The Impact of Metabolic Syndrome on Immune Regulation (IL-17, IL-23, and FOXP3+), Psoriasis Severity, Flare Frequency, and Quality of Life in Psoriasis Patients: A Cross-Sectional Study.

Abstract

Introduction: Psoriasis is a chronic inflammatory skin disease that exhibits a strong association with metabolic syndrome (MetS). The involvement of various proinflammatory cytokines in MetS is thought to play a critical role in the pathogenesis of psoriasis. This study aims to evaluate the impact of MetS on immunological markers (IL-17, IL-23, and FOXP3+ regulatory T cells), disease severity, and quality of life (QoL) among patients with psoriasis. Methods: This cross-sectional study involved 42 psoriasis patients, divided into two groups: 29 without MetS (Pso) and 13 with MetS (Pso-MetS). Clinical parameters such as blood pressure, fasting blood glucose, and triglyceride levels were measured. Immunological markers (IL-17, IL-23, and FOXP3+) were analyzed using ELISA. Psoriasis severity was assessed using the Psoriasis Area and Severity Index (PASI), and QoL was evaluated with the Dermatology Life Quality Index (DLQI). Results: The Pso-MetS group was significantly older than the Pso group (p value = 0.003). Higher systolic (p value < 0.001), fasting glucose (p value = 0.002), and triglycerides (p value < 0.001) were observed in the Pso-MetS group. Lower HDL observed in the Pso-MetS group (p value = 0.004). FOXP3+ expression was significantly lower in the Pso-MetS group (p=0.02), while waist circumference, diastolic blood pressure, IL-17, IL-23, PASI, and DLQI scores levels showed no significant differences. Conclusions: MetS is associated with immune dysregulation, evidenced by reduced FOXP3+ expression in psoriasis patients. Further studies are needed to explore the immunological link between psoriasis and MetS.