Systemic comorbidities in patients of psoriasis: a case–control study from India

Abstract

Background There is paucity of Indian studies on comprehensive assessment of systemic comorbidities in psoriasis. This study aimed at assessing the systemic comorbidities in patients of psoriasis in India. Patients and methods A case–control study was conducted from September 2019 to August 2021. Study participants of more than 18 years, with 30 psoriasis patients as cases and 30 healthy individuals as controls. Assessment of Psoriasis Area Severity Index in cases, BMI, waist circumference, blood pressure, and detailed systemic index evaluation was done in both the groups. Analyses were done using χ2 test and independent t test. Analysis of variance test is used to compare continuous variables among more than two groups. Odds ratio (OR) and 95% confidence interval were calculated. Results The mean age of psoriasis cases was 45.03±13.1 years with 73.3% of male and 26.7% of female population. Mean duration of psoriasis observed is 6.9±4.2 years with the mean Psoriasis Area Severity Index of 17.73±6.389. Comparison of systemic indices demonstrated significant increase in neutrophil count (P=0.006), erythrocyte-sedimentation rate (P<0.0001), glycated hemoglobin (P=0.037), low-density lipoprotein (P=0.0418), T3 (P<0.0001), and T4 (P=0.018). No significant difference in the liver-function test and renal-function test was seen in both the groups. Comparison of the prevalence of diseases associated with psoriasis, shows that the prevalence of metabolic syndrome (60 vs. 30%, OR=3.5, P=0.021), nonalcoholic fatty liver disease (26.6 vs. 6.6%, P=0.002, OR=14), increase in the carotid artery intimal thickness on both sides (right P=0.007, OR=5; left P=0.005, OR=7), and the inflammatory marker C-reactive protein (70 vs. 33.3%, P=0.005, OR=4.66) is significantly increased in cases as compared with controls. Other diseases like obesity (BMI: OR=2.0417, P=0.187; waist circumference: OR=2.25, P=0.123), type-2 diabetes mellitus (P=0.56, OR=1.40), hypertension (P=0.78, OR=1.15), and renal disease (P=1, OR=1) is found to have greater risk in psoriasis patients than controls, but the reflecting difference is not statistically significant. Conclusion The study revealed that the patients of psoriasis are more likely to have systemic comorbidities as compared with patients without psoriasis.