High prevalence of metabolic syndrome in patients with psoriasis in Lebanon: a prospective study.

BACKGROUND: Psoriasis is a chronic inflammatory disease that affects not only the skin but also other organs as well. Genetic factors play an important role in individual predisposition. Lately, a positive association has been confirmed between psoriasis and metabolic syndrome (MBS), in western as well as in Middle Eastern countries. AIM: Assess the prevalence of MBS in Lebanese patients with psoriasis and the differential effect according to types and disease severity. METHODS: This was a case-control study including 150 psoriasis patients and 150 age- and gender-matched controls admitted to the dermatology clinics at the American University of Beirut-Medical Center, a tertiary care center in Beirut. Psoriasis severity was assessed by the Psoriasis Area Severity Index (PASI). Blood samples were collected from fasting subjects and tested for glucose, HDL cholesterol, triglycerides, and C-reactive protein (CRP). Multivariate binary logistic regression models were built to assess the relationship between MBS and psoriasis, after adjustment for smoking as a possible confounding variable. RESULTS: Patients with psoriasis were two times more likely to have MBS as compared to controls (35.3% vs 18.0%, P < 0.001) with an odds ratio (OR) of 2.4. All components of MBS were more prevalent in psoriasis patients than in controls. PASI score was greater in patients with MBS than those without MBS (10.5 ± 11.5 vs. 7.0 ± 8.1, P = 0.05). MBS prevalence tended to be higher in the inverse type than in others (52.2% versus 32.3%; P = 0.06) and in patients with nail pitting versus those without (45.3% vs. 28.2%; P = 0.03). CONCLUSIONS: This was the first study to assess the prevalence of MBS in Lebanese subjects with psoriasis and, to our knowledge, the first study that showed a higher likelihood of MBS in patients with inverse psoriasis and with nail pitting.

Prognostic factors of multiple sclerosis in Lebanon.

BACKGROUND: Multiple sclerosis (MS) has a variable disease course. Identifying early predictive prognostic factors is of paramount importance. Most of the data on these factors however comes from studies performed in western countries. Such data is lacking in the Arab World. The objective of this study is to identify early predictors of disability among MS patients in Lebanon. METHODS: 75 relapsing-remitting MS patients with 5 year follow-up from disease onset were selected from Project MS Lebanon database. The following parameters were studied as potential causes of early disability as defined by an EDSS > or = 3, after five years from disease onset: age at onset of MS, gender, interval between first and second attack, residual deficit after first attack, initial symptoms, treatment for at least 1 year in the first 5 years, and the number of relapses in the first 2 and 5 years. RESULTS: Patients with incomplete recovery from the first relapse were 11.66 times more likely to have a higher EDSS after 5 years (CI = 2.02-67.31, p = .001). Furthermore, the number of relapses during the first 5 years was also an independent predictor of EDSS > or = 3 at 5 years (p = .024). Other factors were not shown to predict a worse outcome. CONCLUSION: Overall, early predictors of disability in MS among the Lebanese population were not very different from similar predictors in western countries.