Psoriasis linked to cluster of diseases known as metabolic syndrome
By Cliff Collins
Editor's note: This is the fourth in a series of Psoriasis Advance articles about health risks associated with psoriasis. Previous articles discussed overall health risks, the risk of developing heart disease and a potential cancer link. This and future articles will look at individual health conditions (doctors call them comorbidities) associated with psoriasis.
Medical specialists know that psoriasis is associated with other disorders that fall under the umbrella term "metabolic syndrome."
Several health organizations use varying definitions for diagnosing metabolic syndrome, but according to guidelines developed by the National Cholesterol Education Program, with modifications by the American Heart Association, you have metabolic syndrome if you have three or more of these characteristics:
- Obesity: a waist size greater than 35 inches for women and 40 inches for men. Certain genetic risk factors, such as having a family history of diabetes or being of Asian descent, lower the waist circumference limit: If you have one of these genetic risk factors, waist size limits are 31 to 35 inches for women and 37 to 39 inches for men.
- Abnormal blood cholesterol levels: either elevated triglycerides (a type of fat in the blood) or low levels of HDL (the "good cholesterol")
- High blood pressure
- Diabetes or insulin resistance
Metabolic syndrome has been estimated to affect up to 24 percent of American adults, with the highest prevalence in people ages 60 through 69.
One 2009 study showed that older age as well as greater severity and surface of the body covered by psoriasis were associated with an increased likelihood of having metabolic syndrome, whereas the length of time a patient has had psoriasis and the type of the disease did not affect the risk.
As a chronic inflammatory condition, psoriasis contributes to the increased risk for developing metabolic syndrome, according to Dr. M. Alan Menter, chairman of the psoriasis research unit of Baylor Research Institute at Baylor University Medical Center in Dallas.
Menter co-authored a study, "Psoriasis and the metabolic syndrome," published in the June 2008 Journal of Drugs in Dermatology. The study found that people with metabolic syndrome were up to 2 1/2 times more likely to develop coronary heart disease during an 11-year follow-up period than those who did not have metabolic syndrome. The risk increases as patients acquire additional disorders that are associated with metabolic syndrome.
In addition, the study found that people with metabolic syndrome have a higher risk of dying of heart attack or cardiovascular disease.
Menter and his co-authors advise that patients with psoriasis should be evaluated for risk factors of metabolic syndrome and provided appropriate treatment, if necessary. Further studies are needed to determine whether drugs such as so-called TNF inhibitors that sometimes are prescribed for psoriasis treatment could also improve associated metabolic syndrome or cardiovascular risks.
What you can do
You can do something about your risk of metabolic syndrome and its complications such as diabetes, stroke and heart disease. Start by making these lifestyle changes, as recommended by the Mayo Clinic:
- Lose weight. Losing as little as 5 percent to 10 percent of your body weight can reduce insulin levels and blood pressure, and decrease your risk of diabetes.
- Exercise. Doctors recommend getting 30 to 60 minutes of moderate-intensity exercise, such as brisk walking, every day.
- Stop smoking. Smoking cigarettes increases insulin resistance and worsens the health consequences of metabolic syndrome.
- Eat fiber-rich foods. Make sure you include whole grains, beans, fruits and vegetables in your grocery cart. These items are packed with dietary fiber, which can lower your insulin levels.