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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Obesity is common in psoriatic patients, and it has been shown to be important for many aspects of the condition. In particular, low-calorie diets can improve the symptoms and response to treatment in pustular psoriasis. The present study investigates the influence of body-weight alteration on the disease's clinical manifestations in moderate to severe psoriasis patients treated with biological drugs. Finally, the influence of a caloric restriction was assessed. This observational transversal study enrolled 33 patients attending our Severe Psoriasis Outpatient Clinic, who were treated with biological drugs. Body Mass Index (BMI) was used as a diagnostic indicator of being overweight and of obesity. Waist circumference was also measured. Body weight and Psoriasis Area Severity Index (PASI) index were measured at follow-up visits at 4 and 8 months. Nonparametric test of Mann-Whitney was used to detect the differences between patient groups. Fisher's exact test was performed to evaluate the different results depending on the therapeutic changes of BMI. There was a strong prevalence of overweight-obese individuals in the group with a mean BMI of 30.59 +/- 6.94. Waist circumference was also above normal in the majority of the patients. Obese patients had a PASI index higher than the average of the whole group (25.03 +/- 12.43), with grade III obese patients having an average PASI of 44 +/- 3.37. At the first and second follow-ups, patients who put on weight did not achieve PASI 50; patients who had a stable weight presented variable response to treatment, while patients who decreased their weight achieved PASI 90 or PASI 75 even when not responding at the first. Further studies are needed to understand if the poor response observed in heavier patients is due to biological drugs pharmacokinetics or because therapy should be BMI based rather than administered in fixed doses, posing then an ethical consideration.
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PMID:Correlation between BMI and PASI in patients affected by moderate to severe psoriasis undergoing biological therapy. 2013 16

Psoriasis is well-known immune-mediated skin disease often associated with co-morbidities, including dyslipidaemia and obesity. Few reports imply that the disease might be also related to pathology of mucosal surfaces, especially that of the digestive system. The authors present a case of psoriasis and concurrent digestive system abnormalities, and review the literature regarding the topic. A 40-year-old man suffered from an exacerbation of exudative psoriasis for about 6 months. Topical antipsoriatics proved ineffective and the disease gradually progressed to a severe disseminated form. Subsequent detailed examinations revealed persistent gastroduodenitis due to H. pylori infection, pancreatic dysfunction and fatty change of the liver, although the patient denied any gastrointestinal symptoms. As a result appropriate treatment of the diagnosed digestive system disorders was added to topical antipsoriatic therapy. Within 2 weeks of treatment clinical symptoms and laboratory signs showed a marked trend to normalisation. The presented medical history seems to suggest that there may be some kind of interplay between psoriasis and digestive system disorders.
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PMID:Psoriasis vulgaris and digestive system disorders: is there a linkage? 2016 41

Recent studies suggest that psoriasis patients have higher rates of comorbidities. We sought to determine the prevalence of comorbidities and co-medications in our psoriasis patients. We conducted case-control study in 1835 patients with psoriasis vulgaris and age- and gender-matched cohort without psoriasis. Patients were examined for clinical characteristics of psoriasis, PASI scores, and data of age, sex, body mass index (BMI), smoking status, comorbidities, and co-medications were analysed for both patients and controls. We identified 1661 (92.8%) patients with mild to moderate psoriasis (PASI < 10) and 129 patient's (7.03%) with severe psoriasis (PASI > 10). Patients with psoriasis were more likely to be current smokers (51.34% vs 32.51% controls). Respective prevalence rates of risk factors in those with mild-moderate psoriasis, severe psoriasis, and controls were as follows: inflammatory arthritis (20%, 31% and 10.68%); coronary heart disease (4.1%, 8.35% and 1.42%); obesity (BM1) (32.5%, 41% and 17%); diabetes mellitus type II (37.4%, 41% and 16%); hypertension (32%, 40.3% and 11.55%); dyslipidemia (14.1%, 22.48% and 4.96%); metabolic syndrome (16%, 26.35% and 6.76%); chronic obstructive pulmonary disease (COPD) (5.36%, 6.98% and 4.03%); cancer (0.3%, 1.55% and 0.16%). They had a higher odds of inflammatory arthritis, coronary heart disease, obesity, diabetes mellitus II, hypertension, dyslipidemia, and metabolic syndrome. They were receiving significantly wider varieties of drugs. Which most commonly included antidiabetic drugs, antihypertensives, and hypolipidemic drugs.
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PMID:Comorbidities associated with psoriasis: an experience from the Middle East. 2017 49

