# The Impact of Metabolic Syndrome on Immune Regulation (IL-17, IL-23, and FOXP3+), Psoriasis Severity, Flare Frequency, and Quality of Life in Psoriasis Patients: A Cross-Sectional Study

## TL;DR

This study explores how metabolic syndrome affects immune markers, disease severity, and quality of life in psoriasis patients.

## Contribution

The study identifies a link between metabolic syndrome and reduced FOXP3+ regulatory T cell expression in psoriasis patients.

## Key findings

- Patients with psoriasis and metabolic syndrome had significantly lower FOXP3+ expression.
- Metabolic syndrome was associated with higher systolic blood pressure, fasting glucose, and triglycerides.
- No significant differences were found in IL-17, IL-23, PASI, or DLQI scores between groups.

## Abstract

Introduction: Psoriasis is a chronic inflammatory skin disease that exhibits a strong association with metabolic syndrome (MetS). The involvement of various proinflammatory cytokines in MetS is thought to play a critical role in the pathogenesis of psoriasis. This study aims to evaluate the impact of MetS on immunological markers (IL-17, IL-23, and FOXP3+ regulatory T cells), disease severity, and quality of life (QoL) among patients with psoriasis.

Methods: This cross-sectional study involved 42 psoriasis patients, divided into two groups: 29 without MetS (Pso) and 13 with MetS (Pso-MetS). Clinical parameters such as blood pressure, fasting blood glucose, and triglyceride levels were measured. Immunological markers (IL-17, IL-23, and FOXP3+) were analyzed using ELISA. Psoriasis severity was assessed using the Psoriasis Area and Severity Index (PASI), and QoL was evaluated with the Dermatology Life Quality Index (DLQI).

Results: The Pso-MetS group was significantly older than the Pso group (p value = 0.003). Higher systolic (p value < 0.001), fasting glucose (p value = 0.002), and triglycerides (p value < 0.001) were observed in the Pso-MetS group. Lower HDL observed in the Pso-MetS group (p value = 0.004). FOXP3+ expression was significantly lower in the Pso-MetS group (p=0.02), while waist circumference, diastolic blood pressure, IL-17, IL-23, PASI, and DLQI scores levels showed no significant differences.

Conclusions: MetS is associated with immune dysregulation, evidenced by reduced FOXP3+ expression in psoriasis patients. Further studies are needed to explore the immunological link between psoriasis and MetS.