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Psoriasis, Metabolic Syndrome Linked to High Leptin Levels

Psoriasis and metabolic syndrome both are associated with high serum levels of leptin, according to a new report. “Body weight loss could potentially become part of the general treatment of psoriasis, especially in patients with obesity.”

Although association does not necessarily signify causation, it is possible that the proinflammatory mediators in psoriasis may stimulate leptin expression, which may in turn eventually lead to metabolic dysregulation, according to Dr. Yi-Ju Chen of the department of dermatology at Taichung (Taiwan) Veterans General Hospital, and associates.

 

It has been found that ischemic heart disease and stroke are significantly more common in psoriasis patients than in the general population. Therefore, the investigators wanted to examine the role of leptin, an adipocyte-derived hormone that helps regulate energy homeostasis, metabolism, and immune-inflammatory processes. They used serum samples from 77 psoriasis patients and 81 control patients matched for age and gender.

The median serum leptin level was found to be significantly higher in psoriasis patients (7,311 pg/mL) than in controls (4,804 pg/mL). Patient age, severity of psoriasis, presence or absence of psoriatic arthritis, and clinical subtype of psoriasis was found to have no relation to leptin levels.

In addition, psoriasis patients who also had metabolic syndrome had significantly higher leptin levels than did psoriasis patients without the metabolic syndrome, Dr. Chen and colleagues reported (Arch. Derm. 2008;144:1571-5). It seems that high circulating leptin levels in psoriasis derive not only from adipose tissue but also from an inflammation process, the authors wrote.

Since weight loss is known to decrease leptin levels, improve insulin sensitivity, and reduce the chance of developing metabolic syndrome and cardiovascular disease, “weight loss could potentially become part of the general treatment of psoriasis,” the investigators concluded.

People with psoriasis have higher levels of the obesity-related hormone leptin than those without psoriasis, new research shows.

The Taiwanese study included 77 psoriasis patients and a control group of 81 people without the skin condition. The researchers gathered health information about the participants and analyzed blood samples for levels of leptin, which helps control food intake, body weight and fat stores. The hormone also plays a role in immune and inflammatory processes.

The psoriasis patients were more likely than those in the control group to be obese, to have high blood pressure, and to have elevated blood glucose levels or diabetes. High blood levels of leptin were found more often in females and in participants who were obese, had high blood pressure, had metabolic syndrome, or had psoriasis.

After the researchers adjusted for sex, body-mass index and cardiovascular risk factors, they concluded that psoriasis was independently associated with high leptin levels (hyperleptinemia). They also found that hyperleptinemia in psoriasis patients was associated with an increased risk of developing metabolic syndrome (a set of cardiovascular risk factors that includes high blood pressure and high cholesterol), a finding that links the chronic inflammation of psoriasis with metabolic disturbances.

The high blood levels of leptin in people with psoriasis may come not only from fat tissue but also from inflammation, Dr. Yi-Ju Chen, of the Taichung Veterans General Hospital and National Chung Hsing University, and colleagues, said in a university news release.

“Body weight loss has been reported to significantly decrease leptin levels and improve insulin sensitivity and may reduce the likelihood of developing metabolic syndrome and adverse cardiovascular diseases,” the researchers concluded. “Body weight loss could potentially become part of the general treatment of psoriasis, especially in patients with obesity.”

Archives of Dermatology, Dec. 2008