Background A significant association between psoriasis and the metabolic syndrome (MetS) has been frequently reported.
Objective The aim of this study was to specify the main factors that determine the MetS in psoriatic Tunisian patients.
Methods A case–control study has included 164 psoriatic patients and 216 controls.
Results The prevalence of MetS was higher in cases than in controls but without statistical differences [35.5% vs. 30.8%, odds ratio (OR): 1.39 CI: 0.88–2.18; P = 0.095]. According to gender, the prevalence of MetS was significantly increased only in psoriatic women (47.4% vs. 30%, OR: 1.89, CI: 1.11–3.21; P = 0.01). A multiple logistic regression, considering the effect of age, and gender, showed that the prevalence of MetS was significantly higher in cases than in controls (OR: 1.73, CI: 1.06–2.82; P = 0.03). MetS components analysed seperately showed a significantly higher prevalence of decreased high-density lipoprotein cholesterol (HDLc) (60.9% vs. 35.9%, OR: 2.77, CI: 1.8–4.27, P < 0.001) and for increased hypertension (50% vs. 40%, OR: 1.48, CI: 0.97–2.257, P = 0.04) in psoriatic patients. According to gender, HDLc was significantly decreased in both genders (male: OR: 2.075, CI: 1.24–3.47, P = 0.004; female: OR: 3.58, CI: 2.07–6.19, P < 0.0001), while hypertension was increased only in psoriatic men (OR: 2.09, CI: 1.24–3.51, P = 0.004) and abdominal obesity only in psoriatic women (OR: 2.31, CI: 1.30–4.11, P = 0.002).
Conclusion Decreased HDLc is the main biological abnormality that characterized MetS in Tunisian psoriatic patients. Moreover, contrary to men, psoriatic women have shown a significantly higher prevalence of MetS, which is, in addition to decreased HDLc, mainly attributed to abdominal obesity.