The link between psoriasis and obesity

Obesity is a risk factor for psoriasis, and it can make psoriasis worse. The cause of this condition may be due to inflammatory mediators and the microbiome in the body. Scientists are still conducting research as well as clinical trials to better explain this relationship.

Psoriasis is a common chronic inflammatory skin disease. It affects about 2 to 4% of the general population, and patients often present with erythema, scaly patches, and plaques on the scalp, back, elbows, and knees. Psoriasis has a mortality rate. mortality is very low (possibly rare) but it greatly affects the quality of life of patients. Furthermore, the disease is associated with a number of comorbidities such as: psoriatic arthritis (this is a potentially debilitating inflammatory joint condition that affects approximately 34% of patients with psoriasis), increased risk of skin cancer, lymphoma, diabetes, metabolic syndrome, venous thrombosis, stroke, and heart attack. The pathogenesis of psoriasis is thought to be the result of interactions between genetic components, immune dysfunction, and environmental factors. The immune response in psoriasis is characterized by proliferation of Th1, Th17 and Th22 cells leading to the production of inflammatory mediators, tumor necrosis factor (TNF)-α, interleukins ( IL) -6 and IL -22.

The prevalence of psoriasis in adults is increasing. It is possible that the cause is genetic, but it is not the only cause. In addition, it is also due to environmental factors including lifestyle, eating habits, exercise... are also very important. Today, the eating habits in developing countries are often high in fat, especially saturated fat, high in salt and sugar, creating excess calories leading to overweight, obesity and diseases of the metabolic syndrome. chemical.

2.1. Studies on the relationship between psoriasis and obesity In a Norwegian study with 35,000 participants, the results of the metabolic syndrome and the risk of developing psoriasis were found. When analyzing the factors affecting metabolism, the authors have shown that obesity is a special influencing factor for psoriasis. Similar to the results of this study, epidemiological researchers also studied and provided reliable evidence that obesity is a cause of psoriasis and disease development.

In addition, a study by Setty and colleagues in 78,626 women (of whom 892 reported psoriasis) found that fat and weight gain were risk factors for the development of psoriasis. . Patients with a body mass index (BMI) of 35 or higher were 2.69 times more likely to develop psoriasis than the general population.
Or a recent study has also shown that obesity and high belly fat double the risk of psoriasis. The study also suggested that preventing weight gain or maintaining a normal weight could reduce the incidence of psoriasis.
Studies consistently show a positive effect of weight loss on psoriasis severity. Therefore, dietary weight loss is recommended in overweight and obese patients with psoriasis.

2.2. Explanations for this association One question arises as to whether dietary differences (low-carbohydrate, ketogenic, or vegetarian) have an effect on psoriasis improvement. Therefore, understanding the epidemiological relationship between obesity and/or diet and psoriasis is important in the assessment of modifiable risk factors for the occurrence and development of psoriasis. .
As is known, adipose tissue is an important endocrine organ secreting soluble factors involved in inflammation and immunity. Thus, adipose tissue enlargement and secretion of inflammatory mediators may worsen psoriasis.

In addition, obesity alters the cellular composition and activity of inflammatory cells in the skin. Nakamizo et al described the accumulation of IL-17A-producing γδ T cells in psoriatic skin lesions of a high-fat diet (HFD) and resulting in psoriatic dermatitis. Furthermore, transgenic (db/db) diabetic mice showed increased psoriatic dermatitis with increased IL-17A and IL-22.
Another important aspect is the fact that obesity and diet affect the body's microbiome. Recently, scientists have demonstrated that the microbiome - represents the entire microbiome on the outer and inner surfaces of the human body. It can have a powerful effect on autoimmune diseases. At the same time, there is some evidence that this may also be the case in psoriasis. Therefore, the role of the microbiome has been emphasized in recent experimental studies.
Psoriasis is a chronic inflammatory skin disease with a complex interplay between immune cells and tissue cells. Genetic and environmental factors contribute to psoriasis. One of the environmental factors that are obesity and nutrition has an important impact on the onset and severity of the disease. And studies have shown that dietary saturated fat appears to be an amplifying factor for psoriasis inflammation.

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References: ncbi.nlm.nih.gov, webmd.com

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