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April 11, 2011

Prevalence of the Metabolic Syndrome in Psoriasis: Results From the National Health and Nutrition Examination Survey, 2003-2006

Author Affiliations

Author Affiliations: Departments of Medicine (Drs Love and Karlson) and Dermatology (Dr Qureshi), Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Medicine, Landspitali University Hospital, Reykjavik, Iceland (Dr Love); Department of Dermatology and Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Pittsburgh (Dr Gelfand); and Department of Medicine, Boston University School of Medicine (Dr Choi).

Arch Dermatol. 2011;147(4):419-424. doi:10.1001/archdermatol.2010.370

Objectives  To estimate the prevalence of the metabolic syndrome among individuals with psoriasis and to examine the association between these 2 conditions in the general US population.

Design  Cross-sectional health survey of a nationally representative random sample of the noninstitutionalized civilian US population.

Setting  The National Health and Nutrition Examination Survey, 2003-2006.

Participants  The study included 6549 participants aged 20 to 59 years.

Main Outcome Measures  Prevalence of the metabolic syndrome defined by the revised National Cholesterol Education Program Adult Treatment Panel III definition and odds ratios for associations after adjustment for age, sex, race/ethnicity, smoking status, and C-reactive protein levels.

Results  The prevalence of the metabolic syndrome was 40% among psoriasis cases and 23% among controls. According to 2008 US census data, the projected number of patients with psoriasis aged 20 to 59 years with the metabolic syndrome was 2.7 million. The univariate and multivariate odds ratios for patients with psoriasis and the metabolic syndrome were 2.16 (95% confidence interval, 1.16 to 4.03) and 1.96 (1.01 to 3.77), respectively. The most common feature of the metabolic syndrome among patients with psoriasis was abdominal obesity, followed by hypertriglyceridemia and low levels of high-density lipoprotein cholesterol.

Conclusions  The prevalence of the metabolic syndrome is high among individuals with psoriasis. Given the serious complications associated with the metabolic syndrome, this frequent comorbidity should be recognized and taken into account in the long-term treatment of individuals with psoriasis.