Psoriasis is a chronic inflammatory disease associated with obesity. The increased production of adipocytokines in central adiposity contributes to the systemic inflammation of obesity and perhaps to psoriasis.
Objective:
The objective of this systematic review is to determine the association of obesity with psoriasis severity.
Methods:
We searched PubMed, EMBASE, and Cochrane Database for English-language papers involving human subjects for all years. We extracted data on age, sex, body mass index (BMI), proportion obese, and psoriasis severity index score (PASI).
Results:
We identified 254 articles in our search and included 9. The sample size was 134 823 psoriasis patients. Seven of the 9 studies found a statistically significant association of increased psoriasis severity with higher BMI.
Conclusion:
Increased severity of psoriasis appears to be associated with increased BMI. Most studies were cross-sectional or case-control, making it difficult to determine temporality. Dermatologists should consider recording BMI for psoriasis patients and offering them lifestyle counseling.
MenterAGottliebAFeldmanSR. Guidelines of care for the management of psoriasis and psoriatic arthritis, section 1: overview of psoriasis and guidelines of care for the treatment of psoriasis with biologics. J Am Acad Dermatol. 2008;58(5):826-850.
2.
GulliverW. Long-term prognosis in patients with psoriasis. Br J Dermatol. 2008;159(suppl 2):2-9.
3.
MussiABonifatiCCarducciM. Serum TNF-alpha levels correlate with disease severity and are reduced by effective therapy in plaque-type psoriasis. J Biol Regul Homeost Agents. 1997;11(3):115-118.
4.
CalderPCAhluwaliaNBrounsF. Dietary factors and low-grade inflammation in relation to overweight and obesity. Br J Nutr. 2011;106(suppl 3):S5-S78.
5.
O’RourkeRW. Inflammation, obesity, and the promise of immunotherapy for metabolic disease. Surg Obes Relat Dis. 2013;9(5):609-616.
6.
LiberatiAAltmanDGTetzlaffJ. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009;339:b2700.
7.
US Preventive Services Task Force. U.S. Preventive Services Task Force procedure manual. Appendix VII. AHRQ Publication No. 08-05118-EF. July2008. http://www.ncbi.nlm.nih.gov/books/NBK47515/. Accessed February 25, 2013. 2008.
8.
HowickJChalmersIGlasziouP. Oxford levels of evidence 2. Oxford Centre for Evidence-Based Medicine. http://www.cebm.net/index.aspx?o=5653. Accessed March 1, 2013.
9.
AhdoutJKotlermanJElashoffDKimJChiuMW. Modifiable lifestyle factors associated with metabolic syndrome in patients with psoriasis. Clin Exp Dermatol. 2012;37(5):477-483.
10.
BholeVMChoiHKBurnsLC. Differences in body mass index among individuals with PsA, psoriasis, RA and the general population. Rheumatology (Oxford). 2012;51(3):552-556.
11.
BardazziFBalestriRBaldiEAntonucciADe TommasoSPatriziA. Correlation between BMI and PASI in patients affected by moderate to severe psoriasis undergoing biological therapy. Dermatol Ther. 2010;23(suppl 1):S14, S19.
12.
HuangYHYangLCHuiRY. Relationships between obesity and the clinical severity of psoriasis in Taiwan. J Eur Acad Dermatol Venereol. 2010;24(9):1035-1039.
13.
MurrayMLBergstresserPRAdams-HuetBCohenJB. Relationship of psoriasis severity to obesity using same-gender siblings as controls for obesity. Clin Exp Dermatol. 2009;34(2):140-144.
14.
NeimannALShinDBWangXMargolisDJTroxelABGelfandJM. Prevalence of cardiovascular risk factors in patients with psoriasis. J Am Acad Dermatol. 2006;55(5):829-835.
15.
Soltani-ArabshahiRWongBFengBJGoldgarDEDuffinKCKruegerGG. Obesity in early adulthood as a risk factor for psoriatic arthritis. Arch Dermatol. 2010;146(7):721-726.
16.
DuarteGVOliveira MdeFCardosoTM. Association between obesity measured by different parameters and severity of psoriasis. Int J Dermatol. 2013;52(2):177-181.
17.
XueKLiuHJianQ. Leptin induces secretion of pro-inflammatory cytokines by human keratinocytes in vitro—a possible reason for increased severity of psoriasis in patients with a high body mass index. Exp Dermatol. 2013;22(6):406-410.
18.
GreenbergASObinMS. Obesity and the role of adipose tissue in inflammation and metabolism. Am J Clin Nutr. 2006;83(2):461S-465S.
19.
YudkinJSStehouwerCDEmeisJJCoppackSW. C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue?Arterioscler Thromb Vasc Biol. 1999;19(4):972-978.
20.
Zahorska-MarkiewiczBOlszanecka-GlinianowiczMJanowskaJKocelakP. The effect of weight loss on serum concentrations of FAS and tumour necrosis factor alpha in obese women. Endokrynol Pol. 2008;59(1):18-22.
21.
AricanOAralMSasmazSCiragilP. Serum levels of TNF-alpha, IFN-gamma, IL-6, IL-8, IL-12, IL-17, and IL-18 in patients with active psoriasis and correlation with disease severity. Mediators Inflamm. 2005;2005(5):273-279.
22.
KimballABJacobsonCWeissSVreelandMGWuY. The psychosocial burden of psoriasis. Am J Clin Dermatol. 2005;6(6):383-392.
23.
BlockJPHeYZaslavskyAMDingLAyanianJZ. Psychosocial stress and change in weight among US adults. Am J Epidemiol. 2009;170(2):181-192.
24.
BellCGWalleyAJFroguelP. The genetics of human obesity. Nat Rev Genet. 2005;6(3):221-234.
25.
JensenPZachariaeCChristensenR. Effect of weight loss on the severity of psoriasis: a randomized clinical study. JAMA Dermatol. 2013;149(7):795-801.
26.
de Menezes EttingerJEAzaroEde SouzaCA. Remission of psoriasis after open gastric bypass. Obes Surg. 2006;16(1):94-97.
27.
FariasMMAchurraPBozaCVegaAdelaCruzC. Psoriasis following bariatric surgery: clinical evolution and impact on quality of life on 10 patients. Obes Surg. 2012;22(6):877-880.
28.
HosslerEWMaroonMSMowadCM. Gastric bypass surgery improves psoriasis. J Am Acad Dermatol. 2011;65(1):198-200.
29.
HammingaEAvan der LelyAJNeumannHAThioHB. Chronic inflammation in psoriasis and obesity: implications for therapy. Med Hypotheses. 2006;67(4):768-773.
30.
PappKPoulinYVieiraA. Examining the risk of cardiovascular disease in patients with psoriasis: a critical review. J Cutan Med Surg. 2013;17(2):89-105.
31.
FlemingPGodwinM. Lifestyle interventions in primary care: systematic review of randomized controlled trials. Can Fam Physician. 2008;54(12):1706-1713.
