Acta Demato-Venereologica 98-2CompleteContent | Page 27

282 SHORT COMMUNICATION

Advances in dermatology and venereology Acta Dermato-Venereologica

Central Obesity in Children with Psoriasis

Lucia GUIDOLIN, Marco BORIN, Elena FONTANA, Francesca CAROPPO, Stefano PIASERICO and Anna BELLONI FORTINA * Pediatric Dermatology Unit, Department of Medicine DIMED, University of Padova, Via Gallucci, 4, IT-35128 Padova, Italy. * E-mail: anna. bellonifortina @ gmail. com Accepted Oct 16, 2017; Epub ahead of print Oct 19, 2017

Psoriasis is a chronic inflammatory disease that affects up to 1.37 % of children in Europe( 1). Recent studies report that, not only in adults, but also in children, psoriasis may be associated with certain morbidities, including obesity, hypertension, dyslipidemia, diabetes mellitus, metabolic syndrome( 2 – 8). Most of these studies, however, have been designed as multicenter studies, and thus may have limitations because of the inter-institution variations in data-collecting methodologies, data interpretation, different populations studied or limited number of patients investigated.

We performed a single-centre study, investigating the association between psoriasis and body mass index( BMI) and central obesity( waist-to-height ratio; WHtR) in 107 children with psoriasis and 107 age- and sex-matched controls.

METHODS

From 2013 to 2016 a single-centre, cross-sectional study of 107 consecutive children with psoriasis( mean age 9.94 ± 3.48 years) and 107 age- and sex-matched children without psoriasis( control group) was performed at the Pediatric Dermatology Unit, Padua University, Padua, Italy.

The children in the control group were recruited from among children consecutively attending the Pediatric Dermatology clinic for non-inflammatory diseases( i. e. warts, naevi, moles, etc.). Children with and without psoriasis were from the same geographical area, with similar demographic characteristics and, presumably, similar lifestyles. The following data were collected for each patient: physical examination, height, body weight, BMI, WHtR, duration and family history of psoriasis.

Psoriasis severity was classified as mild or moderate-to-severe according to Psoriasis Area Severity Index( PASI) and body surface area( BSA). When PASI was ≥ 10 and / or BSA was > 10 % psoriasis was designated as moderate-to-severe( 8).

BMI( in kg / m 2) allowed us to classify children as normal weight(< 85 th and > 5 th percentile), overweight( ≥ 85 th and < 95 th percentile) or obese( ≥ 95 th percentile)( 9).

Waist circumference( WC) was measured twice, midway between the lowest border of the rib cage and the upper border of the iliac crest, at the end of normal expiration, using inextensible anthropometric tape with the patients standing erect and relaxed with arms at their sides and feet positioned close together. The mean values were considered for analysis. Evaluation of central obesity was performed using WHtR, calculated as WC( in cm) divided by height( in cm). Patients with a WHtR ≥ 0.5 were classified as having central obesity( 8).

Descriptive statistics are presented as counts and percentages for categorical variables and mean ± standard deviation( SD) for continuous data. The distribution of continuous variables was tested for normality using the Kolmogorov – Smirnov test. The χ 2 test and Fisher’ s exact test were used to compare categorical variables and the Student’ s t-test or Mann – Whitney U test to compare continuous variables between groups. Odds ratios( OR) and the corresponding 95 % confidence intervals( 95 % CI) were estimated. The independent associations between disease status( patients with psoriasis and those without) and the clinical and analytical variables were assessed using multivariable logistic regression models. The level of statistical significance was set at α = 0.05. Data were collected in a database using Microsoft Excel 2016 for Windows 10 and statistical analyses were performed with SPSS version 23.0( Statistical Package for Social Science Inc., Chicago, IL, USA) for Microsoft Windows 10.

RESULTS

Table I. Demographic, anthropometric and clinical data of children with psoriasis and control group

Demographic data are shown in Table I. A family history of psoriasis was present in 67 out of 107( 62.62 %) children, of whom 35( 32.71 %) reported that first-degree parents were affected. Paternal imprinting was found in 37.38 % children with psoriasis; maternal imprinting was found in 20.56 % children with psoriasis( p < 0.001).

Children with psoriasis n = 107

Control group n = 107 p-value

Odds ratio( 95 % confidence interval)

doi: 10.2340 / 00015555-2816 Acta Derm Venereol 2018; 98: 282 – 283

This is an open access article under the CC BY-NC license. www. medicaljournals. se / acta Journal Compilation © 2018 Acta Dermato-Venereologica.