Obesity Worsens Comorbidity Risk in Children With Psoriasis

Children with psoriasis have a higher risk of developing various comorbidities such as diabetes, hypertension, and metabolic syndrome, according to a new study.

For their study, the researchers assessed claims data on children with psoriasis (n=29,957) and a matched comparator cohort (n=29,957). Mean age was 12.0 years, and 16,034 (53.5%) participants were girls. Children were categorized into 1 of 4 groups: nonobese without psoriasis (reference), nonobese with psoriasis, obese without psoriasis, or obese with psoriasis.
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Results indicated that more affected children were obese than nonaffected children at baseline (2.9% vs 1.5%), and that children with psoriasis had a significantly higher risk of developing comorbidities than those without psoriasis. Specifically, nonobese children with psoriasis had 40% to 75% higher risk of developing various comorbidities vs those without psoriasis, including elevated lipid levels (hazard ratio [HR] 1.42), hypertension (HR 1.64), diabetes (HR 1.58), metabolic syndrome (HR 1.62), polycystic ovarian syndrome (HR 1.49), nonalcoholic liver disease (HR 1.76), and elevated liver enzyme levels (HR 1.46).

The researchers noted that, regardless of psoriasis status, obesity was associated with a higher risk of developing comorbidities. With the exception of hypertension, the researchers observed no significant interaction between psoriasis and obesity in regard to the risk of comorbidities.

“Children with psoriasis are at greater risk of developing obesity, hyperlipidemia, hypertension, diabetes, metabolic syndrome, polycystic ovarian syndrome, nonalcoholic liver disease, and elevated liver function enzyme levels than children without psoriasis,” the researchers concluded. “While psoriasis is a small independent risk factor for the development of these comorbidities, obesity is a much stronger contributor to comorbidity development in children with psoriasis.”

—Christina Vogt

Reference:

Tollefson MM, Van Houten HK, Asante D, Yao X, Kremers HM. Association of psoriasis with comorbidity development in children with psoriasis [Published online January 10, 2018]. JAMA Dermatol. doi:10.1001/jamadermatol.2017.5417.