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Adipositas - Ursachen, Folgeerkrankungen, Therapie 2010; 04(04): 171-175
DOI: 10.1055/s-0037-1618716
Adipositas und Dermatologie
Schattauer GmbH

Adipositas und Psoriasis

Adipositas and psoriasis
M. Sticherling
1   Hautklinik, Universitätsklinikum Erlangen
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Publication History

Publication Date:
22 December 2017 (online)

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Zusammenfassung

Die Psoriasis ist eine der häufigsten chronisch entzündlichen Erkrankungen des Menschen. Sie ist mit einer Reihe anderer Erkrankungen assoziiert, die den Verlauf wie die Therapie maßgeblich beeinflussen. Die verschiedenen Manifestationsformen des metabolischen Syndroms treten bei Patienten mit Psoriasis statistisch signifikant häufiger auf als in der Normalbevölkerung und führen zu einer erhöhten kardiovaskulären Mortalität. Diese ist mit der entzündlichen Aktivität in der Haut wie der systemischen Inflammation korreliert. Insbesondere die Adipositas scheint über die endokrinologische und immunologische Aktivität des intraabdominellen Fettes in das entzündliche Geschehen der Erkrankung direkt mit einbezogen. Daher ist die Psoriasis als eine Systemerkrankung zu werten. Insbesondere Hochrisiko-Patienten, zu denen solche mit einer begleitenden Adipositas vorrangig zu rechnen sind, bedürfen daher einer frühzeitigen und effizienten Therapie ihrer Schuppenflechte und einer engen klinischen Kontrolle.

Summary

Psoriasis is one of the most common chronic inflammatory skin diseases of man. It is associated with a number of other diseases which are able to distinctly influence the course of the disease as well as therapy. The different manifestations of the metabolic syndrome are significantly more common in psoriatics than in the general population and will result in an increased cardiovascular mortality. This is correlated with the local inflammatory activity in the skin as well as systemic inflammation. Obesity seems to be a prominent part of these pathogenic pathways by the distinct endocrinologic and immunologic activity of the intraabdominal fat tissue. Accordingly, psoriasis has to be regarded as a systemic disease. High-risk patients, especially those with obesity need early and efficient treatment of their psoriasis and close clinical control.

