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High burden of the metabolic syndrome and its component disorders in South Africans with psoriasis
Author(s) -
Goolam Mahyoodeen Nasrin,
Crowther Nigel J.,
Snyman Tracy,
Pillay Lushen,
Tikly Mohammed
Publication year - 2019
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.14348
Subject(s) - psoriasis , medicine , metabolic syndrome , odds ratio , body mass index , anthropometry , cohort , diabetes mellitus , logistic regression , gastroenterology , psoriasis area and severity index , type 2 diabetes , obesity , endocrinology , dermatology
Abstract Background Psoriasis is associated with cardiometabolic diseases ( CMD s) in Caucasians, but no data is available from sub‐Saharan populations on either CMD prevalence or psoriasis risk factors. Our aim was to investigate the prevalence of CMD s in a predominantly non‐Caucasian cohort of South Africans with psoriasis and to determine the principal risk factors associated with psoriasis. Methods This was a cross‐sectional case‐control study of adult psoriasis patients ( n = 103) and controls ( n = 98), comparing sociodemographic, anthropometric, clinical, and biochemical characteristics. The groups were matched for gender, ethnicity, and body mass index ( BMI ). Results The prevalence of metabolic syndrome (MetS) (52.4% vs. 33.7%; P = 0.007), type 2 diabetes (T2D) (25.2% vs. 4.1%; P < 0.0001), and hypertension (70.9% vs. 46.6%; P = 0.001) were all higher in the psoriasis group. High‐sensitivity CRP was higher in psoriasis patients than controls (4.70 (2.00, 10.9) vs. 2.00 (1.10, 4.80) ng/ ml ; P < 0.0005). Multivariable logistic regression analysis showed that severe psoriasis was independently associated with MetS (odds ratio [95% CI s]: 4.42 [1.72, 11.4]; P = 0.002), T2D (11.3 [3.07, 41.3]; P = 0.0002), and hypertension (2.48 [0.97, 6.32]; P = 0.05), whilst for psoriasis the principal risk factors were smoking (3.87 [1.97, 7.63]; P < 0.0001) and hs CRP (1.05 [1.00, 1.10]; P = 0.029), with completion of high school (0.23 [0.11, 0.48]; P < 0.0001) being protective. Conclusions In this population, psoriasis is characterized by a high burden of CMD s, particularly in those subjects with severe psoriasis. Inflammation plays a role in the etiology of psoriasis, whilst smoking and poor education further increase disease risk.