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Children with psoriasis at increased risk of obesity

01 Oct 2016

Higher waist-to-height ratio (WtHR) was more common in patients with psoriasis than in controls, suggesting that WtHR may be a better toll than body mass index (BMI) in identifying children at increased risk of greater central adiposity, suggests a study.

“WtHR can easily identify children with increased central adiposity and is a simpler alternative to BMI that does not require growth charts or percentiles,” researchers said. “Having a WtHR of 0.5 or greater is associated with future cardiovascular risk.”

A multicentre, cross-sectional, prospective case-control study was conducted to determine whether children with psoriasis are more likely to have increased WtHR, obesity, and metabolic syndrome compared with those without psoriasis. A total of 208 children (mean age 8.9 years; 110 girls) were involved, of which 135 had psoriasis and 73 were controls with noninflammatory skin conditions.

The primary outcomes were increased central adiposity indicated by WtHR ≥0.5, metabolic syndrome, and increased BMI.

Children with psoriasis relative to those without were more likely to have increased central adiposity, with WtHR ≥0.5 (29 vs 11 percent; p=0.002). Among children older than 10 years, 4 of 53 with psoriasis had metabolic syndrome compared with none of 29 in the control group (8 vs 0 percent; p=0.29). Metabolic syndrome was observed in 3 of 15 children with moderate to severe psoriasis compared with 1 of 38 children with mild psoriasis (20 vs 3 percent; p=0.6).

Children with moderate to severe psoriasis had a higher mean WtHR than children with mild psoriasis (0.48 vs 0.46; p=0.04). Overweight and obesity according to BMI did not vary significantly between children with psoriasis and controls (17 vs 16 percent; p=0.91).

The WtHR is a simple and valid tool to identify children with increased central adiposity. It has been shown to be associated with future cardiometabolic risk; it is easy to perform in children presenting with psoriasis; and we propose that it should be part of a standard workup,” researchers said.

“Children with psoriasis who are not overweight according to BMI are still more likely to have a WtHR of 0.5 or higher than children without psoriasis. This finding in a child with psoriasis is an opportunity to counsel the family about healthy lifestyle choices and is an opportunity for early intervention,” they added.

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