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Children with psoriasis more likely to be overweight, obese
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Children with psoriasis had excess adiposity, with increased central adiposity regardless of disease severity, according to study results.
Psoriasis “often starts in childhood [and] is associated with a risk of being overweight or obese in children,” researcher Amy S. Paller, MD, chair of dermatology at Northwestern University Feinberg School of Medicine, told Healio.com.
Amy S. Paller
Researchers conducted a multicenter, international, cross-sectional study of 409 children (mean age, 12.2 years; 43.5% male) with psoriasis and 205 children (mean age, 11.5 years; 46.8% male) in a noninflammatory control group. A Physician’s Global Assessment Score was used to classify psoriasis as mild (worst score ≤3, body mass surface area ≤10%) or severe (worst score ≥ 3, body surface area >10%). Patients, required to have a history of plaque psoriasis for 6 months or more, were recruited from nine countries between June 19, 2009, and Dec. 2., 2011. Excess adiposity (BMI percentile) and central adiposity (waist circumference percentile or waist–height ratio) were primary outcome measures.
One hundred fifty-five (37.9%) psoriatic children had excess adiposity (BMI≥85th percentile) compared with 42 (20.5%) of controls; severity did not differ significantly. Obesity (BMI≥95th percentile) had an OR of 4.29 (95% CI, 1.96-9.36) in psoriatic children compared with controls and was greater in severe psoriasis (OR=4.92; 95% CI, 2.20-10.99) compared with mild psoriasis (OR=3.60; 95% CI, 1.56-8.30). This was particularly true in children from the United States (OR=7.60; 95% CI, 2.47-23.34, severe psoriasis; OR=4.72; 95% CI, 1.43-15.56, mild psoriasis). Children with a waist circumference greater than the 90th percentile were present in 9.3% of controls (n=19), 14% of mild psoriasis patients (n=27) and 21.2% of severe psoriasis patients (n=43). US patients displayed the greatest incidence (12% [n=13], 20.8% [n=16] and 31.1% [n=32], respectively). Psoriatic children had a significantly greater waist–height ratio compared with controls (0.48 vs. 0.46), which was unaffected by psoriasis severity.
“[There are] very high odds ratios with children with severe psoriasis being obese and having central adiposity with cardiovascular [risk],” Paller said. “The odds ratios are much higher than what we see in adult studies.”
Disclosure: See the study for a full list of relevant disclosures.