Cardiovascular comorbidities in childhood psoriasis

Psoriasis is a common, chronic, systemic inflammatory skin disease associated with numerous cardiovascular comorbidities. Much evidence of this association exists in the adult population, data available in childhood psoriasis is more limited.

To analyze the prevalence of excess adiposity, cardiovascular risk factors, metabolic syndrome and lipid profile in children with psoriasis comparing to control group with similar age and sex distribution.

A case-control study was conducted with children, 5-15 years-old, with moderate-to-severe plaque-type psoriasis and a control group comprising children with other skin diseases without systemic inflammatory diseases.

Psoriatic children had a significantly higher prevalence and greater odds of excess adiposity compared to controls: BMI (≥85(th) percentile; OR 4.4; 95%CI 1.2-15.6), waist circumference (>75(th) percentile; OR 7.4; 95%CI 2.0-27.7) and waist-to-height ratio (>0.490; OR 4.6; 95%CI 1.3-17.0). A higher prevalence of metabolic syndrome was observed in children with psoriasis compared to controls (25% vs 3.7%; P = 0.07), and two components of the metabolic syndrome were significantly higher in the psoriasis group: waist circumference (75% vs 29.6%; P = 0.002) and the high blood pressure component (30% vs 3.7% P = 0.032). Finally, an altered and more atherogenic lipid profile was observed among psoriatic patients without excess adiposity.

This study demonstrates that comorbidities known to be associated with adult psoriasis are also observed in childhood psoriasis, reinforcing the need for screening cardiovascular comorbidities in children with psoriasis and promoting healthy lifestyle choices in these patients. Moreover, it also suggests that its association with psoriasis may be in part genetically determined rather than uniquely acquired.