Prevalencija metaboličkog sindroma kod obolelih od psorijaze

Abstract

Uvod. Najnovija epidemiološka istraživanja ukazuju na nezavisnu povezanost psorijaze i metaboličkog sindroma (MS). Cilj rada bio je da se utvrdi prevalencija MS i pojedinih njegovih komponenti kod obolelih od psorijaze u odnosu na kontrolnu grupu pacijenata bez psorijaze, kao i da se odrede mogući prediktivni faktori za MS. Metod. Istraživanje koje je sprovedeno po tipu hospitalne studije preseka obuhvatilo je 244 pacijenta ambulantno i hospitalno lečenih od psorijaze i 163 pacijenta sa drugim dermatološkim bolestima koji su činili kontrolnu grupu, na Klinici za dermatovenerologiju, Kliničkog centra Srbije, od oktobra 2011. do oktobra 2012. godine. MS je definisan prisustvom tri ili više revidiranih kriterijuma National Cholesterol Education Program’s Adult Panel III (NCEP ATP III). Težina kliničke slike psorijaze merena je pomoću Psoriasis Area and Severity Index (PASI) i Body Surface Area (BSA). Rezultati. Prevalencija MS bila je značajno veća kod obolelih od psorijaze u odnosu na kontrolnu grupu (45,1% naspram 19,6%, p<0,001). Sve komponente MS, osim sniženih vrednosti HDL holesterola bile su značajno učestalije u grupi sa psorijazom u odnosu na kontrolnu grupu: abdominalna gojaznost (46,7% naspram 26,4%), hipertrigliceridemija (38,1% naspram 24,5%), povišen krvni pritisak (67,2% naspram 25,8%), hiperglikemija ili dijabetes tip 2 (31,6% naspram 13,5%). Statistički značajna povezanost između MS i težine psorijaze nije utvrđena. Kasniji početak i duže trajanje psorijaze su prediktivni faktori za MS kod obolelih od psorijaze. Zaključak. Značajno učestalija prevalencija MS kod obolelih od psorijaze, bez razlike u odnosu na težinu bolesti, naglašava potrebu za njihovim ranim lečenjem i praćenjem u cilju otkrivanja i kontrolisanja mogućih metaboličkih komorbiditeta.

Introduction. Emerging epidemiological evidence suggests independent association between psoriasis and metabolic syndrome (MetS). The aims of this study were to investigate the prevalence of MetS and its components in patients with psoriasis, to compare them with control subjects without psoriasis, and to assess which factors may predict MetS in psoriatic patients. Method. We performed a hospital-based, cross-sectional study with 244 psoriatic patients and 163 control subjects with skin diseases other than psoriasis, at the Clinic of Dermatovenereology, Clinical Center of Serbia, from October 2011 to October 2012. MetS was defined by the presence of three or more criteria of the revised National Cholesterol Education Program’s Adult Panel III (NCEP ATP III). Severity of psoriasis was measured by Psoriasis Area and Severity Index (PASI) and Body Surface Area (BSA). Results. The MetS was more prevalent in patients with psoriasis compared to controls (45.1% vs. 19.6%, P<0.001). All the components of MetS, except low level of HDL, were significantly higher in psoriatic group compared with controls: abdominal obesity (46.7% vs. 26.4%), raised triglyceride (38.1% vs.24.5%), high blood pressure (67.2% vs. 25.8%), and raised glucose or type 2 DM (31.6% vs.13.5%).We failed to find any statistically significant association between the MetS and clinical severity of psoriasis. Later onset and longer duration of psoriasis were predicting factors for MetS in our patients. Conclusion. A higher prevalence of MetS in patients with psoriasis than in controls, regardlless of disease severity, emphasizes the need for early treatment and follow-up of all psoriatic patients with respect to metabolic diseases.