Table of Content - Volume 7 Issue 2 - August 2017
A study of association of metabolic syndrome and psoriasis at tertiary health care centre
T V Ramana Rao1*, Prathyusha Y2, Ajay Kumar Reddy Bobba3
1,2Assistant Professor, Department of Dermatology, Gayatri Vidya Parishad Institute of Health care and Medical Technology, INDIA. 3Assistant Professor, Department of Community Medicine, Pinnamaneni Siddardha Institute of Medical Sciences, INDIA. Email: drtvramanarao94404@gmail.com
Abstract Background: Psoriasis is now considered as a systemic inflammatory disease. The chronic inflammatory nature of psoriasis has been suggested to be a contributing and potentially independent risk factor for development of MS. Aims and Objectives: To Study association of metabolic syndrome and psoriasis at tertiary health care centre. Methodology: After approval from institutional ethical committee this cross-sectional study was carried out at the department of Skin and VD of a tertiary health care centre during one year period i.e. June 2017 to June 2018 in the patients with Psoriasis were studied. All details of the patients like age, sex etc. were noted. The statistical analysis was done by chi-square test and unpaired t-test, was analyzed by SPSS 18 version. Result: The age distribution both the group was comparable i.e. average age both the group was 7 ±3.16 and 7 ±4.95 respectively. (p>0.05). The male to female ratio in group A was 1.91:1 and in Group B was 1.18: 1 was comparable to each other (p>0.05). The disease duration in patients with Metabolic syndrome was 9±5.12 Yrs. and 4±2.34 Yrs. was significantly higher (t = 5.2546, df = 68, p<0.0001). As per the PASI score the severity of psoriasis was significantly more in the patients with Metabolic syndrome (χ2 = 6.898, df=1, p< 0.0086), as per the area of body affected by BSA score; the significantly more area was affected in the patients with metabolic syndrome (χ2 =8.289, df=1, p< 0.004). Conclusion: It can be concluded from our study that severity of the psoriasis and area of affected was significantly associated with the Metabolic syndrome. Key Words: Metabolic Syndrome (MS), Psoriasis Area and Severity Index (PASI), Body surface area (BSA).
INTRODUCTION Psoriasis is now considered as a systemic inflammatory disease. The chronic inflammatory nature of psoriasis has been suggested to be a contributing and potentially independent risk factor for development of MS.1Several studies has shown an association between psoriasis and MS. Most of these were of cross sectional design. There have been only a few case control studies addressing the issue.1,2,3,4,5,6 Only a few studies from India have used the revised population specific criteria for diagnosis of MS.2,3,6 A recent study concluded that inclusion of modified waist circumference and specific body mass index (BMI) cut offs for Asians may help predict MS at an early stage.7 So we have studied the association of metabolic syndrome and psoriasis at tertiary health care centre.
MATERIAL AND METHODS After approval from institutional ethical committee this cross-sectional study was carried out at the department of Skin and VD of a tertiary health care centre during one year period i.e. June 2017 to June 2018 in the patients with Psoriasis were studied. Metabolic syndrome was diagnosed by the presence of three or more of the five criteria of the National Cholesterol Education Program Adult Panel III (ATP III): Waist circumference >102 cm in men or >88 cm in women; hypertriglyceridemia, >1.7 mmol/L (150 mg/dL); HDL cholesterol 130/85 mmHg; fasting plasma glucose of >6.1 mmol/L (100 mg/dL). Those patients who shown above features were included into Group A (with Metabolic Syndrome) were 35, Group B without metabolic syndrome were 35 allotted randomly. Severity of psoriasis was assessed according to Psoriasis Area and Severity Index (PASI) and body surface area (BSA)10. All details of the patients like age, sex etc. were noted. The statistical analysis was done by chi-square test and unpaired t-test, was analyzed by SPSS 18 version.
RESULT
Table 1: Distribution of the patients as per the age
The age distribution both the group was comparable i.e. average age both the group was 7 ±3.16 and 7 ±4.95 respectively. (p>0.05)
Table 2: Sex wise distribution of the patients
The male to female ratio in group A was 1.91:1 and in Group B was 1.18: 1 was comparable to each other (p>0.05)
Table 3: Distribution of the patients as per the Severity of Psoriasis
The disease duration in patients with Metabolic syndrome was 9±5.12 Yrs. and 4±2.34 Yrs. was significantly higher (t = 5.2546, df = 68, p<0.0001). As per the PASI score the severity of psoriasis was significantly more in the patients with Metabolic syndrome (χ2 = 6.898, df=1,p< 0.0086), as per the area of body affected by BSA score ; the significantly more area was affected in the patients with metabolic syndrome (χ2 =8.289,df=1,p< 0.004).
DISCUSSION Psoriasis is a chronic immune‑mediated inflammatory disorder affecting 1%–3% of the general population. Metabolic syndrome (MS) which encompasses the following, namely, central obesity, atherogenic dyslipidemia, hypertension, and glucose intolerance, is considered to arise from insulin resistance and abnormal adipose tissue function.8 Chronic inflammation with persistent elevation of proinflammatory cytokines forms the crux of MS. Various immune mediators such as leptin, adiponectin, tumor necrosis factor-alpha (TNF-α), and interleukin (IL)‑6 have been regarded to play an important role in insulin resistance and therefore in psoriasis pathogenesis associated with MS.9 The age distribution both the group was comparable i.e. average age both the group was 7 ±3.16 and 7 ±4.95 respectively. (p>0.05). The male to female ratio in group A was 1.91 :1 and in Group B was 1.18 : 1 was comparable to each other (p>0.05). The disease duration in patients with Metabolic syndrome was 9±5.12 Yrs. and 4±2.34 Yrs. was significantly higher (t = 5.2546, df = 68, p<0.0001). As per the PASI score the severity of psoriasis was significantly more in the patients with Metabolic syndrome (χ2 = 6.898, df=1,p< 0.0086), as per the area of body affected by BSA score ; the significantly more area was affected in the patients with metabolic syndrome (χ2 =8.289,df=1,p< 0.004). These findings are similar to Chintaginjala Aruna 10 Metabolic syndrome was signifi cantly more common among patients with psoriasis than among controls [42% vs 22%, odds ratio (OR) = 2.5674, P < 0.0028] also Some other studies have reported an increased prevalence of MS in patients with moderate-to-severe psoriasis.11,12 Other studies13,14 detected no correlation between severity of psoriasis and MS. This difference in the findings could be due to difference in study population and difference in the genetic and geographic variation.
CONCLUSION It can be concluded from our study that severity of the psoriasis and area of affected was significantly associated with the Metabolic syndrome
REFERENCES
Policy for Articles with Open Access
|
|