Correlation between BMI and PASI in patients affected by moderate to severe psoriasis undergoing biological therapy
Correlation between BMI and PASI in patients affected by moderate to severe psoriasis undergoing biological therapy
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DOI：
10.1111/j.1529-8019.2009.01281.x
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发表时间：
2010-01-01
影响因子：
3.6
通讯作者：
Patrizi, A.
中科院分区：
文献类型：
--
作者：
Bardazzi, F.;Balestri, R.;Patrizi, A.
肥胖在银屑病患者中很常见，并且已被证明对病情的许多方面都很重要。特别是，低热量饮食可以改善脓疱型银屑病的症状和治疗反应。本研究探讨了体重变化对接受生物药物治疗的中重度银屑病患者的疾病临床表现的影响。最后，评估了热量限制的影响。这项观察性横向研究招募了 33 名在我们的严重银屑病门诊就诊并接受生物药物治疗的患者。体重指数（BMI）被用作超重和肥胖的诊断指标。还测量了腰围。在 4 个月和 8 个月的随访中测量体重和银屑病面积严重指数 (PASI) 指数。 Mann-Whitney 非参数检验用于检测患者组之间的差异。进行 Fisher 精确检验来评估根据 BMI 的治疗变化而产生的不同结果。该组中超重肥胖者的比例很高，平均 BMI 为 30.59 +/- 6.94。大多数患者的腰围也高于正常值。肥胖患者的PASI指数高于全组平均值（25.03+/-12.43），其中III级肥胖患者的平均PASI为44+/-3.37。在第一次和第二次随访中，体重增加的患者没有达到 PASI 50；体重稳定的患者对治疗的反应各不相同，而体重减轻的患者即使一开始没有反应，也能达到 PASI 90 或 PASI 75。需要进一步的研究来了解在较重的患者中观察到的不良反应是否是由于生物药物的药代动力学所致，或者是因为治疗应该基于体重指数而不是固定剂量，从而提出伦理考虑。
Obesity is common in psoriatic patients, and it has been shown to be important for many aspects of the condition. In particular, low-calorie diets can improve the symptoms and response to treatment in pustular psoriasis. The present study investigates the influence of body-weight alteration on the disease's clinical manifestations in moderate to severe psoriasis patients treated with biological drugs. Finally, the influence of a caloric restriction was assessed. This observational transversal study enrolled 33 patients attending our Severe Psoriasis Outpatient Clinic, who were treated with biological drugs. Body Mass Index (BMI) was used as a diagnostic indicator of being overweight and of obesity. Waist circumference was also measured. Body weight and Psoriasis Area Severity Index (PASI) index were measured at follow-up visits at 4 and 8 months. Nonparametric test of Mann-Whitney was used to detect the differences between patient groups. Fisher's exact test was performed to evaluate the different results depending on the therapeutic changes of BMI. There was a strong prevalence of overweight-obese individuals in the group with a mean BMI of 30.59 +/- 6.94. Waist circumference was also above normal in the majority of the patients. Obese patients had a PASI index higher than the average of the whole group (25.03 +/- 12.43), with grade III obese patients having an average PASI of 44 +/- 3.37. At the first and second follow-ups, patients who put on weight did not achieve PASI 50; patients who had a stable weight presented variable response to treatment, while patients who decreased their weight achieved PASI 90 or PASI 75 even when not responding at the first. Further studies are needed to understand if the poor response observed in heavier patients is due to biological drugs pharmacokinetics or because therapy should be BMI based rather than administered in fixed doses, posing then an ethical consideration.