title: High prevalence of metabolic syndrome in patients with psoriasis in Lebanon: a prospective study.
abstract: BACKGROUND
  Psoriasis is a chronic inflammatory disease that affects not only the skin but also other organs as well. Genetic factors play an important role in individual predisposition. Lately, a positive association has been confirmed between psoriasis and metabolic syndrome (MBS), in western as well as in Middle Eastern countries.
  
  
  OBJECTIVE
  Assess the prevalence of MBS in Lebanese patients with psoriasis and the differential effect according to types and disease severity.
  
  
  METHODS
  This was a case-control study including 150 psoriasis patients and 150 age- and gender-matched controls admitted to the dermatology clinics at the American University of Beirut-Medical Center, a tertiary care center in Beirut. Psoriasis severity was assessed by the Psoriasis Area Severity Index (PASI). Blood samples were collected from fasting subjects and tested for glucose, HDL cholesterol, triglycerides, and C-reactive protein (CRP). Multivariate binary logistic regression models were built to assess the relationship between MBS and psoriasis, after adjustment for smoking as a possible confounding variable.
  
  
  RESULTS
  Patients with psoriasis were two times more likely to have MBS as compared to controls (35.3% vs 18.0%, P < 0.001) with an odds ratio (OR) of 2.4. All components of MBS were more prevalent in psoriasis patients than in controls. PASI score was greater in patients with MBS than those without MBS (10.5 ± 11.5 vs. 7.0 ± 8.1, P = 0.05). MBS prevalence tended to be higher in the inverse type than in others (52.2% versus 32.3%; P = 0.06) and in patients with nail pitting versus those without (45.3% vs. 28.2%; P = 0.03).
  
  
  CONCLUSIONS
  This was the first study to assess the prevalence of MBS in Lebanese subjects with psoriasis and, to our knowledge, the first study that showed a higher likelihood of MBS in patients with inverse psoriasis and with nail pitting.
authors.affiliation: Department of Dermatology, American University of Beirut, Beirut, Lebanon.
authors.forename: Salam
authors.initials: S
authors.lastname: Itani
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
authors.forename: Asma
authors.initials: A
authors.lastname: Arabi
authors.affiliation: Department of Dermatology, American University of Beirut, Beirut, Lebanon.
authors.forename: Dana
authors.initials: D
authors.lastname: Harb
authors.affiliation: Department of Dermatology, American University of Beirut, Beirut, Lebanon.
authors.forename: Diana
authors.initials: D
authors.lastname: Hamzeh
authors.affiliation: Department of Dermatology, American University of Beirut, Beirut, Lebanon.
authors.forename: Abdul-Ghani
authors.initials: AG
authors.lastname: Kibbi
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D011565:Psoriasis / Q000145:classification / Q000453:epidemiology*; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult