Editorial
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Dermatol. Nov 2, 2013; 2(4): 32-35
Published online Nov 2, 2013. doi: 10.5314/wjd.v2.i4.32
Metabolic co-morbidities and psoriasis: The chicken or the egg?
Maria Dalamaga, Evangelia Papadavid
Maria Dalamaga, Department of Clinical Biochemistry, Medical School, University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece
Evangelia Papadavid, Department of Dermatology, Medical School, University of Athens, “Attikon” General University Hospital, 12462 Athens, Greece
Author contributions: Dalamaga M designed the editorial and wrote the manuscript; Papadavid E reviewed the manuscript.
Correspondence to: Maria Dalamaga, MD, PhD, MS, MPH, Assistant Professor, Department of Clinical Biochemistry, Medical School, University of Athens, “Attikon” General University Hospital, 1 Rimini street, Karyotaki 29, 12462 Athens, Greece. madalamaga@med.uoa.gr
Telephone: +30-210-5831915 Fax: +30-210-6082467
Received: June 15, 2013
Revised: September 25, 2013
Accepted: October 17, 2013
Published online: November 2, 2013
Processing time: 138 Days and 14.9 Hours
Abstract

Accumulating evidence supports that psoriasis may be a potential multisystem inflammatory disease associated with a range of co-morbidities showing an overlapping pathology and an important health impact such as metabolic diseases. Psoriasis is associated with an increased risk of obesity, metabolic syndrome (Mets) and diabetes mellitus type 2, following a “dose-response” relationship from mild to severe psoriasis. Conversely, recent evidence from large prospective studies suggests that obesity constitutes a risk factor for psoriasis and psoriatic arthritis. Also, a dyslipidemic profile may precede psoriasis onset. Both obesity, Mets and psoriasis, characterized as chronic inflammatory states, stem from a shared underlying pathophysiology exhibiting common genetic predisposition and risk factors such as high caloric intake, physical inactivity and psychological stress. Excess weight may potentiate the inflammation of psoriasis through the deregulation of adipocytokines while, at the same time, it may help the development of Mets. Interestingly, recent translational data has shown that psoriasis, through increased T-helper inflammatory cytokines in skin and sera, may exert a plethora of effects on insulin regulation and lipid metabolism. Larger population-based prospective cohort and longitudinal studies are needed to unravel the association between psoriasis and metabolic co-morbidities. The recognition of the intricate complex interplay between psoriasis and metabolic co-morbidities may help dermatologists to be aware of associated metabolic co-morbidities in order to screen for metabolic diseases and manage holistically and effectively the psoriatic patient.

Keywords: Psoriasis; Obesity; Metabolic syndrome; Metabolic co-morbidities; Diabetes mellitus; Insulin resistance

Core tip: Psoriasis is associated with an increased risk of obesity, metabolic syndrome (Mets) and diabetes mellitus type 2, following a “dose-response” relationship from mild to severe psoriasis. Conversely, recent evidence from large prospective studies suggests that obesity constitutes a risk factor for psoriasis and psoriatic arthritis. Both obesity, Mets and psoriasis, characterized as chronic inflammatory states, stem from a shared underlying pathophysiology exhibiting common genetic predisposition and risk factors such as high caloric intake, physical inactivity and psychological stress. Larger population-based prospective cohort and longitudinal studies are needed to unravel the association between psoriasis and metabolic co-morbidities.