Psoriasis Linked to Metabolic Disorders in Adult Patients, Study Finds

Researchers have identified significant associations between psoriasis and metabolic disorders, including diabetes, hypertension (HTN), hyperlipidemia, and obesity in adult patients.

These findings highlight the importance of routine screening and monitoring of these metabolic disorders in individuals with psoriasis, as well as understanding the symbiotic impact of these conditions.

Woman with psoriasis | Image credit: Andre Popov - stock.adobe.com

This systemic review and meta-analysis is published in Cureus.

“Patients with psoriasis should be regularly screened and monitored for metabolic disorders and receive appropriate treatment and lifestyle interventions to reduce their risk of cardiovascular diseases,” wrote the researchers of the study. “Clinicians should also consider the potential impact of psoriasis treatment on metabolic disorders, as some therapies may have beneficial or adverse effects on glucose and lipid metabolism.”

The researchers conducted a comprehensive search of PubMed, EMBASE, and Cochrane Library from inception to December 2023. Inclusion criteria were original research articles published in peer-reviewed journals, studies that investigated associations between psoriasis and metabolic disorders, observational studies, and studies with human participants.

Data extraction requirements included study characteristics, such as study design, study site and time, total sample size criteria, duration of follow-up, age, gender, and relevant outcome data.

The researchers identified 3598 articles in their initial search, in which 3537 were screened, 68 full text articles were assessed for eligibility, and 32 were included for analysis. The included studies were divided into qualitative (n = 16) and quantitative (n = 16) cohorts.

These studies encompassed 6.6 million participants and were published between 1975 and 2023. A significant association was identified between psoriasis and type 2 diabetes, with a pooled risk ratio (RR) of 1.18 (95% CI, 1.16-1.20), indicating an 18% increased incidence in patients with psoriasis compared with patients who did not have psoriasis.

Significant associations also were found between psoriasis and HTN (RR, 1.35; 95% CI, 1.06-1.64), hyperlipidemia (RR, 1.19; 95% CI, 0.47-1.92), and obesity (RR, 1.25; 95% CI, 1.01-1.49), indicating 35%, 19%, and 25% increased incidence, respectively, of these outcomes in patients with psoriasis compared with patients without psoriasis.

The researchers acknowledged some limitations to their study that may have had an impact on their findings. These limitations included the heterogeneity and variety of the included studies in terms of study design, population characteristics, diagnostic criteria, confounding factors, and outcome measures. Additionally, the researchers noted their analyses were limited due to the availability and quality of data. Therefore, they believe these results should be interpreted with caution. Furthermore, the possibility of publication bias may have limited their findings.

“Based on our findings and limitations, we recommend the following directions for future research: More high-quality observational studies, especially prospective cohort studies, are needed to confirm and clarify the association between psoriasis and metabolic disorders and to control for potential confounding factors, such as age, sex, smoking, alcohol, and other comorbidities,” wrote the researchers. “More standardized and validated diagnostic criteria and outcome measures are needed to improve the comparability and consistency of the studies and to reduce the heterogeneity and variability of the results.”

Despite these limitations, the researchers believe their study has important clinical and practical implications. In addition to regular screening and monitoring of metabolic disorders in patients with psoriasis, the researchers believe some systemic therapies, such as methotrexate, cyclosporine, and biologics, may improve the metabolic profile of patients with psoriasis by reducing inflammation and oxidative stress. Topical therapies such as corticosteroids, they caution, may worsen the metabolic profile by inducing skin atrophy and systemic absorption.

Reference

Alajroush WA, Alrshid AI, Alajlan AH, et al. Psoriasis and metabolic disorders: a comprehensive meta-analysis of million adults worldwide. Cureus. Published January 11, 2024. 16(1):e52099. doi:10.7759/cureus.52099