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Like their adult counterparts, psoriasis in children is an independent risk factor for comorbidity, but not as much as obesity.
Using claims data from Optum Laboratories Data Warehouse (150 million privately insured and Medicare enrollees), of 29 957 children with psoriasis were matched with a comparator cohort (children without psoriasis) and studied for the effects of psoriasis and obsesity.
Psoriasis children were likely to be obese (2.9% vs 1.5%; P < .001). They were also significantly more likely to develop each of the studied comorbidities than those without psoriasis (P < .01).
In nonobese children, psoriasis was associated with a 40% to 75% risk of comorbidity:
- Hyperlipidemia - HR, 1.42; 95% CI, 1.25-1.62
- HTN - HR, 1.64; 95% CI, 1.40-1.93
- Diabetes - HR, 1.58; 95% CI, 1.27-1.95
- Metabolic syndrome - HR, 1.62; 95% CI, 1.13-2.33
- Polycystic ovarian syndrome - HR, 1.49; 95% CI, 1.18-1.88
- Nonalcoholic liver disease (HR, 1.76; 95% CI, 1.16-2.65
- Elevated liver enzymes - HR, 1.46; 95% CI, 1.27-1.67
Obesity was a strong risk factor for development of comorbidity, even without psoriasis (HR ranging from 2.26 to 18.11).
Children with psoriasis are at greater risk of developing obesity, hyperlipidemia, hypertension, diabetes, metabolic syndrome, polycystic ovarian syndrome, nonalcoholic liver disease, and elevated liver function enzyme levels than children without psoriasis.
However, obesity is a much stronger risk factor for comorbidity in children with psoriasis.