Schlüsselwörter

Adipositas - Psoriasis - metabolisches Syndrom

Keywords

Obesity - psoriasis - metabolic syndrome
 

  • Literatur

  • 1 Bernstein L, Berry J, Kim S. et al. Effects of etanercept in patients with the metabolic syndrome. Arch Intern Med 2006; 166: 902-908.
    CrossrefPubMedGoogle Scholar
  • 2 Boehncke WH, Buerger C, Boehncke S. Komorbidität bei Psoriasis vulgaris. Hautarzt 2009; 60: 116-121.
    CrossrefPubMedGoogle Scholar
  • 3 Boehncke S, Thaci D, Beschmann H. et al. Psoriasis patients show signs of insulin resistance. Br J Dermatol 2007; 157: 1249-1251.
    CrossrefPubMedGoogle Scholar
  • 4 Cohen AD, Sherf M, Vidavsky L. et al. Association between psoriasis and the metabolic syndrome. A cross-sectional study. Dermatology 2008; 216: 152-155.
    CrossrefPubMedGoogle Scholar
  • 5 Colsman A, Brügel M, Thierry J. Lipid parameters in psoriasis vulgaris. Exp Dermatol 2007; 16: 229.
    PubMedGoogle Scholar
  • 6 Colsman A, Sticherling M. Simvastatin in psoriatic patients: ambiguous effects. Acta Derma Venereol 2010; 90: 411.
    PubMedGoogle Scholar
  • 7 Dominguez H, Storgaard H, Rask-Madsen C. et al. Metabolic and vascular effects of tumor necrosis factor-a blockade with etanercept in obese patients with type 2 diabetes. J Vasc Res 2005; 42: 517-525.
    CrossrefPubMedGoogle Scholar
  • 8 Dreiher J, Weitzman D, Davidovici B. et al. Psoriasis and dyslipidaemia: a population-based study. Acta Derm Venereol 2008; 88: 561-565.
    PubMedGoogle Scholar
  • 9 Eckel R, Grundy S, Zimmet P. The metabolic syndrome. Lancet 2005; 365: 1415-1428.
    CrossrefPubMedGoogle Scholar
  • 10 Gelfand J, Neimann A, Shin D. et al. Risk of myocardial infarction in patients with psoriasis. JAMA 2006; 296: 1735-1741.
    CrossrefPubMedGoogle Scholar
  • 11 Gerdes S, Zahl VA, Knopf H. et al. Comedication related to comorbidities: a study in 1203 hospitalized patients with severe psoriasis. Br J Dermatol 2008; 159: 1116-1112.
    PubMedGoogle Scholar
  • 12 Henseler T, Christophers E. Disease concomitance in psoriasis. J Am Acad Dermatol 1995; 32: 982-986.
    CrossrefPubMedGoogle Scholar
  • 13 Herron M, Hinckley B, Hoffman MS. et al. Impact of obesity and smoking on psoriasis presentation and management. Arch Dermatol 2005; 141: 1527-1534.
    PubMedGoogle Scholar
  • 14 Hotamisligil GS. Inflammation and metabolic disorders. Nature 2006; 444: 860-867.
    CrossrefPubMedGoogle Scholar
  • 15 Hürlimann D, Forster A, Noll G. et al. Anti-tumor necrosis factor-α treatment improves endothelial function in patients with rheumatoid arthritis. Circulation 2002; 106: 2184-2187.
    CrossrefPubMedGoogle Scholar
  • 16 Jacobi TC, Highet A. A clinical dilemma while treating hypercholesterolaemia in psoriasis. Br J Dermatol 2003; 149: 1305-1306.
    CrossrefPubMedGoogle Scholar
  • 17 Jacobsson LT, Turesson C, Gülfe A. et al. Treatment with tumor necrosis factor blockers is associated with a lower incidence of first cardiovascular events in patients with rheumatoid arthritis. J Rheumatol 2005; 32: 1213-1218.
    PubMedGoogle Scholar
  • 18 Karpouzis A, Caridha R, Tripsianis G. et al. Apolipoprotein E gene polymorphism in psoriasis. Arch Dermatol Res 2009; 301: 405-410.
    CrossrefPubMedGoogle Scholar
  • 19 Li G, Barrett EJ, Barrett MO, Cao W, Liu Z. TNF-α induces insulin resistance in endothelial cells via a p38 MAPK-dependent pathway. Endocrinology 2007; 148: 3356-3363.
    CrossrefPubMedGoogle Scholar
  • 20 Ludwig RJ, Herzog C, Rostock A. et al. Psoriasis: a possible risk factor for development of coronary artery calcification. Br J Dermatol 2007; 156: 271-276.
    CrossrefPubMedGoogle Scholar
  • 21 Mallbris L, Granath F, Hamsten A, Stahle M. Psoriasis is associated with lipid abnormalities at the onset of skin disease. J Am Acad Dermatol 2006; 54: 614-621.
    CrossrefPubMedGoogle Scholar
  • 22 Martínez-Abundis E, Reynoso-von Drateln C, Hernández-Salazar E, González-Ortiz M. Effect of etanercept on insulin secretion and insulin sensitivity in a randomized trial with psoriatic patients at risk for developing type 2 diabetes mellitus. Arch Dermatol Res 2007; 299: 461-465.
    CrossrefPubMedGoogle Scholar
  • 23 Mira E, León B, Barber DF. et al. Statins induce regulatory T cell recruitment via a CCL1 dependent pathway. J Immunol 2008; 181: 3524-3534.
