乾癬兒童常合併高血脂、高血壓、糖尿病、多囊、肝病，體重過重者更是如此

乾癬，中醫經方的治療實例，請見這裡。

乾癬，期刊研究，請看這裡。

期刊研究整理，請見這裡。

本篇研究全文，請見這裡（外部網站）。

Association of Psoriasis With Comorbidity Development in Children With Psoriasis

Importance：Children with psoriasis are at increased risk for comorbidities. Many children with psoriasis are also overweight or obese; it is unknown whether the increased risk of comorbidities in these children is independent of obesity.

Objective：To determine the risk of elevated lipid levels (hyperlipidemia/hypertriglyceridemia), hypertension, metabolic syndrome, polycystic ovarian syndrome, diabetes, nonalcoholic liver disease, and elevated liver enzyme levels in children with and without psoriasis, after accounting for obesity.

Design, Setting, and Participants：This was a retrospective cohort study of claims data from Optum Laboratories Data Warehouse (includes 150 million privately insured and Medicare enrollees). A cohort of 29 957 children with psoriasis (affected children) and an age-, sex-, and race-matched comparator cohort of 29 957 children without psoriasis were identified and divided into 4 groups: (1) nonobese, without psoriasis (reference cohort); (2) nonobese, with psoriasis; (3) obese, without psoriasis; and (4) obese, with psoriasis.

Main Outcomes and Measures：Risk of developing comorbidities (Cox proportional hazards regression).

Results：The overall mean (SD) age of those included in the cohort was 12.0 (4.4) years, and 16 034 (53.5%) were girls. At baseline, more affected children were obese (862 [2.9%] vs 463 [1.5%]; P < .001 for all comparisons).

Children with psoriasis were significantly more likely to develop each of the comorbidities than those without psoriasis (P < .01). Obesity was a strong risk factor for development of each comorbidity, even in those without psoriasis (hazard ratios [HRs] ranging from 2.26 to 18.11).

The risk of comorbidities was 40% to 75% higher among nonobese children with vs without psoriasis: elevated lipid levels (HR, 1.42; 95% CI, 1.25-1.62), hypertension (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), and elevated liver enzyme levels (HR, 1.46; 95% CI, 1.27-1.67). Except for hypertension (P = .03), no significant interaction occurred between psoriasis and obesity on the risk of comorbidities.

Conclusions and Relevance：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.

While psoriasis is a small independent risk factor for the development of these comorbidities, obesity is a much stronger contributor to comorbidity development in children with psoriasis.

原始論文

Association of Psoriasis With Comorbidity Development in Children With Psoriasis（外部網站）

Tollefson MM, Van Houten HK, Asante D, Yao X, et al. JAMA Dermatology. 2018;154(3):286-292. doi:10.1001/jamadermatol.2017.5417

論文摘要（Google 翻譯）

以下為 Google 翻譯，並校正明顯錯誤，僅供參考，內容以英文原文為準。

兒童乾癬患者中乾癬與共病發生的關聯

重要性：乾癬兒童發生共病的風險較高。許多乾癬兒童同時過重或肥胖；目前尚不清楚這些兒童增加的共病風險是否獨立於肥胖之外。

目的：在考量肥胖後，判定有無乾癬的兒童發生血脂升高（高脂血症／高三酸甘油酯血症）、高血壓、代謝症候群、多囊性卵巢症候群、糖尿病、非酒精性肝病與肝指數升高的風險。

設計、場域與參與者：這是一項回溯性世代研究，使用 Optum Laboratories Data Warehouse 的保險理賠資料（涵蓋 1.5 億名私人保險與 Medicare 投保者）。研究找出 29,957 名乾癬兒童（患病兒童）世代，以及年齡、性別與種族配對的 29,957 名無乾癬兒童對照世代，並分為 4 組：（1）非肥胖、無乾癬（參考世代）；（2）非肥胖、有乾癬；（3）肥胖、無乾癬；（4）肥胖、有乾癬。

主要結果與測量指標：發生共病的風險（Cox 比例風險迴歸）。

結果：世代整體平均（SD）年齡為 12.0（4.4）歲，其中 16,034 名（53.5%）為女孩。基線時，患病兒童中肥胖者較多（862 名［2.9%］對 463 名［1.5%］；所有比較 P < .001）。

乾癬兒童發生每一種共病的可能性都顯著高於無乾癬兒童（P < .01）。肥胖是每一種共病發生的強烈危險因子，即使在無乾癬者中也是如此（風險比［HR］介於 2.26 至 18.11）。

在非肥胖兒童中，有乾癬者的共病風險比無乾癬者高 40% 至 75%：血脂升高（HR 1.42；95% CI 1.25–1.62）、高血壓（HR 1.64；95% CI 1.40–1.93）、糖尿病（HR 1.58；95% CI 1.27–1.95）、代謝症候群（HR 1.62；95% CI 1.13–2.33）、多囊性卵巢症候群（HR 1.49；95% CI 1.18–1.88）、非酒精性肝病（HR 1.76；95% CI 1.16–2.65）及肝指數升高（HR 1.46；95% CI 1.27–1.67）。除高血壓外（P = .03），乾癬與肥胖對共病風險沒有顯著的交互作用。

結論與意義：與無乾癬兒童相比，乾癬兒童發生肥胖、高脂血症、高血壓、糖尿病、代謝症候群、多囊性卵巢症候群、非酒精性肝病及肝功能指數升高的風險較高。

雖然乾癬對這些共病的發生是一個較小的獨立危險因子，但在乾癬兒童中，肥胖對共病發生的影響要大得多。