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The association of metabolic syndrome and psoriasis: A systematic review and meta-analysis of observational study.

BACKGROUND
Metabolic syndrome worsens complications in psoriasis patients by predisposing them to cardiovascular diseases. Psoriasis has been widely associated with metabolic syndrome; however, it has still not been proven owing to a limited number of studies and some of those reporting conflicting results.


OBJECTIVE
Psoriasis has been reported to be associated with metabolic syndrome; however, it has still not been established beyond doubt owing to conflicting studies. Present meta-analysis of observational studies aims to assess the prevalence of metabolic syndrome in psoriasis patients.


RESEARCH DESIGN AND METHODS
A systematic web search for 'Psoriasis', 'Metabolic Syndrome', 'Hypertension', 'Plasma Glucose', 'Dyslipidaemia', 'Waist Circumference' was performed, collecting all original observational studies on humans up to April 30, 2018. Depending on the inclusion and exclusion criteria, articles were screened for eligibility. Due to the presence of significant heterogeneity, the Odds Ratio (OR) was calculated using random-effect model with Der-Simonian and Laird method. The statistical heterogeneity was determined using I2 statistics. Comprehensive Meta-Analysis Software, Version 3 was used to perform all the analysis.


RESULTS
Sixty-three studies encompassing 15939 psoriasis patients and 103984 controls were included in this meta-analysis. Among them, 30.29 % of psoriasis patients were reported with metabolic syndrome in comparison to 21.70 % subjects in the control group. The present study clearly indicates an increased prevalence of metabolic syndrome among psoriasis patients (OR: 2.077 [95% CI, 1.84 - 2.34]).


CONCLUSIONS
The findings support the fact that psoriasis patients have a higher incidence of metabolic syndrome. Our study also recommends that psoriasis patients should be regularly monitored for metabolic syndrome complications and its associated risk factors such as hypertension, raised triglyceride, lowered HDL Cholesterol, increased fasting plasma glucose, and waist circumference.