NEW YORK (Reuters Health) – Overweight or obese children have a significantly higher prevalence of psoriasis and adolescents with psoriasis have elevated levels of blood lipids, researchers report in an April 29th on-line paper in The Journal of Pediatrics.

Dr. Corinna Koebnick told Reuters Health by email that the findings not only suggest a link between obesity and psoriasis in children. But, she said, “they also suggest that the higher heart disease risk for patients with psoriasis starts in childhood in the form of higher cholesterol levels.”

Dr. Koebnick of Kaiser Permanente Southern California, Pasadena and colleagues note that there are indications that in children, obesity and psoriasis are associated and portend a higher prevalence of dyslipidemia and hypertension.

To investigate further, the researchers used electronic health records to study data on almost 711,000 racially and ethnically diverse children.

The odds ratio for psoriasis was reduced in underweight children (0.68). But compared to normal children, it was elevated in those who were overweight (1.31), moderately obese (1.39) and extremely obese (1.78).

No underweight children were receiving treatment with systemic therapy or phototherapy (an indicator of severity or extent) but the odds ratio for such treatment was 2.78 in overweight children and 4.19 in the extremely obese.

After adjustment for body mass index, in adolescents, mean total cholesterol, low density lipoprotein cholesterol, triglycerides, and alanine aminotransferase were significantly higher in the psoriasis group compared to those without psoriasis.

“Although the differences appear to be small,” say the investigators, “they are of clinical relevance.”

Given these findings, Dr. Koebnick pointed out that “We may need to monitor youth with psoriasis more closely for cardiovascular risk factors, especially if they are obese.”

In fact, she and her colleagues conclude that “Clinical care for pediatric patients with psoriasis should include surveillance for elevated cardiovascular risk.”

J Pediatr 2011.