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首页> 外文期刊>American journal of clinical dermatology >Considerations for Systemic Treatment of Psoriasis in Obese Patients
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Considerations for Systemic Treatment of Psoriasis in Obese Patients

机译：肥胖患者牛皮癣全身治疗的注意事项

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Psoriasis is an immune-mediated inflammatory skin disease frequently associated with metabolic disorders, including diabetes, dyslipidaemia and metabolic syndrome. Moreover, a growing number of studies confirm the association between psoriasis and obesity. It has been found that obesity, as measured by body mass index > 30 kg/m(2), can double the risk of incident psoriasis. A positive correlation between different measures of adiposity and the severity of psoriasis has also been reported. Epidemiologic studies have also provided robust evidence confirming the association between obesity and psoriatic arthritis. Genetic, metabolic and environmental factors are all likely to contribute to these associations. Adipose tissue is an active endocrine and paracrine organ that has a key role in lipid and glucose metabolism as well as inflammation. Fat tissue is traditionally distributed into two main compartments with different metabolic characteristics, i.e. the subcutaneous and visceral adipose tissue. Particular attention has been devoted to visceral adiposity because of its contribution to inflammation and atherosclerosis. The association between psoriasis and obesity should be properly considered when choosing a systemic treatment, because it could exert negative effects on metabolic parameters, including liver enzymes, serum lipids and renal function. Obesity may increase the risk of liver and renal toxicity from methotrexate and cyclosporine. Moreover, obesity can compromise the effectiveness of systemic treatments for psoriasis (conventional and biological therapies). Dermatologists are also expected to promote a healthy lifestyle and weight loss for obese patients because they could improve metabolic parameters and responsiveness to psoriasis therapies.
机译：牛皮癣是一种免疫介导的炎症性皮肤病，通常与包括糖尿病，血脂异常和代谢综合征在内的代谢疾病有关。此外，越来越多的研究证实了牛皮癣和肥胖之间的关联。已经发现，通过体重指数> 30 kg / m（2）来衡量，肥胖可使牛皮癣的发病风险加倍。还已经报道了不同的​​肥胖测量与牛皮癣严重程度之间的正相关。流行病学研究还提供了强有力的证据，证实了肥胖与牛皮癣性关节炎之间的关联。遗传，代谢和环境因素都可能导致这些关联。脂肪组织是活跃的内分泌和旁分泌器官，在脂质和葡萄糖代谢以及炎症中起关键作用。传统上，脂肪组织分布在两个具有不同代谢特征的主要隔室中，即皮下和内脏脂肪组织。由于内脏肥胖症对炎症和动脉粥样硬化的贡献，因此特别关注内脏肥胖症。选择全身性治疗时，应适当考虑牛皮癣和肥胖之间的关联，因为它可能对代谢参数（包括肝酶，血脂和肾功能）产生负面影响。肥胖可能会增加甲氨蝶呤和环孢素对肝脏和肾脏毒性的风险。此外，肥胖症会损害牛皮癣全身治疗（传统和生物疗法）的有效性。皮肤科医生还有望促进肥胖患者的健康生活方式和减轻体重，因为他们可以改善代谢参数和对牛皮癣治疗的反应性。

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