Sat-24-09-2011, 13:00 PM
Psoriasis is a stronger predictor of elevated cholesterol in children than is body weight, according to an analysis of electronic medical records from Kaiser Permanente Southern California (KPSC). The findings reinforce the need for physicians to address the condition as a systemic metabolic disorder rather than as a superficial skin disease.
The study examined the records of 710,949 children ages 2 through 19 who had at least one visit to KPSC that recorded height and body weight during the years 2007 and 2008. It identified those with a coding for psoriasis or a prescription associated with the treatment of psoriasis; a chart review confirmed the diagnosis in 1,350 patients.
The patient records were stratified into categories of underweight, normal weight, overweight, moderately obese and extremely obese using standard age-adjusted BMI criteria. Excessive body weight was associated with a higher odds for psoriasis. Analyses found the odds ratios for psoriasis were 0.68, 1.00, 1.31, 1.39 and 1.78, respectively.
The odds ratios for severe psoriasis, as assessed by use of systemic therapy or phototherapy by 53 patients, were 0.00, 1.00, 2.78, 2.93 and 4.19, respectively.
Comparing those characterized as overweight to extreme obese to normals, adolescents (ages 12 to 19) with psoriasis had significantly higher mean total cholesterol (P = .020), LDL cholesterol (P = .007), triglycerides (P = 0.14) and ALT (P = .016) than those who did not have psoriasis. The differences were moderate but significant. There was no significant difference between the two groups with regard to HDL.
"I think the most important point for clinicians is that teens with psoriasis have higher cholesterol levels, regardless of their body weight, and this may be a risk factor for cardiovascular disease," says Corinna Koebnick, Ph.D., research scientist at the KPSC's Department of Research & Evaluation and the lead author of the study.
"The second point is that children who are obese have a much higher prevalence of psoriasis. When physicians treat young people for psoriasis, they should monitor for risk factors of cardiovascular disease, especially if the patient is obese," she says.
Source: .modernmedicine.com
The study examined the records of 710,949 children ages 2 through 19 who had at least one visit to KPSC that recorded height and body weight during the years 2007 and 2008. It identified those with a coding for psoriasis or a prescription associated with the treatment of psoriasis; a chart review confirmed the diagnosis in 1,350 patients.
The patient records were stratified into categories of underweight, normal weight, overweight, moderately obese and extremely obese using standard age-adjusted BMI criteria. Excessive body weight was associated with a higher odds for psoriasis. Analyses found the odds ratios for psoriasis were 0.68, 1.00, 1.31, 1.39 and 1.78, respectively.
The odds ratios for severe psoriasis, as assessed by use of systemic therapy or phototherapy by 53 patients, were 0.00, 1.00, 2.78, 2.93 and 4.19, respectively.
Comparing those characterized as overweight to extreme obese to normals, adolescents (ages 12 to 19) with psoriasis had significantly higher mean total cholesterol (P = .020), LDL cholesterol (P = .007), triglycerides (P = 0.14) and ALT (P = .016) than those who did not have psoriasis. The differences were moderate but significant. There was no significant difference between the two groups with regard to HDL.
"I think the most important point for clinicians is that teens with psoriasis have higher cholesterol levels, regardless of their body weight, and this may be a risk factor for cardiovascular disease," says Corinna Koebnick, Ph.D., research scientist at the KPSC's Department of Research & Evaluation and the lead author of the study.
"The second point is that children who are obese have a much higher prevalence of psoriasis. When physicians treat young people for psoriasis, they should monitor for risk factors of cardiovascular disease, especially if the patient is obese," she says.
Source: .modernmedicine.com