Adolescents with psoriasis had elevated levels of cardiovascular and metabolic risk factors compared with their counterparts without psoriasis. However, psoriasis in adolescents was generally of mild severity, results from a Danish cohort study published in the Journal of the European Academy of Dermatology suggest.
Adolescents with and without psoriasis were identified from the Danish National Birth Cohort, which comprises data from more than 100,000 children born between 1996 and 2002. Eligible individuals belonged to 1 of 3 categories: those with psoriasis, those with no psoriasis but with maternal predisposition to psoriasis, and those with no psoriasis and no maternal predisposition. Psoriasis diagnosis and maternal predisposition were captured from Danish National Birth Cohort-administered follow-up surveys. Participants then underwent a thorough clinical examination and a series of laboratory tests. The Psoriasis Area and Severity Index was used to quantify psoriasis severity. Blood samples were collected to measure glycated hemoglobin (HbA1c), cholesterol, triglycerides, and C-reactive protein levels. Body mass index, blood pressure, and measures of abdominal obesity were also calculated.
A total of 315 adolescents were enrolled, of whom 81 had psoriasis, 110 had genetic predisposition for psoriasis, and 124 had neither psoriasis nor genetic predisposition. Demographic characteristics were comparable in the 3 groups: median ages were 16.0 (range, 13.5-18.5) years, 15.3 (range, 13.5-18.0) years, and 15.6 (range, 13.8-18.4) years, respectively. A greater percentage of boys (53.1%) was observed in the psoriasis group compared with the psoriasis-free predisposed (44.6%) and psoriasis-free non-predisposed (44.4%) groups. Diaper rash in infancy was significantly more common in the psoriasis group compared with the predisposed and non-predisposed groups (18.5% vs 10.0% vs 4.8%, respectively). Among patients with psoriasis, 66 (81.5%) presented with active disease at study examination.
The most common psoriasis sites at evaluation were scalp (75.8%) and elbows (34.9%). Median Psoriasis Area and Severity Index score was 1.2 (range, 0.1-11.4), indicating relatively mild disease. Obesity was more common in patients with psoriasis than among patients without psoriasis (8.6% vs 1.7%; P =.008). Measures of abdominal obesity were also elevated in the psoriasis group, including waist-to-height and waist-to-hip ratios. HbA1c levels were significantly elevated in the psoriasis group compared with control patients (31.55 vs 30.81 mmol/mol; P =.048). No differences in blood pressure, lipids, or C-reactive protein levels were observed between groups.
Overall, these data suggest that adolescents with psoriasis may be at increased risk for certain cardiometabolic conditions. Psoriatic disease severity was generally low in the studied cohort. As a result, estimates of certain biomarker prevalence rates may be conservative. The researchers suggest that further investigation into the pathophysiology of these risk factors in youth with psoriasis is warranted.
Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
Blegvad C, Nybo Andersen AM, Groot J, Zachariae C, Barker J, Skov L. Clinical characteristics including cardiovascular and metabolic risk factors in adolescents with psoriasis [published online January 27, 2020]. J Eur Acad Dermatol Venereol. doi:10.1111/jdv.16229