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Higher BMI causally linked to greater psoriasis risk
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Patients with a higher BMI have a greater risk for psoriasis, according to researchers who support healthy lifestyle initiatives for weight management in psoriasis prevention and treatment.
"Our findings present strong evidence that higher BMI could increase the risk of psoriasis," Ashley Budu-Aggrey, MD, research associate at MRC Integrative Epidemiology Unit of the University of Bristol, told Healio Dermatology. "This suggests that modifying diet and weight could help reduce disease risk. However, the causal effect of reducing BMI as a short-term intervention for psoriasis is yet to be explored."
The studies analyzed weight or the impact of obesity rates on patients with psoriasis and healthy controls, and all included participants were of European ancestry.
Researchers identified 56 studies through a PubMed search.
The retrospective data included 5,676 psoriasis cases from 396,495 participants aged 40 to 69 years from the UK Biobank.
Additionally, 1,076 adults aged at least 20 years with psoriasis were included from the Nord-Trøndelag Health Study (HUNT).
Furthermore, researchers accessed summary-level data for 356,926 individuals of European ancestry from published genome-wide association studies for BMI (n = 322,154) and psoriasis (n = 34,772).
In a meta-analysis, the mean difference in BMI between psoriasis cases and controls was 1.26 kg/m2 (95% CI, 1.02-1.51) among adults and 1.55 kg/m2 in children (95% CI, 1.13-1.98).
In both adults and children, the observed difference in BMI was equivalent to a 9% increase in the odds of psoriasis per 1 kg/m2 increase in BMI, which the researchers deemed clinically significant.
“An increase in BMI of 5 units from 25 to 30 would increase the risk of psoriasis by 53%,” the researchers wrote.
They found no strong evidence for a causal effect of the genetic risk for psoriasis on BMI, using a reverse Mendelian randomization.
“Our findings suggest that approaches to the prevention and treatment of psoriasis might come from targeting adiposity levels in addition to the immune pathways in the skin,” the researchers wrote. “Although our results imply that such interventions may be effective in the prevention of psoriasis, they cannot determine that they would be effective at improving the disease course after onset.” – by Abigail Sutton
Disclosures: Budu-Aggrey is funded by a grant awarded by the British Skin Foundation and works in a research unit funded by the UK Medical Research Council. Please see the study for all other authors’ relevant financial disclosures.