    CrossrefPubMedGoogle Scholar
  • 24 Mrowietz U, Elder JT, Barker J. The importance of disease associations and concomitant therapy for the long-term management of psoriasis patients. Arch Dermatol Res 2006; 298: 309-319.
    CrossrefPubMedGoogle Scholar
  • 25 Naldi L, Chatenoud L, Belloni A. et al. Medical history, drug exposure and the risk of psoriasis. Evidence from an Italian case-control study. Dermatology 2008; 216: 125-130.
    CrossrefPubMedGoogle Scholar
  • 26 Nast A, Kopp IB, Augustin M. et al.; Deutsche Dermatologische Gesellschaft (DDG); Berufsverband Deutscher Dermatologen (BVDD). Evidence-based (S3) guidelines for the treatment of psoriasis vulgaris. J Dtsch Dermatol Ges 2007; 05 (Suppl. 03) 1-119.
    PubMedGoogle Scholar
  • 27 Novack V, Eisinger M, Frenkel A. et al. The effects of statin therapy on inflammatory cytokines in patients with bacterial infections: a randomized double-blind placebo controlled clinical trial. Intensive Care Med 2009; 35: 1255-1260.
    CrossrefPubMedGoogle Scholar
  • 28 Ohtsuka T. The relation between high-sensitivity C-reactive protein and maximum body mass index in patients with psoriasis. Br J Dermatol 2008; 158: 1141-1143.
    CrossrefPubMedGoogle Scholar
  • 29 Pietsch J, Batra A, Stroh Tm. et al. Toll-like receptor expression and response to specific stimulation in adipocytes and preadipocytes. Ann NY Acad Sci 2006; 1072: 407-409.
    CrossrefPubMedGoogle Scholar
  • 30 Prey S, Paul C, Bronsard Vm. et al. Assessment of risk of psoriatic arthritis in patients with plaque psoriasis: a systematic review of the literature. J Eur Acad Dermatol Venereol 2010; 24 (Suppl. 02) 31-35.
    CrossrefPubMedGoogle Scholar
  • 31 Prey S, Paul C, Bronsard V. et al. Cardiovascular risk factors in patients with plaque psoriasis: a systematic review of epidemiological studies. J Eur Acad Dermatol Venereol 2010; 24 (Suppl. 02) 23-30.
    CrossrefPubMedGoogle Scholar
  • 32 Prodanovich S, Ma F, Taylor JR. et al. Methotrexate reduces incidence of vascular diseases in veterans with psoriasis or rheumatoid arthritis. J Am Acad Dermatol 2005; 52: 262-267.
    CrossrefPubMedGoogle Scholar
  • 33 Rajala M, Scherer P. Minireview: the adipocyte - at the crossroads of energy homeostasis, inflammation and atherosclerosis. Endocrinology 2003; 144: 3765-3773.
    CrossrefPubMedGoogle Scholar
  • 34 del Rincon I, Williams K, Stern M. et al. High incidence of cardiovascular events in a rheumatoid arthritis cohort not explained by traditional cardiac risk factors. Arthritis Rheum 2001; 44: 2737-2745.
    CrossrefPubMedGoogle Scholar
  • 35 Ronti T, Lupattelli G, Mannarino E. The endocrine function of adipose tissue: an update. Clin Endocrinol 2006; 64: 355-365.
    PubMedGoogle Scholar
  • 36 Sattar N, McCarey D, Capell H, McInnes I. Explaining how ‘highgrade’ systemic inflammation accelerates vascular risk in rheumatoid arthritis. Circulation 2003; 108: 2957-2963.
    CrossrefPubMedGoogle Scholar
  • 37 Schmitt J, Zhang Z, Wozel G. et al. Efficacy and tolerability of biologic and nonbiologic systemic treatments for moderate-to-severe psoriasis: meta-analysis of randomized controlled trials. Br J Dermatol 2008; 159: 513-526.
    CrossrefPubMedGoogle Scholar
  • 38 Shirinsky I, Shirinsky V. Efficacy of simvastatin in plaque psoriasis: a pilot study. J Am Acad Dermatol 2007; 57: 529-531.
    CrossrefPubMedGoogle Scholar
  • 39 Sommer DM, Jenisch S, Suchan M. et al. Increased prevalence of the metabolic syndrome in patients with moderate to severe psoriasis. Arch Dermatol Res 2006; 298: 321-328.
    CrossrefPubMedGoogle Scholar
  • 40 Sterry W, Strober BE, Menter A. International Psoriasis Council. Obesity in psoriasis: the metabolic, clinical and therapeutic implications. Report of an interdisciplinary conference and review. Br J Dermatol 2007; 157: 649-655.
    CrossrefPubMedGoogle Scholar
  • 41 Werner N, Kosiol S, Schiegl T. et al. Circulating endothelial progenitor cells and cardiovascular outcomes. N Engl J Med 2005; 353: 999-1017.
    CrossrefPubMedGoogle Scholar
  • 42 Zarkesh-Esfahani H, Pockley AG, Wu Z. et al. Leptin indirectly activates human neutrophils via induction of TNF-α. J Immunol 2004; 172: 1809-1814.
    CrossrefPubMedGoogle Scholar