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Journal of the American Academy of Dermatology
Volume 80, n° 6
pages 1682-1690 (juin 2019)
Doi : 10.1016/j.jaad.2019.02.038
accepted : 14 February 2019
Original Articles

Inflammatory dietary pattern and incident psoriasis, psoriatic arthritis, and atopic dermatitis in women: A cohort study
 

Alanna C. Bridgman, MSc a, Abrar A. Qureshi, MD, MPH b, c, d, e, Tricia Li, MD, MS b, Fred K. Tabung, PhD, MSPH f, g, Eunyoung Cho, MS, ScD b, d, e, Aaron M. Drucker, MD, ScM b, h, i,
a School of Medicine, Queen's University, Kingston, Canada 
b Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island 
c Department of Dermatology, Rhode Island Hospital, Providence, Rhode Island 
d Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island 
e Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 
f Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, Ohio 
g Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 
h Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada 
i Women's College Research Institute and Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, Canada 

Correspondence to: Aaron M. Drucker, MD, ScM, Women's College Hospital, 76 Grenville St, Toronto, ON M5S1B2, Canada.Women's College Hospital76 Grenville StTorontoONM5S1B2Canada
Abstract
Background

Diet is a modulator of inflammation that might impact inflammatory skin diseases.

Objective

To assess the relationship between pro-inflammatory dietary patterns and incident psoriasis, psoriatic arthritis (PsA), and atopic dermatitis (AD).

Methods

We conducted cohort studies among women in the Nurses' Health Study II. The Empirical Dietary Inflammatory Pattern (EDIP) score was calculated at baseline and every 4 years. Incident psoriasis, PsA, and AD were assessed by validated self-report. We used multivariable-adjusted Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between EDIP quintiles and risk for psoriasis, PsA, and AD.

Results

We had 85,185 participants in the psoriasis analysis and 63,443 in the AD analysis. There were 1432 cases of psoriasis, 262 cases of PsA, and 403 cases of AD. Pro-inflammatory dietary patterns were not associated with the risk for outcomes in multivariable models (all P values for trend >.05). HRs comparing the highest to the lowest EDIP quintile were 0.99 (95% CI 0.83-1.18) for psoriasis, 1.22 (95% CI 0.81-1.83) for PsA, and 0.96 (95% CI 0.69-1.34) for AD.

Limitations

Recall and self-report.

Conclusion

Our findings do not support dietary inflammatory potential as a risk factor for psoriasis, PsA, or AD.

The full text of this article is available in PDF format.

Key words : atopic dermatitis, CRP, EDIP, IL-6, inflammatory diet, Nurses' Health Study II, psoriasis, psoriatic arthritis, TNF-α

Abbreviations used : BMI, CI, CRP, EDIP, HR, IL-6, NHS-II, TH 1, TNF-α



 Funding sources: Supported by the Brown University Department of Dermatology and an investigator-initiated grant from Regeneron and Sanofi (to Dr Qureshi) from the National Institutes of Health (CA207736 and CA176726) and R00CA207736 from the National Cancer Institute.
 Conflicts of interest: In the past 3 years, Dr Drucker served as an investigator and has received research funding from Sanofi and Regeneron and has been a consultant for Sanofi, RTI Health Solutions, Eczema Society of Canada, and the Canadian Agency for Drugs and Technology in Health. He has received honoraria from Prime Inc, Spire Learning, CME Outfitters, and Eczema Society of Canada. His institution receives education grants from Sanofi. Dr Qureshi has served as a consultant (honoraria donated to charity) for Eli Lilly, Amgen, Centers for Disease Control and Prevention, Janssen, Merck, Novartis, and Pfizer; has been a noncompensated investigator for Sanofi; and has a patent pending for Nix-Tix tick remover. Ms Bridgman, Dr Li, Dr Tabung, and Dr Cho have no conflicts of interest to disclose.
 Reprints not available from the authors.



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