Modifiable lifestyle factors associated with metabolic syndrome in patients with psoriasis

Psoriasis is a chronic inflammatory skin disease, which is associated with obesity and with cardiovascular morbidity and mortality.

To evaluate modifiable lifestyle factors including stress level, physical activity and nutrition, which may be associated with metabolic syndrome in patients with psoriasis.

In total, 65 patients with psoriasis and 52 control subjects from our university dermatology clinic were enrolled in this case-control pilot study. The study questionnaire included the Perceived Stress Scale (PSS), the Godin Leisure-Time Exercise Questionnaire (GLTEQ) and the Rapid Eating Assessment for patients (REAP). For subjects with psoriasis, the Psoriasis Area and Severity Index (PASI) was measured.

Subjects with psoriasis (mean BMI 27.72) displayed a trend towards a higher BMI compared with controls (mean BMI 25.67). Subjects with psoriasis were not found to have an increased prevalence of self-reported metabolic syndrome-associated diseases including diabetes, heart disease, high cholesterol, hypertension or stroke compared with controls (P=0.25, P=0.46, P=0.96, P=0.26, and P=0.16, respectively). There was no significant difference in exercise or stress between patients with psoriasis and controls (P=0.06 and P=0.26, respectively). However, compared with controls, subjects with psoriasis (mean REAP score=2.23) did report poorer overall nutrition as assessed by the REAP score (mean=2.38, P<0.01). Among subjects with psoriasis, the factors of stress, smoking and systemic therapy were associated with increased PASI (r=0.13, r=3.47 and r=3.19, respectively).

Our study suggests that poor dietary and exercise habits may be factors contributing to obesity and metabolic syndrome in patients with psoriasis. Further studies with larger numbers are needed to confirm these results.