Higher BMI Is Associated With an Increased Risk of Psoriasis Journal of the American Academy of Dermatology

TAKE-HOME MESSAGE

• Using a multi-health system dataset, over 1.5 million patients with psoriasis were stratified by body mass index (BMI). The incidence of psoriasis per 10,000 person-years was 9.5 among normal or underweight patients, 11.9 among overweight patients, 14.2 among obese class 1 patients, and 17.4 among obese class 2/3 patients. Compared with patients with BMI<25, overweight individuals were 19% more likely to have psoriasis, obese class 1 patients were 43% more likely to have psoriasis, and obese class 2/3 were 83% more likely to have psoriasis. A 5-unit increase in BMI was associated with a 17% increase in the risk of developing psoriasis.

• Higher BMI was associated with an increased risk of developing psoriasis independent of age, sex, race, and smoking status.

–  Kelly B. Scarberry, MD

Written by

 

 

Eliot N. Mostow MD, MPH

Obesity contributes to so many diseases that every clinician should be discussing strategies with patients who are overweight and "out of shape." Although I am well aware that there is a concept that is described as "fit, but fat," the overwhelming data suggest that most people who are overweight have multiple additional risks associated with that simple measure. Although flaws with the body mass index have been discussed, the merits of a simple measure and discussion are low-cost and potentially life-changing. I'm reminded of a TED talk that addresses the idea that you never know the impact that a simple conversation might have on a person (https://www.ted.com/talks/drew_dudley_everyday_leadership/transcript?language=en).

Abstract 

BACKGROUND

Psoriasis has been linked to obesity, although there is limited data on the incidence of psoriasis according to body mass index.

OBJECTIVE

To compare incidence of psoriasis among patients stratified by BMI category (normal or underweight, overweight, obese-class 1, obese-class 2/3).

METHODS

Retrospective cohort analysis of a demographically heterogeneous sample of over 1.5 million patients in the U.S. between January 1, 2008 and September 9, 2019 RESULTS: Crude incidence of psoriasis per 10,000 person-years was 9.5 (95% CI, 9.1-10.0) among normal or underweight patients, 11.9 (95% CI, 11.4-12.4) among overweight patients, 14.2 (95% CI, 13.6-14.9) among obese class-1 patients, and 17.4 (95% CI, 16.6-18.2) among obese-class 2/3 patients. Compared to patients with BMI <25.0, those who were overweight (aHR, 1.19; 95% CI, 1.12-1.27; p<.001), obese-class 1 (aHR, 1.34; CI, 1.34-1.53; p<.001) and obese-class 2/3 (aHR, 1.83; CI, 1.71-1.95; p<.001) had significantly increased risks of developing psoriasis.

LIMITATIONS

Influence of obesity on psoriasis severity could not be measured.

CONCLUSION

Body mass index independently influences the development of psoriasis. There appears to be a graded association between BMI and risk of psoriasis.

Journal of the American Academy of Dermatology

Risk of Psoriasis According to Body Mass Index: A Retrospective Cohort Analysis

J Am Acad Dermatol 2021 Jun 09;[EPub Ahead of Print], A Norden, S Rekhtman, A Strunk, A Garg 

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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