Childhood-Onset Psoriasis and Future Comorbidities
Background Psoriasis is associated with higher prevalences of cardiovascular and metabolic comorbidities in adults but the relationship of age at onset and those prevalences is unknown.
Objective To evaluate whether the childhood onset of psoriasis (COP) is correlated with the frequency of cardiovascular and metabolic comorbidities in adulthood.
Methods This noninterventional, cross-sectional, multicentre study of adults with psoriasis was conducted in 29 dermatology centres in France. Data on sex, age at onset of psoriasis and its clinical characteristics, and cardiovascular risk factors, including weight, body mass index, waist circumference, dyslipidaemia, diabetes, hypertension, smoking, and personal/familial major adverse cardiovascular events (MACE) were systematically recorded.
Results Two thousand two hundred and one patients with psoriasis (male: 56%; mean age: 49 years; 25% with COP) were included consecutively in the study. Univariate analysis showed that COP was associated with lower frequencies of obesity, high waist circumference, diabetes, dyslipidaemia, hypertension, familial cardiovascular disease, MACE and metabolic syndrome, but more frequent active smoking. Multivariate analysis retained age as being associated with frequency of cardiovascular and metabolic comorbidities, and sex with smoking, but not age at the onset of psoriasis. Psoriasis severity was associated with higher frequencies of obesity and psoriatic arthritis.
Conclusion Our results showed that COP does not seem to be an additional risk factor for higher frequencies of cardiovascular and metabolic comorbidities during adulthood.
Psoriasis is a chronic immune-mediated inflammatory disorder affecting 2–3% of the white population in western countries. During the past decade, cardiovascular, i.e. hypertension, coronary diseases, major cardiovascular events (MACE), and metabolic, i.e. obesity, abnormal plasma lipid metabolism, and insulin resistance, comorbidities have been associated with psoriasis. Smoking and parental cardiovascular diseases, two major risk factors for cardiovascular diseases, are also associated with psoriasis. The notion of a psoriatic march is debated. The hypothesis of an aetiological role of psoriasis in cardiovascular and metabolic diseases is supported by pathogenic concepts establishing a link between chronic inflammation in psoriasis, insulin resistance, endothelial cell dysfunction and atherosclerosis.
The childhood onset of psoriasis (COP) is relatively common. According to the literature, 35–50% of patients with psoriasis have the disease before the age of 20 years and in Europe about 1% of children are affected. Some studies also show that children with psoriasis have higher risks for cardiovascular and metabolic comorbidities. Little information is available about the link between COP and cardiovascular and metabolic diseases in adulthood. Recently the authors of one study found that COP did not influence future body mass index (BMI).
Therefore, we conducted a multicentre cross-sectional study to evaluate the potential relationship between age at the onset of psoriasis and the patients' frequencies of cardiovascular risk factors, and cardiovascular and metabolic diseases during adulthood.
Abstract and Introduction
Abstract
Background Psoriasis is associated with higher prevalences of cardiovascular and metabolic comorbidities in adults but the relationship of age at onset and those prevalences is unknown.
Objective To evaluate whether the childhood onset of psoriasis (COP) is correlated with the frequency of cardiovascular and metabolic comorbidities in adulthood.
Methods This noninterventional, cross-sectional, multicentre study of adults with psoriasis was conducted in 29 dermatology centres in France. Data on sex, age at onset of psoriasis and its clinical characteristics, and cardiovascular risk factors, including weight, body mass index, waist circumference, dyslipidaemia, diabetes, hypertension, smoking, and personal/familial major adverse cardiovascular events (MACE) were systematically recorded.
Results Two thousand two hundred and one patients with psoriasis (male: 56%; mean age: 49 years; 25% with COP) were included consecutively in the study. Univariate analysis showed that COP was associated with lower frequencies of obesity, high waist circumference, diabetes, dyslipidaemia, hypertension, familial cardiovascular disease, MACE and metabolic syndrome, but more frequent active smoking. Multivariate analysis retained age as being associated with frequency of cardiovascular and metabolic comorbidities, and sex with smoking, but not age at the onset of psoriasis. Psoriasis severity was associated with higher frequencies of obesity and psoriatic arthritis.
Conclusion Our results showed that COP does not seem to be an additional risk factor for higher frequencies of cardiovascular and metabolic comorbidities during adulthood.
Introduction
Psoriasis is a chronic immune-mediated inflammatory disorder affecting 2–3% of the white population in western countries. During the past decade, cardiovascular, i.e. hypertension, coronary diseases, major cardiovascular events (MACE), and metabolic, i.e. obesity, abnormal plasma lipid metabolism, and insulin resistance, comorbidities have been associated with psoriasis. Smoking and parental cardiovascular diseases, two major risk factors for cardiovascular diseases, are also associated with psoriasis. The notion of a psoriatic march is debated. The hypothesis of an aetiological role of psoriasis in cardiovascular and metabolic diseases is supported by pathogenic concepts establishing a link between chronic inflammation in psoriasis, insulin resistance, endothelial cell dysfunction and atherosclerosis.
The childhood onset of psoriasis (COP) is relatively common. According to the literature, 35–50% of patients with psoriasis have the disease before the age of 20 years and in Europe about 1% of children are affected. Some studies also show that children with psoriasis have higher risks for cardiovascular and metabolic comorbidities. Little information is available about the link between COP and cardiovascular and metabolic diseases in adulthood. Recently the authors of one study found that COP did not influence future body mass index (BMI).
Therefore, we conducted a multicentre cross-sectional study to evaluate the potential relationship between age at the onset of psoriasis and the patients' frequencies of cardiovascular risk factors, and cardiovascular and metabolic diseases during adulthood.
Source...