This trial was an investigator-initiated assessor blinded study of MetS and surrogate markers of increased CVD risk in pediatric psoriasis patients versus a control
group of patients with warts. Our study included twenty children, ages 10 to 17 with moderate-to-severe psoriasis compared
to twenty age- and sex-matched controls. All patients provided written informed consent before entering the study and the protocol was approved by the Institutional Review Board at Tufts Medical Center. Baseline demographics are depicted in Table 1. Patients with psoriasis had plaques that covered greater than 5% body surface area or a documented history of body surface area of at least 5%. Psoriasis patients were permitted to use any topical, systemic, or biologic agent throughout the trial. MetS was defined by the presence of three of the following criteria: triglycerides ≥100 mg/dl, HDL-C <50 mg/dl for females or <45 mg/dl males, fasting blood glucose ≥110 mg/dl, waist circumference >75th percentile for age and sex, systolic or diastolic blood pressure >90th percentile for age, sex and height.4 Fasting glucose and serum lipid profiles were obtained after a 12-hour fast.
Preliminary results outlined in Table 2 of 18 enrolled children showed that patients with psoriasis had lower mean HDL-C levels,
41.7 mg/dl versus 53.8 mg/dl in the control group (P=0.048).
LDL-C, triglycerides and fasting glucose were not statistically different between the two groups. One-third of pediatric psoriasis
patients (four out of 12 patients) met criteria for MetS versus no children in the control group (P=0.245), shown in Figure 1. Analysis on completion of the study may yield a statistically
significant incidence of MetS in psoriasis patients. These interim results suggest that children with psoriasis may have an increased risk for CVD and MetS. It may be important to screen pediatric psoriasis patients for these risk factors earlier than current recommended guidelines.
