About one-third of patients with psoriasis globally have metabolic syndrome (MetS), according to findings from a study published in the Journal of the European Academy of Dermatology and Venereology.
Researchers conducted a systematic review and meta-analysis after a search of the PubMed, Embase, CNKI, Wanfang, and Sinomed databases through September 2021. Eligible studies were original research with an observational design and full text available, included a population of patients with psoriasis and the absolute number or percentage of MetS cases, and met specific diagnostic criteria.
The Agency for Healthcare Research and Quality tool was used to assess the risk for bias in cross-sectional studies, and the Newcastle-Ottawa Scale was used to evaluate the quality of case-control and cohort studies.
A total of 45 studies were included in the analysis, of which 1 study was omitted from the quality evaluations. All studies reported the pooled prevalence of MetS in patients with psoriasis, 15 reported the prevalence in men and women, 38 reported the prevalence in adults, and 4 reported the prevalence in children and teenagers.
The overall prevalence of MetS was 32% (95% CI, 0.26-0.38) in patients with psoriasis. The prevalence of MetS was 32% (95% CI, 0.29-0.36) in adult patients and 9% (95% CI, 0.00-0.18) in children and adolescents.
The prevalence of MetS was comparable for men (35%) and women (35%). Latin America had the highest prevalence (47%), followed by Africa (37%), Europe (34%), Asia (29%), and North America (26%).
Among adult patients with psoriasis in Europe, Asia, and Africa, Israel (55%), Singapore (45%), and Algeria (37%) had the highest prevalence of comorbid psoriasis and MetS. Portugal (25%) had the highest prevalence of MetS in young children with psoriasis, and the United States had the lowest prevalence (0.38%).
The prevalence of MetS in patients with psoriasis vulgaris, erythrodermic psoriasis, pustular psoriasis, psoriatic arthritis, and mixed psoriasis was 29%, 16%, 15%, 28%, and 17%, respectively. The prevalence of mild to moderate psoriasis with MetS was 31%, and the prevalence of severe psoriasis with MetS was 37%.
Meta-regression analysis determined that age group (P <.001), research region (P =.024), and diagnostic criteria (P =.002) were sources of heterogeneity. A sensitivity analysis showed no statistically significant difference in the findings after the exclusion of any study.
Among several study limitations cited by the researchers, most of the included studies were of medium quality, and only studies published in Chinese and English were included. Also, the prevalence of MetS in patients with psoriasis was not reported in some countries.
“Our findings suggest the need to identify and manage metabolic disorders in patients with psoriasis,” stated the researchers. “Future studies should evaluate the pathogenesis of MetS in this patient population.”
Liu L, Cai X-C, Sun X-Y, et al. Global prevalence of metabolic syndrome in patients with psoriasis in the past two decades: current evidence. J Eur Acad Dermatol Venereol. Published online June 6, 2022. doi:10.1111/jdv.18296