|LETTER TO EDITOR
|Year : 2020 | Volume
| Issue : 1 | Page : 64
Metabolic syndrome in patients with psoriasis: A hospital-based case–control study
Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq
|Date of Submission||10-Aug-2018|
|Date of Decision||21-Nov-2018|
|Date of Acceptance||06-Dec-2018|
|Date of Web Publication||06-Jan-2020|
Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, P.O. Box: 55302, Baghdad Post Office, Baghdad
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Al-Mendalawi MD. Metabolic syndrome in patients with psoriasis: A hospital-based case–control study. Clin Dermatol Rev 2020;4:64
I read with interest the outstanding study by Gangaiah et al. on the metabolic syndrome (MS) in Indian patients with psoriasis. On employing the updated National Cholesterol Education Program–Adult Treatment Panel III (ATPIII) with Asian modification for waist circumference (WC) (ATPIII criteria), the authors found that MS was significantly more common in psoriatic patients than in controls (38% vs. 22%, P = 0.043). Psoriatic patients had higher prevalence of increased fasting blood sugar (FBS) (32% vs. 16%, P = 0.0334), high serum triglyceride (TG) (34% vs. 18%, P = 0.037), low serum high-density lipoprotein cholesterol (HDLC) (50% vs. 20%, P = 0.00093), and hypertension (38% vs. 20%, P = 0.025). Although not statistically significant (P = 0.08), increased values of WC were estimated higher in psoriatic patients than in controls. I presume that these results ought to be interpreted cautiously. This is based on the presence of the following methodological limitation related to the MS definition criteria employed in the study. The impact of this limitation could be explained in dual aspects. On one hand, there are many definition criteria for MS in the clinical field. These include the following: The National Cholesterol Education Program–ATPIII, the American Heart Association (AHA), and the International Diabetes Federation (IDF). Evaluation of these three criteria showed that the prevalence of MS was significantly estimated greater on employing the AHA and IDF as compared to the ATPIII definition and that AHA and IDF definitions were found more sensitive than that of ATPIII in diagnosing MS. On the other hand, the updated ATPIII criteria employed in Gangaiah et al' s study  is old and it is no more worthy as it was set nearly a decade ago. To my knowledge, the new diagnostic MS criteria in the Indian population have been set to be employed in the clinical setting and researches. These include the following: WC >35” in men and >31” in women; serum TG ≥150 mg/dl; serum HDLC <40 mg/dl for men and <50 mg/dl for women; blood pressure ≥130/85 mmHg; and FBS >100 mg/dl (prediabetes). I wonder why Gangaiah et al. did not refer to the Indian-specific MS criteria in their study. I presume that if they employed these criteria, different results might be obtained. Despite the aforementioned limitation, the increased susceptibility of psoriatic patients to have MS compared with the general population necessitates strict actions to minimize the future risk of diabetes mellitus and cardiovascular sequelae.
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Conflicts of interest
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| References|| |
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