Obesity in childhood may lead to psoriasis; psoriasis may lead to heart disease

Obesity in childhood significantly increases the risk of developing psoriasis, and psoriasis may increase the risk of cardiovascular disease later in life by increasing cholesterol levels, researchers reported Wednesday. Patients with psoriasis early in life should be monitored for early signs of cardiovascular disease and given therapy to reduce the risk of later heart attacks and stroke, a team from Kaiser Permanente reported in the Journal of Pediatrics.

Psoriasis is a common autoimmune condition characterized by skin redness and irritation. Most patients have thick red skin with flaky, silver-white patches called scales. The disorder is genetic in origin, but can be exacerbated by a number of environmental factors, including excessive exposure to sunlight, excess alcohol consumption, stress, dry air or skin, certain drugs and many infections. Most subjects develop their first symptoms between age 15 and 35. An estimated 7 million Americans suffer from the disorder.

Previous studies have shown that adults with psoriasis have a higher risk of developing metabolic diseases such as diabetes, hypertension, heart attack and stroke. Conversely, obesity in adults has also been linked with a higher risk of developing psoriasis. The new study suggests that the same factors that increase risk in adults may be operating in children as well.

Epidemiologist Corinna Koebnick of Kaiser Permanente Southern California’s Department of Research & Evaluation in Pasadena and her colleagues studied electronic health records of 710,949 ethnically diverse children. The team found that obese children were 40% more likely to have psoriasis than normal-weight children and severely obese children were almost 80% more likely. Moreover, those with psoriasis had 4% to 16% higher cholesterol levels than other children of the same weight, suggesting one path by which the disorder increases the risk of cardiovascular disease.

“As we follow these patients over 30 to 40 years, we will be able to determine if these increased cardiovascular risk factors in turn increase the risk for major adverse cardiac events,” said study co-author Dr. Jashin J. Wu. Meanwhile, Koebnick added, children with psoriasis should be closely monitored for the development of cardiovascular risk factors and treatment initiated when appropriate.