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J Am Acad Dermatol. 2018 Feb;78(2):315-322.e1. doi: 10.1016/j.jaad.2017.10.050. Epub 2017 Nov 8.

Psoriasis and the risk of diabetes: A prospective population-based cohort study.

Author information

1
Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
2
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
3
National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
4
Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania. Electronic address: Joel.Gelfand@uphs.upenn.edu.

Abstract

BACKGROUND:

Data evaluating the impact of objectively measured psoriasis severity on type 2 diabetes mellitus (T2DM) risk are lacking.

OBJECTIVE:

To determine the risk for T2DM in patients with psoriasis compared with that in adults without psoriasis, stratified by categories of directly assessed body surface area (BSA) affected by psoriasis.

METHODS:

A prospective, population-based, cohort study from the United Kingdom in which 8124 adults with psoriasis and 76,599 adults without psoriasis were followed prospectively for approximately 4 years.

RESULTS:

There were 280 incident cases of diabetes in the psoriasis group (3.44%) and 1867 incident cases of diabetes in those without psoriasis (2.44%). After adjustment for age, sex and body mass index, the hazard ratios for development of incident diabetes were 1.21 (95% confidence interval [CI], 1.01-1.44), 1.01 (95% CI, 0.81-1.26), and 1.64 (95% CI, 1.23-2.18) in the groups with 2% or less of their BSA affected, 3% to 10% of their BSA affected, and 10% or more of their BSA affected compared with in the groups without psoriasis, respectively (P = .004 for trend). Worldwide, we estimate an additional 125,650 new diagnoses of T2DM per year in patients with psoriasis as compared with in those without psoriasis.

LIMITATIONS:

Relatively short-term follow-up and exclusion of prevalence cases, which may have masked associations in patients with less extensive psoriasis.

CONCLUSION:

Clinicians may measure BSA affected by psoriasis to target diabetes prevention efforts for patients with psoriasis.

KEYWORDS:

body surface area; cohort study; diabetes; epidemiology; psoriasis

PMID:
29128465
PMCID:
PMC5768452
DOI:
10.1016/j.jaad.2017.10.050
[Indexed for MEDLINE]
Free PMC Article

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