title: Nutrition: a key environmental dietary factor in clinical severity and cardio-metabolic risk in psoriatic male patients evaluated by 7-day food-frequency questionnaire.
abstract: BACKGROUND
  Western dietary pattern is included among the environmental dietary factors involved in the pathogenesis of psoriasis. Nutritional data collection methods and gender differences might affect the association between diet and psoriasis. The 7-day food records is considered the "gold standard" of self-administered food frequency questionnaires. In this study, we evaluated the differences in the dietary intake, anthropometric measurements and cardio-metabolic risk profile in a group of psoriatic patients compared with an age and Body Mass Index (BMI)-matched control group. In addition, in the group of psoriatic patients we investigated the association between the dietary intake and clinical severity of psoriasis.
  
  
  METHODS
  Cross-sectional case control observational study. A total of 82 adult males, 41 treatment-naïve patients with psoriasis and 41 healthy subjects matched for age and BMI were included in the study. The clinical severity of psoriasis was by assessed by Psoriasis Area and Severity Index (PASI) score. The dietary interview data were collected by a 7-day food records. Anthropometric measures, glucose and lipid profile, liver function tests and C-reactive protein levels were measured. Homeostasis Model Assessment of Insulin Resistance (HoMA-IR), Visceral Adiposity Index (VAI) and the Fatty Liver Index (FLI) were calculated.
  
  
  RESULTS
  Psoriatic patients consumed a higher percentage of total and simple carbohydrates, total fat, polyunsaturated fatty acid (PUFA) and n-6/n-3 PUFAs ratio, and cholesterol, while the consumption of protein, complex carbohydrates, monounsaturated fatty acid (MUFA), n-3 PUFA and fiber was lower than in the control group. In addition, psoriatic patients presented altered anthropometric measurements, glucose and lipid profile, liver function tests, and elevated values of HoMA-IR, VAI and FLI. PASI score well correlated with anthropometric measures, glucose and lipid profile, liver function tests, cardio-metabolic indices, and the dietary components, except for protein and total carbohydrates. At logistic regression analysis between PASI score and MUFA, MetS presence was well predicted only by higher PASI score (OR = 1.794; p = 0.002; CI 1.242-2.591). At multiple regression analysis, MUFA was the best predictor of PASI score (r(2) = 0.387, β = -0.635, t = -5.127, p < 0.001).
  
  
  CONCLUSIONS
  Differences in dietary intake were observed in adult male psoriatic patients compared with the controls. These differences were associated to the severity of the psoriasis and cardio-metabolic risk. FLI represented an early indicator of the cardio-metabolic risk profile in psoriatic patients, and dietary MUFA were major predictor of the clinical severity of psoriasis, while the association between psoriasis and metabolic syndrome appeared to be independent of MUFA intake. The low MUFA consumption might act as a possible adjunctive mechanism in increasing the inflammation milieu of psoriatic patients.
authors.affiliation: I.O.S. & COLEMAN Srl, Naples, Italy. luigi.barrea@unina.it.
authors.forename: Luigi
authors.initials: L
authors.lastname: Barrea
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Medical School of Naples, Federico II University, Via Sergio Pansini, 5, 80131, Naples, Italy. pmacchia@unina.it.
authors.forename: Paolo Emidio
authors.initials: PE
authors.lastname: Macchia
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Medical School of Naples, Federico II University, Via Sergio Pansini, 5, 80131, Naples, Italy. tarantin@unina.it.|Centro Ricerche Oncologiche di Mercogliano, Istituto Nazionale per lo studio e la Cura Dei Tumori "Fondazione Giovanni Pascale", IRCCS, Mercogliano, Italy. tarantin@unina.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tarantino
authors.affiliation: IRCCS SDN, Napoli Via Gianturco 113, 80143, Naples, Italy. cdisomma@unina.it.
authors.forename: Carolina
authors.initials: C
authors.lastname: Di Somma
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Medical School of Naples, Federico II University, Via Sergio Pansini, 5, 80131, Naples, Italy. dott.ssapane@libero.it.
authors.forename: Elena
authors.initials: E
authors.lastname: Pane
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Medical School of Naples, Federico II University, Via Sergio Pansini, 5, 80131, Naples, Italy. nicola.balato@unina.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Balato
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Medical School of Naples, Federico II University, Via Sergio Pansini, 5, 80131, Naples, Italy. maddy.napolitano@gmail.com.
authors.forename: Maddalena
authors.initials: M
authors.lastname: Napolitano
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Medical School of Naples, Federico II University, Via Sergio Pansini, 5, 80131, Naples, Italy. colao@unina.it.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Medical School of Naples, Federico II University, Via Sergio Pansini, 5, 80131, Naples, Italy. sisavast@unina.it.
authors.forename: Silvia
authors.initials: S
authors.lastname: Savastano
mesh_terms: D050154:Adiposity; D000328:Adult; D000367:Age Factors; D000886:Anthropometry; D015992:Body Mass Index; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003625:Data Collection; D004032:Diet; D005234:Fatty Liver / Q000473:pathology; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications; D008875:Middle Aged; D009752:Nutritional Status; D011565:Psoriasis / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D014463:Ultrasonography