Ann Dermatol.  2019 Aug;31(4):378-386. 10.5021/ad.2019.31.4.378.

Association between Homocysteine Levels and Psoriasis: A Meta-Analysis

• Kim JE
• Lee HJ
• Lee JS
• Whang KU
• Park YL
• Lee SY
• Kim HJ

• KMID: 2451474
• DOI: http://doi.org/10.5021/ad.2019.31.4.378

Abstract

BACKGROUND
Psoriasis is a multifactorial disease associated with an increased risk for metabolic syndrome and cardiovascular diseases. Elevated levels of homocysteine (Hcy) are a marker of cardiovascular risk. Several studies have evaluated the associations between psoriasis and Hcy levels; however, the results remain inconclusive.
OBJECTIVE
We performed a systematic review of the literature and a meta-analysis to better understand the relationship between psoriasis and Hcy.
METHODS
Five scientific databases (MEDLINE, Embase, Cochrane Library, Scopus, and Web of Science) were searched to identify relevant studies. A review of 307 publications identified 16 studies that directly assessed plasma levels of Hcy in psoriasis patients.
RESULTS
A total of 16 studies including 2,091 subjects were included in the meta-analysis. Hcy levels were significantly higher in psoriasis patients relative to healthy controls (weighted mean difference [WMD], 3.30; 95% confidence interval [CI], 1.58∼5.02; I²=82.1%). Subgroup analyses revealed that patients with higher mean psoriasis area severity index (PASI) scores (PASI>10) had significantly higher Hcy levels compared to healthy controls (WMD, 4.17; 95% CI, 1.18∼7.16; I²=88.3%), whereas patients with lower mean PASI scores (PASI ≤10) had not (WMD, 0.76; 95% CI, −1.84∼3.35; I²=72.2%).
CONCLUSION
This meta-analysis found that psoriasis patients, in particular those with PASI >10, had significantly higher Hcy levels compared to healthy controls. Further research is needed to determine the association between Hcy levels and psoriasis severity.

Keyword

Homocysteine; Meta-analysis; Psoriasis

MeSH Terms

Cardiovascular Diseases
Homocysteine*
Humans
Plasma
Psoriasis*
Homocysteine

Figure

• 

  Fig. 1 Flow diagram of study identification, inclusion, and exclusion.

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  Fig. 2 Forest plot of the meta-analysis for homocysteine levels. (A) Homocysteine levels in psoriasis patients and controls. (B) Subgroup analysis according to mean psoriasis area severity index (PASI) scores. (C) Meta-analysis of two studies which directly compared homocysteine levels according to psoriasis severity within studies. WMD: weighted mean difference, CI: confidence interval.

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  Fig. 3 Forest plot of the meta-analysis for sensitivity analysis. PASI: psoriasis area severity index, WMD: weighted mean difference, CI: confidence interval.

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  Fig. 4 Funnel plot of included studies. SE: standard error, WMD: weighted mean difference.

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