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Is Adiposity in Women a Risk Factor for Psoriasis?

Weight gain and multiple measures of adiposity were strong risk factors for incident psoriasis in women.

Approximately 2% of people have psoriasis, a chronic inflammatory skin disease. Chronic inflammation from adipose tissue might pose an increased risk for the disorder. To determine the relation between adiposity and incident psoriasis, researchers studied nearly 79,000 women who were psoriasis free at enrollment in the Nurses’ Health Study II and for whom self-reported BMI, weight gain since age 18, waist and hip circumference, and waist-hip ratio were obtained.

In biennial health questionnaires, 862 women reported physician-diagnosed psoriasis since 1991. When women with BMIs of 21.0–22.9 were used as the reference group, the adjusted relative risk for psoriasis increased progressively with higher BMI. Women who were overweight (BMI, 25.0–29.9), obese (BMI, 30.0–34.9), and morbidly obese (BMI, ≥35) were 1.40, 1.48, and 2.69 times as likely to develop psoriasis. A waist measuring more than 40 inches and a higher waist-hip ratio also were significantly associated with increasing risk for the disorder. Women who had gained at least 35 pounds since age 18 were almost twice as likely to develop psoriasis as those who had maintained their weight.

Comment: The connection between obesity and psoriasis is not intuitive. Nonetheless, the inflammatory nature of obesity (particularly when it involves abdominal adipose tissue) is increasingly recognized as an important factor in a number of conditions, including cardiovascular disease. Family history of psoriasis, which was not obtained in this study, is a potential confounding factor. However, if future data confirm these findings, weight loss might become an important strategic addition to the prevention and management of psoriasis.

Wendy S. Biggs, MD

Published in Journal Watch Women's Health October 11, 2007

Citation(s):

Setty AR et al. Obesity, waist circumference, weight change, and the risk of psoriasis in women: Nurses’ Health Study II. Arch Intern Med 2007 Aug 13/27; 167:1670.

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