Diabetes, heart failure, obesity... are these conditions more prevalent in patients with psoriasis?

The psoriasis is an inflammatory disease. As a result, the immune system of psoriasis patients does not function normally. Health issues related to the immune system increase and promote certain diseases.

• Psoriasis and Diabetes.

  Individuals with psoriasis are likely to develop type 2 diabetes. This disease is characterized by insufficient insulin production, leading to hyperglycemia. A study has shown that psoriasis increases the risk of diabetes by 59%. In cases of severe forms, this increase can go up to 97%. Psoriasis is linked to body inflammation. It triggers an inflammatory response in tissues, particularly in fat storage cells. This can lead to insulin resistance in the liver and muscles, resulting in an insulin action defect. Consequently, this leads to the onset of type 2 diabetes.

• Psoriasis and Cardiovascular Diseases.

  Cardiovascular diseases related to psoriasis are often caused by the treatment followed. MACE is the acronym that refers to the risk of heart attack (myocardial infarction), stroke (cerebrovascular accident), and cardiovascular death. Researchers note that certain interleukin inhibitors increase the risk of MACE. These include IL-12 and IL-23. However, their mode of action on the onset of cardiovascular diseases is not yet understood. Furthermore, the cyclosporine, an immunosuppressant, is likely to damage cardiac muscle tissues, although its mode of action is not yet well understood.

• Psoriasis and Obesity.

  The risk of obesity increases in individuals suffering from psoriasis. This condition, a source of embarrassment, discomfort, and self-consciousness, has numerous effects on a person's morale and psychological state. Those affected are at a higher risk of social isolation and poor dietary habits, which promote obesity. Indeed, a study has shown that patients with psoriasis consume significantly more fats andalcohol compared to individuals without psoriasis.

• Psoriasis and Inflammatory Bowel Diseases.

  Inflammatory bowel diseases are conditions characterized by inflammation of the digestive tract. The risk of developing inflammatory bowel diseases in individuals with psoriasis is four times higher than in healthy individuals. Moreover, psoriasis promotes the onset of Crohn's disease and ulcerative colitis. These are inflammatory bowel diseases characterized by diarrhea, abdominal pain, and a feeling of fatigue. However, the link between the onset of these diseases and psoriasis is not yet clear.

• Psoriasis and Depression.

  During the course of psoriasis, changes in blood levels have been observed, particularly an increase in cytokines IL-12, IL-1α, IL-2, and IL-6. These cytokines play a role in the onset of depression symptoms by influencing the hypothalamic-pituitary-adrenal (HPA) axis, which regulates the stress response. Prolonged activation of this axis can lead to an excessive production of cortisol, a stress hormone, which can disrupt emotional balance and lead to depression.

• Psoriasis and cancer.

  Researchers have found that the risk rate of cancer development in individuals with psoriasis is 1.18 times higher than that of healthy individuals. However, this risk can vary depending on the severity of the psoriasis. Individuals with severe psoriasis have a 1.22 times higher risk of developing cancer compared to a population without psoriasis. This can be explained by treatments involving immunomodulators that weaken the immune system. This results in a decrease in the body's ability to detect and eliminate cancer cells, thereby promoting their multiplication.

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• ARMSTRONG A. W. & al. Psoriasis and the risk of diabetes mellitus a systematic review and meta-analysis. JAMA Dermatology (2013).

• ARMSTRONG A. W. & al. Psoriasis and major adverse cardiovascular events: A systematic review and meta-analysis of observational studies. Journal of the American Heart Association (2013).

• CHAMOUN A. & al. Psoriasis et dépression. Revue Médicale de Bruxelles (2015).

• JENSEN P. & al. Psoriasis and obesity. Dermatology (2016).