Introduction: A number of studies have suggested an epidemiologic association between metabolic syndrome and psoriasis. A systematic review of the literature is necessary to determine whether the synthesis and interpretation of recent studies support the relationship between psoriasis and metabolic syndrome. The objective of this study conducted a comprehensive systematic review that synthesizes and interprets primary observational studies in order to elucidate the relationship between psoriasis and metabolic syndrome.
Evidence acquisition: We performed a systematic review search using the MEDLINE, EMBASE, Cochrane Central Register, and SCOPUS databases (1946-2016) and performed a manual search of selected references. We identified English-language, human-subject, observational studies that examined the prevalence of metabolic syndrome in conjunction with psoriasis.
Evidence synthesis: We included data from 17 articles with an aggregate of 28,939 participants, among whom 3791 were psoriasis patients. Overall, the studies reported a higher prevalence of metabolic syndrome in patients with psoriasis. The odds ratio (OR) for metabolic syndrome and psoriasis ranged from 1.39-4.49, and the adjusted OR ranged from 1.29 to 5.14. The studies reported a higher prevalence of the individual components of metabolic syndrome in patients with psoriasis. A dose-response relationship was observed between psoriasis severity and the prevalence of metabolic syndrome. Due to the scarcity of cohort studies, it is difficult to fully examine the impact of psoriasis on the development of metabolic syndrome. Variability in how outcomes were recorded existed among some studies, which made between-study comparisons difficult.
Conclusions: Psoriasis patients have a greater prevalence of metabolic syndrome as well as its individual components when compared to the general population. The odds of metabolic syndrome and its components are higher with increased psoriasis disease severity. Prospective studies are needed to better understand the contribution of psoriasis in the development of metabolic syndrome.