Study Shows Higher Incidence of Psoriasis in Patients With PCOS

Patients with polycystic ovary syndrome (PCOS) were found to have a higher risk of developing psoriasis, according to a study published in the Journal of Clinical Medicine, which noted that both conditions are associated with insulin resistance and metabolic syndrome.

Psoriasis is a chronic skin inflammatory disease that features scaly and erythematous plaques; it is thought to result from the combined interaction between genes, the immune system, and endocrine system. It is associated with insulin resistance, metabolic syndrome, and cardiovascular disease.

PCOS is a chronic anovulation disorder characterized by oligomenorrhea, hyperandrogenism, or polycystic ovarian morphology. Patients with PCOS may have elevated androgen levels and insulin resistance. As with individuals with psoriasis, patients with PCOS are also predisposed to develop metabolic syndrome and may also have an increased risk of obesity, hyperinsulinemia, dyslipidemia, and dysglycemia in their 40s.

The national, retrospective, population-based cohort study was drawn from a health insurance database in Taiwan, comprising a group of 4707 patients with PCOS and a control group of 18,828 healthy subjects.

Study results revealed that incidence rates of psoriasis in the PCOS and control groups were 0.70 and 0.34 per 1000 person-years, respectively, (P .

The risk of psoriasis in the group of patients with PCOS was higher than in the control group (hazard ratio [HR], 2.07; 95% CI, 1.25-3.43). The risk of developing psoriasis for patients with PCOS was linked with patients under 20 years of age (HR, 4.02; 95% CI, 1.16—13.9; P<.05) than those between 20 and 50 years old (HR, 1.88; 95% CI, 1.07—3.29, P <.05).

Additionally, patients over the age of 50 were more likely to develop psoriasis (HR, 14.13; 95% CI,1.8-110.7, P < .05) than patients who were younger than 20 years old.

“Psoriasis might occur at any age, notably peaking at approximately 20—30 and over 50 years of age because of hormonal changes at puberty and menopause, which are the reported trigger factors,” noted investigators.

Comorbidities associated with insulin resistance or metabolic syndrome (coronary artery disease, diabetes, hyperlipidemia, and stroke) were not significant factors in the risk of psoriasis in patients with PCOS. Nor were the comorbidities of asthma, chronic obstructive pulmonary disease, chronic liver disease, hypertension, depression, or sleep apnea. Data on potential confounding factors for insulin resistance and metabolic syndrome such as smoking, alcohol consumption, socioeconomic status, and body mass index were unavailable.

Although both PCOS and psoriasis are associated with insulin resistance, investigators concluded that whether control of insulin resistance in patients with PCOS would decrease the incidence or severity of psoriasis needs to be further investigated.

“Further studies should be conducted to investigate the mechanism underlying the association, and to benefit the long-term management of patients with PCOS,” said investigators.

Reference

Lee TH, Wu CH, Chen ML, et al. Risk of psoriasis in patients with polycystic ovary syndrome: A national population-based cohort study. J. Clin. Med. Published online June 19, 2020. doi: 10.3390/jcm9061947.