Children with psoriasis at increased risk for obesity

Children with psoriasis have a greater risk for being overweight or obese than those without the disorder, report researchers.

The association was present in all the children with psoriasis regardless of the severity of their disorder, but the team found that central obesity was more common in children with severe psoriasis and suggest that "monitoring of these patients should be especially vigilant."

Amy Paller (Northwestern University, Chicago, Illinois, USA) and colleagues recruited 409 children with mild (Physician's Global Assessment score ≤3) or severe psoriasis (Physician's Global Assessment score ≥3) to assess links with body mass index (BMI). A group of 205 similarly aged controls without psoriasis were recruited for comparison purposes.

Writing in the Archives of Dermatology, the team reports that overweight (BMI ≥85th percentile for age/gender) was significantly more common in children with psoriasis than controls, at 37.9% versus 20.5%, regardless of severity of psoriasis.

Similarly, obesity (BMI ≥95th percentile for age/gender) was 4.29 times more common in psoriatic children than controls.

However, this association was more pronounced in children with severe psoriasis (odds ratio [OR]=4.92) than in those with mild psoriasis (OR=3.60). In addition, more children in the severe psoriasis than the mild psoriasis and control groups had a waist circumference above the 90th percentile, at 21.2% versus 14.0% and 9.3%, respectively. Both of these associations were most pronounced in children from the USA compared with those from other countries.

Paller and team also found that waist to height ratio was higher in children with psoriasis than those without, at 0.48 versus 0.46, but severity of psoriasis did not influence this finding.

"Children with psoriasis internationally, regardless of severity, are more likely to be overweight or obese and thus are at increased risk for complications related to excess adiposity," write the authors.

"Should further studies show excess adiposity to be a precursor for psoriasis, attempts at early weight loss and lifestyle modification will be important, not only to decrease the risk of metabolic disease but also to modulate the course of pediatric psoriasis," they conclude.

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