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

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