Does the onset of psoriasis in childhood or adulthood affect cardiovascular comorbidity?

Abstract

Background: Psoriasis is a chronic, immune-mediated inflammatory disease with a prevalence of 2-3% in the general population and 0.7-1.2% among children in Western countries. It is often associated with comorbidities, particularly cardiovascular and metabolic diseases. This study aims to investigate the correlation between the onset of psoriasis during childhood (COP) and the prevalence of cardiovascular and metabolic comorbidities in adulthood, focusing on patients aged 30-50 years.

Methods: A cross-sectional, multicenter study was conducted involving 1922 psoriasis patients from 12 centers across Turkey. Data collected included demographic information, disease characteristics, cardiovascular and metabolic comorbidities, laboratory parameters, and treatment history. Metabolic syndrome (MetS) was diagnosed based on established criteria, and logistic regression analysis was used to identify factors associated with comorbidities.

Results: Among the patients, 34.5% had the onset of psoriasis before the age of 18. The average duration of the disease was 28.28±53.42 years. The prevalence and age of onset of MetS were similar in both COP and AOP groups. Although the onset age of obesity was earlier in COP patients, no direct connection between the onset of psoriasis and obesity prevalence was established. Total cholesterol, LDL-cholesterol, and HOMA-IR levels were higher in the AOP group. The use of systemic and biological treatments was significantly higher in COP patients, with earlier initiation of biological treatments.

Conclusions: The prevalence and age of onset of MetS were similar in COP and AOP patients. The onset age of obesity was earlier in COP patients, emphasizing the importance of weight management in pediatric psoriasis. Early and aggressive treatment targeting systemic inflammation may improve long-term outcomes by reducing comorbidities in psoriatic patients. This study highlights the need for a comprehensive treatment approach addressing both skin symptoms and associated systemic conditions.