There is abundant and accumulating evidence on the classification of psoriasis as a systemic disease that exhibits a host of co-morbidities. As a consequence, the second Interdisciplinary Conference on Co-morbidities and Lifestyle Modification, convened by the International Psoriasis Council, has concluded that specialist physicians, primary care physicians and dermatologists are faced with an opportunity to impact, not just psoriasis disease understanding and management, but overall patient well-being. The conference panel was represented by the disciplines of dermatology, cardiology, rheumatology, epidemiology, endocrinology, hepatology and gastroenterology, and medical specialists with particular expertise in obesity, diabetes mellitus, inflammation and genetics. The multiple co-morbidities associated with psoriasis were reviewed with a view to identify possible mechanisms linking psoriatic disease with obesity, metabolic syndrome, diabetes, cardiovascular disease and non-alcoholic fatty liver disease. Consensus was established on the association of psoriasis with other co-morbidities and disease states. Consequently, there is a significant opportunity for specialist and primary care physicians to collaborate with dermatologists in the management of the overall health of psoriasis patients. First, there is an important need for physicians to routinely screen psoriasis patients for the multiple susceptibility risk factors and co-morbidities associated with psoriasis. Second, the design and implementation of lifestyle modification plans including exercise, diet and the limitation of alcohol and tobacco intake, will not only benefit their general medical health but also their psoriasis.
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PMID:Exploring the association between cardiovascular and other disease-related risk factors in the psoriasis population: the need for increased understanding across the medical community. 2038 92

Psoriasis is an inflammatory, immune-mediated cutaneous disorder that has recently been recognized as systemic disease that is associated with multiple comorbidities such as depression, obesity, and the metabolic syndrome. The metabolic syndrome is the constellation of abdominal obesity, dyslipidemia, hypertension and insulin resistance, and presence of the metabolic syndrome significantly increases a patient's risk for cardiovascular disease, stroke and type 2 diabetes. Recent studies have found that psoriasis patients are at increased risk for metabolic syndrome as well as the individual components of metabolic syndrome, and the two diseases appear linked through a common mechanism of inflammation. Speculation exists as to whether this association is causative or whether it is the result of other habits seen in psoriasis patients, such as increased rates of smoking, alcohol consumption, and sedentary lifestyle, which add to the complexity of the association between psoriasis and the metabolic syndrome. However, psoriasis treatments have been shown to reduce the risk of developing metabolic syndrome components and comorbidities. Future studies are needed to better understand the nature of this relationship and the implications this could have for management and treatment of patients with psoriasis.
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PMID:Psoriasis and the metabolic syndrome. 2041 20

Recently, it has emerged a strong association between increased adiposity, obesity, and psoriasis. Body Mass Index (BMI) is a simple index of weight-for-height that is commonly used to classify underweight, overweight and obesity in adults. Psoriasis has also been associated with systemic obesity-related disorders including type 2 diabetes, hypertension, ischemic heart disease, and combined hyperlipidemia, as a part of metabolic syndrome. Not only the obesity may be associated with higher psoriasis incidence and activity, and prevalence of obesity-related syndromes, but it may also influence the therapeutic approach to disease and the clinical response to systemic treatment. Consequently, the approach of the experienced dermatologist will take into account all the aspects of the patient clinical conditions including the analysis of BMI for the choice of the best suitable therapy.
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PMID:Psoriasis and body mass index. 2041 22

