The metabolic syndrome in psoriasis

Psoriasis is a chronic inflammatory skin disease, frequently associated to metabolic disorders including obesity, dyslipidemia, diabetes, liver steatosis and metabolic syndrome. In particular, the association to obesity is relevant for many reasons. Obesity is a significant risk factor for the development of psoriasis and psoriatic arthritis (PsA).Moreover, a higher body mass index (BMI) is correlated to the severity of psoriasis and it negatively affects the clinical response to systemic treatments. Obesity is a low-grade inflammatory condition with increased circulating levels of cytokines including leptin, resistin, visfatin and chemerin produced by adipocytes and macrophages infiltrating the adipose tissue. Adipokines have essential role in glucose and lipid metabolism, cardiovascular functions, as well as modulation of inflammatory responses.Higher levels of leptin and resistin have been associated with endothelial dysfunction, pro-thrombotic state and increased cardiovascular risk. Increased levels of leptin, resistin, IL-6, chemerin and retinol-binding protein-4 have been reported in patients with psoriasis.