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BODY MASS INDEX, ABDOMINAL FATNESS, WEIGHT GAIN AND THE RISK OF PSORIASIS: A
SYSTEMATIC REVIEW AND DOSE-RESPONSE META-ANALYSIS OF PROSPECTIVE STUDIES.

 * Aune, D ;
 * Snekvik, I ;
 * Schlesinger, S ;
 * Norat, T ;
 * Riboli, E ;
 * Vatten, LJ

European journal of epidemiology. 2018;33(12):1163-1178

OTHER RESOURCES

 * View in PubMed


PLAIN LANGUAGE SUMMARY

Psoriasis is an immune-mediated inflammatory skin disease characterised by red,
itchy, scaly and flaky skin. Research has shown an association between adiposity
and inflammation cytokine release triggered by adipose tissue and increased body
mass index and psoriasis. In this meta-analysis, seven prospective studies were
included, and the association between BMI, abdominal fat, and psoriasis was
examined. According to this meta-analysis, the relative risk of psoriasis
increases by 19% for every 5-unit increase in BMI, 24% for a 10 cm increase in
waist circumference, 37% for a 0.1-unit increase in waist-to-hip ratio, and 11%
for a 5 kg weight gain. The risk of psoriasis was lower for people with a BMI
below 20, and it was significantly higher for those with a BMI between 22.5-24.
Psoriasis risk was positively associated with waist circumference, waist-to-hip
ratio, and weight gain. Psoriasis risk escalates by 2-4 times with an increase
in each measure of adiposity. Several potential strategies to reduce the risk of
psoriasis are identified in this meta-analysis, including weight loss, dietary
factors, and physical activity. To evaluate their effectiveness and develop
appropriate strategies, further robust studies are needed. Healthcare
professionals can use the results of this study to develop potential therapeutic
strategies to reduce the risk of psoriasis by understanding the mechanisms and
factors associated with the disease.


ABSTRACT

Greater body mass index (BMI) has been associated with increased risk of
psoriasis in case-control and cross-sectional studies, however, the evidence
from prospective studies has been limited. We conducted a systematic review and
dose-response meta-analysis of different adiposity measures and the risk of
psoriasis to provide a more robust summary of the evidence based on data from
prospective studies. PubMed and Embase databases were searched for relevant
studies up to August 8th 2017. Summary relative risks (RRs) and 95% confidence
intervals (CIs) were calculated using a random effects model. The summary
relative risk (RR) for a 5 unit increment in BMI was 1.19 (95% CI 1.10-1.28,
I2 = 83%, n = 7). The association appeared to be stronger at higher compared to
lower levels of BMI, pnonlinearity < 0.0001, and the lowest risk was observed at
a BMI around 20. The summary RR was 1.24 (95% CI 1.17-1.31, I2 = 0%,
pheterogeneity = 0.72, n = 3) per 10 cm increase in waist circumference, 1.37
(95% CI 1.23-1.53, I2 = 0%, pheterogeneity = 0.93, n = 3) per 0.1 unit increase
in waist-to-hip ratio, and 1.11 (95% CI 1.07-1.16, I2 = 47%,
pheterogeneity = 0.15, n = 3) per 5 kg of weight gain. Adiposity as measured by
BMI, waist circumference, waist-to-hip ratio, and weight gain is associated with
increased risk of psoriasis.


LIFESTYLE MEDICINE

Fundamental Clinical Imbalances : Immune and inflammation ; Structural
Patient Centred Factors : Triggers/Adiposity and obesity
Environmental Inputs : Diet ; Physical exercise
Personal Lifestyle Factors : Nutrition ; Exercise and movement
Functional Laboratory Testing : Not applicable


METHODOLOGICAL QUALITY

Jadad score : Not applicable
Allocation concealment : Not applicable
Publication Type : Journal Article ; Meta-Analysis ; Systematic Review


METADATA

Nutrition Evidence keywords : Body mass index ; Abdominal fat ; Weight gain ;
Psoriasis ; Waist-hip ratio ; Waist circumference ; Adiposity ; Adipose tissue ;
Inflammatory cytokines ; TNF-α ; IL-1 ; IL-6 ; IL-8 ; Obesity ; Overweight ;
Leptin ; Adiponectin ; C-reactive protein ; Monocyte chemoattractant protein 1 ;
Diet ; Lifestyle ; Physical activity

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