Psoriasis is a complex disease which is still not very well understood and one aspect of this chronic skin disease that we have noted before in this article is that people with this skin disease often have or are at increased risk of developing other health issues. A recent study of a large group of twins in Denmark seems to lend credence to this by revealing a possible connection between psoriasis, obesity and type 2 diabetes.
Though not the only cause, the explosion of type 2 diabetes has been tied to the increase in obesity levels in the general population which can affect how insulin operates in relation to blood sugar, and this study seems to conclude that there may be correlation between psoriasis and obesity which may result from genetic factors.
The population-based study found the prevalence of psoriasis in individuals with T2DM (Type 2 Diabetes Mellitus) was nearly twice as high as in those without (7.6% versus 4.1%; P=0.001), reported a research team led by Ann Lønnberg, MD, of the University of Copenhagen in Denmark.
In twins where one individual had psoriasis and the other didn’t, the risk for obesity was nearly two-fold higher in the twin with psoriasis. However, the risk for T2DM was the same, Lønnberg and colleagues reported in JAMA Dermatology.
The study also found a modest but significant genetic correlation between psoriasis and BMI (correlation 0.12; 95% CI 0.08-0.19; P<0.001) but not between psoriasis and T2DM. There was not a significant environmental correlation between psoriasis and BMI (correlation -0.05; 95% CI -0.14 to 0.04; P=0.44), Lønnberg and colleagues said.
“Psoriasis was significantly associated with type 2 diabetes mellitus and obesity in this nationwide study of Danish twins, even after adjustment for confounders. Furthermore, this study is the first, to our knowledge, to determine the contribution of genetic and environmental factors to the interaction between obesity, type 2 diabetes mellitus, and psoriasis,” the investigators wrote.
Lønnberg and colleagues concluded,”Psoriasis, type 2 diabetes mellitus, and obesity are strongly associated in adults after taking key confounding factors, such as sex, age, and smoking, into account. Results indicate a common genetic etiology of psoriasis and obesity. Conducting future studies on specific genes and epigenetic factors that cause this association is relevant.”
However, the researchers are not saying that one condition may cause another condition. For instance, a twin with psoriasis may lead a more sedentary life due to the psychological effects of this skin condition which may increase the risk of developing obesity/type 2 diabetes.
Other limitations of this study is that the questionnaires and BMI results depended on self reporting which can be unreliable.
Despite the limitations of this study, what dermatologists should get from this is that when treating a patient with psoriasis, they should consider addressing the possible connection between this skin disease and type 2 diabetes/obesity and encourage the patient to screen for these other conditions especially type 2 diabetes which is considered a “silent killer” and early detection and changes made can help not only prevent the development of type 2 diabetes but also the symptoms and complications that can result.