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Meta-analysis of psoriasis, cardiovascular disease, and associated risk factors - 14/11/13

Doi : 10.1016/j.jaad.2013.06.053 
Iben Marie Miller, MD a, d, , Christina Ellervik, MD, PhD b, c, Shiva Yazdanyar, MD, PhD a, Gregor B.E. Jemec, DMSc a, d
a Department of Dermatology, Roskilde Hospital, Roskilde, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark 
b Department of Diagnostic Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark 
c Department of Clinical Biochemistry, Naestved Hospital, Naestved, Denmark 
d Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark 

Reprint requests: Iben Marie Miller, MD, Department of Dermatology, Roskilde Hospital, Køgevej 7-13, 4000 Roskilde, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.

Abstract

Background

The possible connection between psoriasis with cardiovascular disease and associated risk factors has been implied, but inconsistent results have been reported.

Objective

We sought to create an overview and statistical summary of the previous literature with elucidating subgroup analysis.

Methods

This was a meta-analysis of observational studies using random effect statistics. A systematic search of observational studies of psoriasis as study variable and cardiovascular disease and associated risk factors as outcome, published before October 25, 2012, was conducted.

Results

Of 835 references in the original search, 75 relevant articles were identified. We included 503,686 cases and 29,686,694 controls. Psoriasis was associated with cardiovascular disease in total (odds ratio [OR] 1.4; 95% confidence interval [CI] 1.2-1.7), ischemic heart disease (OR 1.5; 95% CI 1.2-1.9), peripheral vascular disease (OR 1.5; 95% CI 1.2-1.8), atherosclerosis (OR 1.1; 95% CI 1.1-1.2), diabetes (OR 1.9; 95% CI 1.5-2.5), hypertension (OR 1.8; 95% CI 1.6-2.0), dyslipidemia (OR 1.5; 95% CI 1.4-1.7), obesity by body mass index (OR 1.8; 95% CI 1.4-2.2), obesity by abdominal fat (OR 1.6; 95% CI 1.2-2.3), and the metabolic syndrome (OR 1.8; 95% CI 1.2-2.8), but not associated with cerebrovascular disease (OR 1.1; 95% CI 0.9-1.3) and cardiovascular mortality (OR 0.9; 95% CI 0.4-2.2). The strongest associations were seen in hospital-based studies and psoriatic arthritis. Population-based studies did not show significant associations, with the exception of dyslipidemia.

Limitations

The heterogeneity of the studies makes clinical interpretation challenging.

Conclusions

In aggregate, psoriasis was associated with ischemic heart disease and cardiovascular risk factors. The association was only significant for hospital-based studies, except for dyslipidemia, which was also significant in population-based studies.

Le texte complet de cet article est disponible en PDF.

Key words : cardiovascular disease, diabetes mellitus, hypercholesterolemia, hypertension, inflammation, meta-analysis, obesity, plaque, psoriasis


Plan


 Cofinanced with grants by the Danish Agency for Science, Technology, and Innovation and LEO Pharma A/S (Dr Miller).
 Disclosure: Dr Miller is cofinanced by LEO Pharma A/S. Dr Jemec reports receiving consulting fees from Abbott Laboratories, Astra-Zeneca, Coloplast, MSD, Novartis, Pfizer, and Dumex-Alpharma; lecture fees from Abbott Laboratories, Galderma, Pfizer, and Roche; grant support from Abbott Laboratories, Pfizer, Photocure, and LEO Pharma; equipment on loan from Michelson Diagnostics; and reimbursement for travel expenses from Abbott Laboratories, Galderma, and Photocure. Drs Ellervik, and Yazdanyar have no conflicts of interest to declare.


© 2013  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 69 - N° 6

P. 1014-1024 - décembre 2013 Retour au numéro
Article précédent Article précédent
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