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The Best of the Best
September 2010

Top-Accessed Article: Psoriasis Associated With Hyperleptinemia

Arch Dermatol. 2010;146(9):1057. doi:10.1001/archdermatol.2010.202

Chen YJ, Wu CY, Shen JL, Chu SY, Chen CK, Chang YT, Chen CM. Psoriasis independently associated with hyperleptinemia contributing to metabolic syndrome. Arch Dermatol. 2008;144(12):1571-1575.

In the last 4 years, several large population-based epidemiological studies have suggested that psoriasis, especially when severe, may be an independent risk factor for heart attack, stroke, cardiovascular death, atherosclerosis, and diabetes. Chen and colleagues demonstrated in a small clinic-based cross-sectional study that psoriasis may be an independent risk factor for increased levels of serum leptin, an adipocyte-derived hormone that is involved in the regulation of metabolism and inflammation. The severity of psoriasis was not associated with statistically significant increases in leptin levels. Based on the design of the study, the directionality of the association cannot be determined. Moreover, the clinical significance of elevated leptin as defined by this study is unclear. In particular, in multivariable analysis, the odds ratio (OR) of increased leptin was similar in psoriasis (OR, 4.47; 95% confidence interval [CI], 1.47-14.23) and metabolic syndrome (OR, 4.37; 95% CI, 1.06-17.96), but the most significant risk factor was female sex (OR, 26.36; 95% CI, 7.41-93.75). Additional studies evaluating inflammatory cardiovascular risk biomarkers in patients with psoriasis are indicated.

From June 2004 through August 2009, this article was viewed 2277 times on the Archives of Dermatology Web site.

Contact Dr Gelfand at Department of Dermatology, Center for Clinical Epidemiology and Biostatistics, Hospital of the University of Pennsylvania, One Convention Avenue, 1471 Penn Tower, Philadelphia PA 19104 (joel.gelfand@uphs.upenn.edu).