent polygenic skin disorder. Metabolic Syndrome (MetS) is a combination of metabolic components that include central obesity, hyperglycaemia, hypertension and hyperlipidaemia.

Study objective: To investigate the prevalence of metabolic syndrome (MetS) in patients with chronic plaque psoriasis (cases group) and in patients with skin diseases other than psoriasis (control group).

Study Methodology: This current study was a hospital based, cross-sectional case-control study. The overall study population (n=264) who participated in the study were categorized into Cases group (n=132) and Control group (n=132). In both the groups diagnosis of MetS was established using International Diabetes Federation (IDF) 2006 definition.

Results and discussion: Metabolic Syndrome (MetS) was found to be more prevalent and significant in patients with chronic plaque psoriasis than in the control group (74.24% Vs 53.78%, OR 2.71, RR 1.44, at 95% CI 1.61-4.55, p=0.0002, x² test p = 0.0008 at p<0.05) using IDF 2006 guidelines. The prevalence of MetS was found to be high in the age group of 51-60 and 31-40 years in the cases and controls group respectively. There was a higher prevalence of triglycerides (TGs) and waist circumference (WC) in psoriatic patients, whereas blood pressure (BP), fasting blood sugar (FBS), and high-density lipoprotein cholesterol (HDL-C) levels were not significant. The risk of having MetS is clearly increasing with the increase in severity of psoriasis disease (Mild psoriasis with MetS-52.27%, Moderate psoriasis with MetS-80.35% and severe psoriasis with MetS-93.75%). The order of importance of individual components of MetS for male psoriatic patients is WC> TG>HDL>BMI>FBG>BP, while for female psoriatic patients is TG>BMI>FBG>WC> BP>HDL.

Conclusion:  Our study found a strong association between psoriasis and MetS with Psoriatic group having higher prevalence of MetS than the control group especially in patients with age >50 years. Waist circumference and Triglyceride levels were found to be significantly elevated in cases than in control group. Prevalence of Mets increases with increase in the Severity of Psoriasis disease. We recommend that patients with chronic plaque psoriasis should be evaluated for presence of individual risk factors for MetS and treat accordingly to prevent cardiovascular risk.