Introduction and Objective: Psoriasis and metabolic syndrome (MetS) share complex inflammatory pathways, with unclear sex differences. We aimed to determine whether psoriasis is associated with MetS among U.S. adults and whether sex modifies this association. Methods: We conducted a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) 2009-2014 data of adult, non-pregnant individuals with complete data on main factors of interest. Psoriasis was defined by self-reported physician diagnosis, and MetS was defined per NCEP Adult Treatment Panel III (ATP III) criteria as meeting ≥3 of the following: central adiposity, elevated blood pressure, hyperglycemia, hypertriglyceridemia, and reduced HDL. We performed weighted multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the psoriasis-MetS association, sequentially adjusting for age, sex, insurance, and additionally for race/ethnicity, hypertension, CHD, diabetes, stroke, smoking, physical activity, and education. Effect modification by sex was tested via interaction terms. Results: The analytical sample included 14,052 adults, 20.7% aged 65+, 49.8% aged 35-64 , 49.3% women and 57% non-whites . Participants with psoriasis were generally older, non-Hispanic Whites, and had higher rates of diabetes , hypertension, and tobacco use. The prevalence of psoriasis was 2.64%. The prevalence of MetS was 31.6% overall, 36.6% in psoriasis patients, and 29.7% in those without psoriasis. (OR= 1.35, 95% CI: 0.99-1.83). In sequentially adjusted models the association was attenuated (OR 1.23, 95% CI: 0.89-1.69) and (1.05, 95% CI: 0.73-1.50). No significant sex interaction was observed. A sensitivity analysis exploring the impact of missing data did not change the magnitude of the results. Conclusions: The prevalence of metabolic syndrome was high in psoriasis patients and general population We did not find sex to modify the association of these conditions. Metabolic risk screening remains essential in psoriasis care. Nationwide cardiometabolic surveillance systems need to collect contemporary data on psoriasis and other inflamma-metabolic conditions, to guide disease burden quantification and translation of preventive measures into practice.
Cummings et al. (Tue,) studied this question.