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Psoriasis and the risk of diabetes: A prospective population-based cohort study - 13/01/18

Doi : 10.1016/j.jaad.2017.10.050 
Marilyn T. Wan, MBChB, MPH a, Daniel B. Shin, PhD a, Rebecca A. Hubbard, PhD b, Megan H. Noe, MD, MPH a, Nehal N. Mehta, MD, MSCE, FAHA c, Joel M. Gelfand, MD, MSCE a, b,
a Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 
b Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 
c National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 

Correspondence to: Joel M. Gelfand, MD, MSCE, 3400 Civic Center Blvd, Perelman Center for Advanced Medicine, South Tower, Office 730, Philadelphia, PA, 19104.3400 Civic Center BlvdPerelman Center for Advanced MedicineSouth Tower, Office 730PhiladelphiaPA19104

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.

Le texte complet de cet article est disponible en PDF.

Key Words : body surface area, cohort study, diabetes, epidemiology, psoriasis

Abbreviations used : BMI, BSA, CI, GP, T2DM, THIN


Plan


 Supported in part by a grant (K24 AR064310) from the National Institutes of Health/National Institute of Arthritis and Musculoskeletal and Skin Diseases (to JMG) and a medical dermatology fellowship from the National Psoriasis Foundation (to MTW).
 Disclosure: In the previous 12 months, Dr Gelfand served as a consultant for BMS, Coherus (DSMB), Dermira, GSK, Janssen Biologics, Menlo Therapeutics, Novartis Corp, Regeneron, Dr Reddy's labs, Sanofi, and Pfizer Inc, receiving honoraria; he receives research grants (to the Trustees of the University of Pennsylvania) from Abbvie, Janssen, Novartis Corp, Regeneron, Sanofi, Celgene, and Pfizer Inc, and he has received payment for CME work related to psoriasis that was supported indirectly by Lilly, Valeant, and Abbvie. Dr Gelfand is a coholder of the patent for resiquimod for treatment of cutaneous T-cell lymphoma. Dr Mehta is a full-time US government employee and has received research grants to the National Institutes of Health from Abbvie, Celgene, Novartis, and Janssen. Drs Wan, Shin, Hubbard, and Noe have no conflicts of interest to declare.
 Reprints not available from the authors.


© 2017  American Academy of Dermatology, Inc. Tous droits réservés.
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Vol 78 - N° 2

P. 315 - février 2018 Retour au numéro
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