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Published on: March 1, 2024
Does the onset of psoriasis in childhood or adulthood affect cardiovascular comorbidity?
Leyla Baykal Selçuk1, Esra Adişen2, Yusuf C Edek2
1Department of Dermatology, School of Medicine, Karadeniz Techinical University, Trabzon, Türkiye - lb_leyla@hotmail.com.
Insights
Childhood-onset psoriasis (COP) patients show similar metabolic syndrome rates but earlier obesity onset compared to adult-onset psoriasis (AOP). Early, aggressive treatment is crucial for managing comorbidities in psoriasis patients.
Area of Science:
- Dermatology
- Cardiology
- Endocrinology
Background:
- Psoriasis is a chronic inflammatory disease linked to cardiovascular and metabolic issues.
- Childhood-onset psoriasis (COP) may influence long-term comorbidity development.
- Understanding these links is vital for patient management.
Purpose of the Study:
- To examine the correlation between childhood-onset psoriasis and adult cardiovascular/metabolic comorbidities.
- Focus on patients aged 30-50 years to assess long-term impacts.
Main Methods:
- A cross-sectional, multicenter study of 1922 psoriasis patients.
- Collected data on demographics, disease, comorbidities, labs, and treatments.
- Used logistic regression to identify associated factors for comorbidities.
Main Results:
- 34.5% of patients had psoriasis onset before age 18.
- Metabolic syndrome prevalence and onset age were similar between childhood-onset psoriasis (COP) and adult-onset psoriasis (AOP) groups.
- Obesity onset was earlier in COP, but no direct link to psoriasis onset was found. Higher cholesterol, LDL, and HOMA-IR in AOP. COP patients used more systemic/biologic treatments earlier.
Conclusions:
- Metabolic syndrome prevalence and onset age are comparable in COP and AOP.
- Earlier obesity onset in COP highlights the need for weight management in pediatric psoriasis.
- Comprehensive treatment addressing skin and systemic conditions is essential for long-term outcomes.
Background:
Psoriasis is a chronic, immune-mediated inflammatory disease with a prevalence of 2-3% in the general population and 0.7-1.2% among children in Western countries. It is often associated with comorbidities, particularly cardiovascular and metabolic diseases. This study aims to investigate the correlation between the onset of psoriasis during childhood (COP) and the prevalence of cardiovascular and metabolic comorbidities in adulthood, focusing on patients aged 30-50 years.
Methods:
A cross-sectional, multicenter study was conducted involving 1922 psoriasis patients from 12 centers across Türkiye. Data collected included demographic information, disease characteristics, cardiovascular and metabolic comorbidities, laboratory parameters, and treatment history. Metabolic syndrome (MetS) was diagnosed based on established criteria, and logistic regression analysis was used to identify factors associated with comorbidities.
Results:
Among the patients, 34.5% had the onset of psoriasis before the age of 18. The average duration of the disease was 28.28±53.42 years. The prevalence and age of onset of MetS were similar in both COP and AOP groups. Although the onset age of obesity was earlier in COP patients, no direct connection between the onset of psoriasis and obesity prevalence was established. Total cholesterol, LDL-cholesterol, and HOMA-IR levels were higher in the AOP group. The use of systemic and biological treatments was significantly higher in COP patients, with earlier initiation of biological treatments.
Conclusions:
The prevalence and age of onset of MetS were similar in COP and AOP patients. The onset age of obesity was earlier in COP patients, emphasizing the importance of weight management in pediatric psoriasis. Early and aggressive treatment targeting systemic inflammation may improve long-term outcomes by reducing comorbidities in psoriatic patients. This study highlights the need for a comprehensive treatment approach addressing both skin symptoms and associated systemic conditions.
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