Prevalence of Metabolic Syndrome and Elevated C-Reactive Protein among Patients with Chronic Plaque Type Psoriasis and Its Correlation With Diseaseseverity: A Hospital-Based CrossSectional Study
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 4
Abstract
Background: Previous epidemiological studies suggest an association between psoriasis and metabolic syndrome and risk of subclinical atherosclerosis. However, there is a paucity of data in the Indian population on these associations. Objectives: To evaluate the prevalence of metabolic syndrome in patients with chronic plaque psoriasis compared to healthy controls and to correlate the prevalence of metabolic syndrome with severity of psoriasis as well as to assess the levels of C-reactive protein as a marker of disease severity. Methods: A hospital-based cross-sectional study was performed on 100 patients with chronic plaque type psoriasis and 100 controls. Psoriasis was categorized as mild, moderate and severe based on psoriasis area and severity index (<10, 10–14 and >14, respectively) and as disease of short (<1 year), intermediate (1–3 years) and long duration (>3 years). In all patients and controls, body mass index was calculated, blood pressure and waist circumference were measured and fasting blood sugar, lipid profile and C-reactive protein levels were estimated. Metabolic syndrome was diagnosed by the presence of 3 or more of the modified National Cholesterol Education Program’s Adult Treatment Panel III criteria. Results: The prevalence of metabolic syndrome was significantly more in psoriasis patients than in controls (43% vs. 20%, odds ratio = 3.0175). Psoriatic patients also had a significantly higher prevalence of hypertension, abdominal obesity and diabetes. There was a significant trend to increase in prevalence of metabolic syndrome, hypertension and type 2 diabetes mellitus with increased severity and longer duration of psoriasis. CRP levels were found to be significantly higher among psoriatic patients compared to controls and found to be elevated among 33% of psoriasis patients compared to only 15%controls(p=0.0035) Limitation: This was a hospital-based cross-sectional study with a relatively small sample size. A prospective study with a larger sample would have validated the results further. Conclusion: There is a significantly higher prevalence of metabolic syndrome among psoriasis patients as compared to controls; the prevalence of metabolic syndrome and its components increases with severity and duration of psoriasis. We suggest that patients with moderate to severe psoriasis be screened routinely for metabolic syndrome and cardiovascular diseases and encouraged to correct modifiable cardiovascular risk factors.
Authors and Affiliations
Shaista Huma, Dharmendra Kumar Mishra, ShyamSundar Chaudhary
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