Prevalence of metabolic syndrome as per the NCEP and IDF definitions vis-a-vis severity and duration of psoriasis in a semi-urban Maharashtrian population: A case control study Yugal K. Sharma, Naren Prakash *, Aayush Gupta Dermatology department, Dr. D.Y. Patil Medical College, Hospital & Research Centre, Pimpri, Pune, India 1. Introduction Psoriasis, an immune-mediated inflammatory disease charac- terized by epidermal hyperproliferation, abnormal keratinocyte differentiation, increased angiogenesis, blood vessel dilatation and excess Th-1/Th-17 inflammation, affects 2–3% of the population worldwide [1]. The inexorable inflammation during its chronic course also predisposes its patients to a number of disorders having an inflammatory component epitomised by metabolic syndrome (MS) – a constellation of interrelated risk factors of metabolic origin including abdominal obesity, impaired glucose tolerance, atherogenic dyslipidemia and hypertension [2]. Psoriasis being an independent risk factor for subclinical atherosclerosis and subsequent adverse cardiovascular events, its plaques can be looked upon as closely related to those of atherosclerosis with chronic inflammation underlying its etiopathogenesis, as well as that of metabolic syndrome. Similar inflammatory markers – namely, Th1 cytokines (intracellular adhesion molecule-1, TNF-a), osteopontin, leptin, adiponectin, homocysteine and C-reactive protein – play a role in these conditions [3]. Moreover, psoriatic disease activity can get stimulated by classic risk factors (smoking and obesity) of cardiovascular disease, whose prevalence is increased among psoriasis patients. Both the adipocytes and macrophages, the engines of obesity and psoriasis respectively, have a common mesothelial origin. Each component of the metabolic syndrome is an established cardiovascular risk factor, multiple components conferring greater risk than the sum of the risks associated with each. However, comparison of its prevalence in varied populations – differing in genetic background, diet, levels of physical activity, age, sex and body habits – is inherently difficult and is further compounded by the lack of consensus in its proposed defining criteria (Table 1). The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) [4] and World Health Organization (WHO) [5] definitions, primarily established for epidemiological studies, address the public health implications. However, the ease of measuring the criteria of fasting blood sugar Diabetes & Metabolic Syndrome: Clinical Research & Reviews xxx (2016) xxx–xxx A R T I C L E I N F O Keywords: Metabolic syndrome Psoriasis Obesity Dyslipidemia Diabetes A B S T R A C T Background: The inexorable inflammation in patients of psoriasis predisposes to various disorders, notably, a cluster of cardiovascular and metabolic abnormalities christened ‘metabolic syndrome’. Aim: To assess the prevalence of metabolic syndrome and its correlation with the severity and duration of psoriasis. Methods: One hundred psoriasis patients and 100 age-and-sex matched controls were included, whose waist circumference and blood pressure were measured; fasting serum cholesterol, triglycerides and glucose levels quantified; disease severity assessed and metabolic syndrome defined separately by two globally accepted criteria. Results: Metabolic syndrome (38%:12%), hypertriglyceridemia (53%:25%), impaired glucose tolerance (38%:16%) [P < 0.001] and low HDL (P = 0.002) were significantly more prevalent in cases as compared to controls as were the mean values of triglycerides and fasting blood sugar. Increased mean age of psoriasis patients and duration of disease strongly correlated with the presence of this syndrome. The divergence in definition of the syndrome by two separate criteria was also highly significant (P < 0.001). Conclusion: Metabolic syndrome had significant presence in and increased with the duration but remained unaffected by the severity of psoriasis in our study patients. ß 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved. * Corresponding author at: 7-A Commissioners Lane Civil Lines, Delhi 110054, India. Tel.: +91 9999953266. E-mail address: drnarenprakash@gmail.com (N. Prakash). G Model DSX-570; No. of Pages 5 Please cite this article in press as: Sharma YK, et al. Prevalence of metabolic syndrome as per the NCEP and IDF definitions vis-a-vis severity and duration of psoriasis in a semi-urban Maharashtrian population: A case control study. Diab Met Syndr: Clin Res Rev (2016), http://dx.doi.org/10.1016/j.dsx.2016.01.033 Contents lists available at ScienceDirect Diabetes & Metabolic Syndrome: Clinical Research & Reviews jo ur n al h o mep ag e: www .elsevier .c om /loc ate/d s x http://dx.doi.org/10.1016/j.dsx.2016.01.033 1871-4021/ß 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.