Metabolic Syndrome and Psoriasis: Mechanisms and Future Directions

Abstract

Psoriasis is an immune-mediated systemic disease with associated comorbidities, including metabolic syndrome (MetS) which contributes substantially to premature mortality in patients with psoriasis. However, the pathological mechanisms underlying this comorbidity are unclear. Studies have shown that the pathological parameters of psoriasis mediate the development of MetS. We reviewed the potential mechanisms which mediate the association between psoriasis and MetS, including endoplasmic reticulum stress, pro-inflammatory cytokine releases, excess production of reactive oxygen species, alterations in adipocytokine levels and gut microbiota dysbiosis. Here, we highlight important research questions regarding this association and offer insights into MetS research and treatment.

Keywords: autoimmunity; gut microbiota; insulin resistance; metabolic syndrome; obesity; psoriasis.

Figure 1

Metabolic diseases which frequently occur in patients with psoriasis. Psoriasis is often associated with obesity, hypertension, diabetes mellitus, hyperlipidemia, and obesity-associated non-alcoholic fatty liver disease, all of which belong to metabolic syndrome.

Figure 2

Possible mechanisms linking psoriasis and metabolic syndrome (MetS). The increased release of pro-inflammatory cytokines, adipose tissue secretory adipocytokines, activation of oxidative stress states, increased endoplasmic reticulum (ER) stress, and gut microbiota dysbiosis observed in psoriasis contribute to the development of MetS.