Psoriasis and metabolic syndrome: a systematic review and meta-analysis of observational studies.
BACKGROUND
Increasing population-based studies have suggested a relationship between psoriasis and metabolic syndrome.


OBJECTIVE
The objective of this study was to perform a systematic review and meta-analysis that synthesizes the epidemiologic associations between psoriasis and metabolic syndrome.


METHODS
We searched for observational studies from MEDLINE, EMBASE, and Cochrane Central Register from Jan 1, 1980 to Jan 1, 2012. We applied the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines in the conduct of this study.


RESULTS
We identified 12 observational studies with a total of 1.4 million study participants fulfilling the inclusion criteria, among whom 41,853 were patients with psoriasis. Based on random-effects modeling of cross-sectional and case-controlled studies, the pooled odds ratio (OR) for metabolic syndrome among patients with psoriasis was 2.26 (95% confidence interval [CI] 1.70-3.01) compared with the general population. Visual inspection of a funnel plot and formal analysis with the Egger test suggested publication bias and absence of small studies in the published literature (P = .03). A dose-response relationship was also observed between psoriasis severity and prevalence of metabolic syndrome.


CONCLUSIONS
No studies to date have assessed incidence of metabolic syndrome among patients with psoriasis.


CONCLUSIONS
Compared with the general population, psoriasis patients have higher prevalence of metabolic syndrome, and patients with more severe psoriasis have greater odds of metabolic syndrome than those with milder psoriasis.
University of California Davis, Department of Dermatology, Sacramento, California. Electronic address: aprilarmstrong@post.harvard.edu.
April W
AW
Armstrong
University of California Davis, Department of Dermatology, Sacramento, California.
Caitlin T
CT
Harskamp
University of California Davis, Department of Cardiovascular Medicine, Sacramento, California.
Ehrin J
EJ
Armstrong
D006801:Humans; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D011565:Psoriasis / Q000150:complications* / Q000453:epidemiology