Association between Homocysteine Levels and Psoriasis: A Meta-Analysis

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 (MEDLI NE, 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 similar to 5.02; I-2 = 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, 4.1 7; 95% CI, 1.18 similar to 7.16; I-2 =88.3%), whereas patients with lower mean PASI scores (PASI <= 10) had not (WMD, 0.76; 95% CI, -1.84 similar to 3.35; I-2 = 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.