Psoriatic arthritis (PsA) is a progressive joint disease associated with psoriasis.
To investigate the association of modifiable lifestyle and environmental factors with PsA risk among people with psoriasis.
We conducted a systematic search of PubMed, Embase, and Cochrane Library through May 2, 2020, for observational studies reporting lifestyle or environmental factors for PsA onset in patients with psoriasis. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were combined using a random-effects model.
We included 16 studies comprising 322,967 individuals. Obesity and being overweight were associated with an increased PsA risk in patients with psoriasis (OR, 1.75 [95% CI, 1.42-2.16] and OR, 1.50 [95% CI, 1.08-2.09], respectively), with an increase of approximately 6% for each kg/m2 rise in body mass index (OR, 1.06; 95% CI, 1.03-1.10). The presence of PsA was associated with a history of physical trauma (OR, 1.33; 95% CI, 1.16-1.54) or fracture (OR, 1.46; 95% CI, 1.22-1.74). No significant associations were observed regarding alcohol consumption (OR, 0.99; 95% CI, 0.88-1.13), smoking (OR, 0.89; 95% CI, 0.75-1.06), female hormonal exposure (OR, 1.45; 95% CI, 0.95-2.20), and psychologically traumatic events.
Inherent limitations in the included observational studies.
Several lifestyle and environmental factors are associated with PsA onset among patients with psoriasis. These findings indicate that such risk may be modified with lifestyle changes or avoidance of physical trauma in people with psoriasis.Le texte complet de cet article est disponible en PDF.
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Key words : environmental factors, lifestyle factors, meta-analysis, psoriatic arthritis, psoriasis
Abbreviations used : BMI, CI, IL, OR, PsA
| Funding sources: Supported by the National Natural Science Foundation of China (nos. 81771740 and 81971524) and Youth Clinical Research project of Peking University First Hospital (2019CR28).
| Conflicts of interest: None disclosed.
| IRB approval status: Not applicable.
| Reprints not available from the authors.