Children with psoriasis in the United States are four times as likely to be overweight or obese compared to those without the disease, according to a study(archderm.jamanetwork.com) (abstract) from Northwestern University's Feinberg School of Medicine. Worldwide, children with psoriasis are nearly twice as likely to be obese or overweight.
Published Nov. 19 in the Archives of Dermatology, the global study on physician-treated children with psoriasis looked at 614 children from five to 17 years old in nine countries to investigate the relationship between excess and central adiposity and severity of pediatric psoriasis.
"Globally, children with psoriasis have excess adiposity and increased central adiposity, regardless of psoriasis severity," the authors wrote. "The increased metabolic risks associated with excess and central adiposity warrant early monitoring and lifestyle modification."
According to the authors, although body mass index (BMI) remains the standard method for identifying overweight and obese patients, data indicate central adiposity and the waist-to-height ratio have a higher correlation with metabolic risk, hence their inclusion in the study.
Overall rates of obesity and overweight in Brazilian, Canadian, Chilean, and U.S. children were higher than in children in countries outside the Americas, but the news was worse for U.S. Hispanic and African-American children, who saw significantly greater rates for excess adiposity -- nearly 60 percent -- than their white counterparts, who came in just under 45 percent.
"The particularly high odds of obesity in U.S. children with psoriasis suggest that environment habits (higher caloric diet and less exercise) may affect the risk," the authors wrote.
According to the study, the question as to whether a high BMI serves as the precursor of psoriasis in children versus whether the disease leads to an increased BMI percentile that is further compounded by a lifestyle favoring excess adiposity remains unanswered.
In conclusion, the authors wrote that children with psoriasis are more likely to be overweight or obese, resulting in an increased risk for complications related to excess adiposity.
"The association of central adiposity is greatest in children with severe psoriasis, and monitoring of these patients should be especially vigilant," the authors wrote. "Should further studies show excess adiposity to be a precursor for psoriasis, attempts at early weight loss and lifestyle modification will be important, not only to decrease the risk of metabolic disease but also to modulate the course of pediatric psoriasis."