Obesidad y psoriasis: naturaleza inflamatoria de la obesidad, relación entre psoriasis y obesidad e implicaciones terapéuticas: Obesity and Psoriasis: Inflammatory Nature of Obesity, Relationship Between Psoriasis and Obesity, and Therapeutic Implications

espanolResumen La obesidad, en particular la abdominal, se considera en la actualidad como un proceso inflamatorio cronico de bajo grado que participa de forma activa en el desarrollo de los fenomenos fisiopatologicos responsables del sindrome metabolico y la morbilidad cardiovascular a traves de la secrecion de adipocinas y citocinas proinflamatorias. En los ultimos anos se ha establecido un vinculo firme entre psoriasis y obesidad que abarca aspectos geneticos, patogenicos y epidemiologicos, con importantes repercusiones en la salud del individuo. Es probable una relacion bidireccional, en la que la obesidad predispone a la psoriasis, pero tambien la psoriasis favorece la obesidad. La obesidad tiene tambien importantes implicaciones terapeuticas, como el mayor riesgo de efectos adversos en el caso de los farmacos sistemicos convencionales y la disminucion de la eficacia y/o el incremento del coste en el caso de los farmacos biologicos, que hace recomendable ajustar la dosis al peso del paciente. -------------------------------------------------------------------------------- EnglishAbstract Obesity, particularly abdominal obesity, is currently considered a chronic low-grade inflammatory condition that plays an active role in the development of the pathophysiologic phenomena responsible for metabolic syndrome and cardiovascular disease through the secretion of proinflammatory adipokines and cytokines. In recent years clear genetic, pathogenic, and epidemiologic links have been established between psoriasis and obesity, with important implications for health. The relationship between the 2 conditions is probably bidirectional, with obesity predisposing to psoriasis and psoriasis favoring obesity. Obesity also has important implications in the treatment of psoriasis, such as a greater risk of adverse effects with conventional systemic drugs and reduced efficacy and/or increased cost with biologic agents, for which dosage should be adjusted to the patient's weight.