Clinical Dermatology Review

: 2020  |  Volume : 4  |  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

Correspondence Address:
Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, P.O. Box: 55302, Baghdad Post Office, Baghdad

How to cite this article:
Al-Mendalawi MD. Metabolic syndrome in patients with psoriasis: A hospital-based case–control study.Clin Dermatol Rev 2020;4:64-64

How to cite this URL:
Al-Mendalawi MD. Metabolic syndrome in patients with psoriasis: A hospital-based case–control study. Clin Dermatol Rev [serial online] 2020 [cited 2022 May 22 ];4:64-64
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I read with interest the outstanding study by Gangaiah et al.[1] 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.[1] 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.[2] On the other hand, the updated ATPIII criteria employed in Gangaiah et al' s study [1] is old and it is no more worthy as it was set nearly a decade ago.[3] 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).[4] I wonder why Gangaiah et al.[1] 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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1Gangaiah N, Aysha Roshin NS, Thimmappa V, Shivanna R. Metabolic syndrome in patients with psoriasis: A hospital-based case-Control study. Clin Dermatol Rev 2018;2:64-8.
2Mancia G, Bombelli M, Facchetti R, Casati A, Ronchi I, Quarti-Trevano F, et al. Impact of different definitions of the metabolic syndrome on the prevalence of organ damage, cardiometabolic risk and cardiovascular events. J Hypertens 2010;28:999-1006.
3Alberti KG, Eckel RH, Grundy SM, Zimmet PZ, Cleeman JI, Donato KA, et al. Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; And International Association for the Study of Obesity. Circulation 2009;120:1640-5.
4Mohanan PP. Metabolic syndrome in the Indian population: Public health implications. Hypertens J 2016;2:1-6.