A. Lee, S.D. Smith, E. Hong, S. Garnett,G. Fischer
Recent evidence suggests that psoriasis posesa cardiometabolic risk in children. This has not beenexplored in an Australian population and best way to screenfor this increased risk has not yet been established. Waist toheight ratio(WHtR) can easily identify children withincreased central adiposity and it is a simpler alternative toBMI that does not require growth charts or percentiles. Hav-ing a WHtR≥0.5 is predictive for future cardiovascular risk.
A multi-centre cross-sectional prospective studycase control study from 7 February 2014 to 15 July 2015 inAustralia. Inclusion criteria included a diagnosis of psoria-sis by a specialist dermatologist and age 2–16 years(n = 173). Controls were selected randomly in patientswith non-inﬂammatory skin conditions (n = 88).
Children with psoriasis were more likely to haveincreased central adiposity with WHtR≥0.5 (29% vs. 11%;p = 0.002). Four children with psoriasis were found to havemetabolic syndrome compared to none in the controlgroup. Children with moderate or severe psoriasis had aslightly higher incidence of overweight/obesity relative tothose with mild psoriasis using BMI (19.5% vs. 12.9%).Three children with moderate/ severe psoriasis had meta-bolic syndrome compared to 1 child with mild psoriasis(7.3% vs. 0.8%; p = 0.04). BMI did not vary signiﬁcantlybetween children with psoriasis compared to controls(12% vs. 14%; p = 0.55).
A third of children with psoriasis were notoverweight according to BMI but had a high WHtR. Wesuggest that the WHtR, an easily administered screeningtool be utlilized in the management of children with psori-asis.