Epidemiological studies have shown that, in patients with psoriasis, associated disorders may occur more frequently than expected. Such comorbidities include, among others, psoriatic arthritis, inflammatory bowel disease, obesity, diabetes, cardiovascular disease, several cancer types, and depression. Comorbidities often become clinically manifest years after onset of psoriasis and tend to be more frequently seen in severe disease.
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PMID:Epidemiology of comorbidities in psoriasis. 2041 17

Psoriasis is a common chronic inflammatory, immune-mediated skin disease that is frequently associated with comorbidities including psoriatic arthropathy, chronic inflammatory bowel diseases, and cardio-metabolic disorders. In particular, nonalcoholic fatty liver disease affects about half of patients, Crohn's disease 0.5% and celiac disease 0.2-4.3% of patients with psoriasis. Some shared genetic traits as well as common inflammatory pathways may underlie these associations. The presence of comorbidities has important implications in the global approach to patients. In particular, traditional systemic antipsoriatic agents could negatively affect cardio-metabolic comorbidities as well as nonalcoholic fatty liver disease and may have important interactions with drugs commonly used by psoriasis patients. Moreover, patients with psoriasis should be encouraged to drastically correct their modifiable cardiovascular and liver risk factors, in particular obesity, alcohol consumption, and smoking habit, because this could positively affect both psoriasis and their life expectance.
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PMID:Psoriasis, the liver, and the gastrointestinal tract. 2041 23

Obesity and related metabolic conditions are of epidemic proportions in most of the world, affecting both adults and children. The accumulation of lipids in the body in the form of white adipose tissue in the abdomen is now known to activate innate immune mechanisms. Lipid accumulation causes adipocytes to directly secrete the cytokines interleukin (IL) 6 and tumor necrosis factor alpha (TNFalpha), but also monocyte chemoattractant protein 1 (MCP-1), which results in the accumulation of leukocytes in fat tissue. This sets up a chronic inflammatory state which is known to mediate the association between obesity and conditions such as cardiovascular disease, type 2 diabetes, and cancer. There is also a substantial literature linking inflammation with risk for depression. This includes the observations that: (1) people with inflammatory diseases such as multiple sclerosis, cardiovascular disease, and psoriasis have elevated rates of depression; (2) many people administered inflammatory cytokines such as interferon alpha develop depression that is indistinguishable from depression in non-medically ill populations; (3) a significant proportion of depressed persons show upregulation of inflammatory factors such as IL-6, C-reactive protein, and TNFalpha; (4) inflammatory cytokines can interact with virtually every pathophysiologic domain relevant to depression, including neurotransmitter metabolism, neuroendocrine function, and synaptic plasticity. While many factors may contribute to the association between inflammatory mediators and depression, we hypothesize that increased adiposity may be one causal pathway. Mediational analysis suggests a bi-directional association between adiposity and depression, with inflammation possibly playing an intermediary role.
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PMID:Eating ourselves to death (and despair): the contribution of adiposity and inflammation to depression. 2041 47

Psoriasis is a chronic inflammatory disorder that affects approximately 2% of the general population. Numerous studies have evaluated the increased prevalence of comorbid diseases and risk factors in psoriatic patients, including obesity, metabolic syndrome, cardiovascular disease, psoriatic arthritis, autoimmune disease, psychiatric illness, liver disease, smoking, malignancy, chronic obstructive pulmonary disease, sleep apnea, and alcohol abuse. Insight into the overlapping pathogenesis of these comorbidities of psoriasis highlights the importance of immune-mediated mechanisms in these disease states. Psoriasis, with its comorbidities, must be approached in a multidisciplinary manner to effectively and comprehensively understand, manage, and treat those with this complex disorder.
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PMID:Comorbidities in psoriasis patients. 2043 Mar 2


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