Psoriasis severity and the prevalence of major medical comorbidity: a population-based study.
Psoriasis severity and the prevalence of major medical comorbidity: a population-based study.
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DOI：
10.1001/jamadermatol.2013.5015
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发表时间：
2013-10
期刊：
影响因子：
10.9
通讯作者：
Gelfand, Joel M.
中科院分区：
文献类型：
--
作者：
Yeung, Howa;Takeshita, Junko;Mehta, Nehal N.;Kimmel, Stephen E.;Ogdie, Alexis;Margolis, David J.;Shin, Daniel B.;Attor, Rosemary;Troxel, Andrea B.;Gelfand, Joel M.
尽管关于银屑病合并症风险的文献越来越多，但客观测量银屑病严重程度可能影响主要医学合并症患病率的程度仍然存在重要的知识差距。研究轻、中、重度牛皮癣患者与无牛皮癣患者主要合并症的发生率，根据体表面积累及客观分类。以人群为基础的横断面研究。英国的电子医疗记录。9035名年龄在25岁至64岁之间的牛皮癣患者和90350名年龄和实践匹配的无牛皮癣患者。牛皮癣的诊断和严重程度，基于体表面积受累，由基于提供者的问卷确定。主要合并症的患病率，包括Charlson合并症指数。在银屑病患者中，51.8%、35.8%和12.4%分别为轻度、中度和重度。轻度（0.375 vs. 0.347）、中度（0.398 vs. 0.342）和重度（0.450 vs. 0.348）牛皮癣患者的平均Charlson共发病指数均高于对照组（p均< 0.05）。银屑病总体上与慢性肺病（校正优势比1.08;95% CI 1.02-1.15）、糖尿病（1.22;1.11-1.35）、糖尿病合并全身并发症（1.34;1.11-1.62）、轻度肝病（1.41;1.12-1.76）、心肌梗死（1.34;1.07-1.69）、消化性溃疡疾病（1.27;1.03-1.58）、外周血管疾病（1.38;1.07-1.77）、肾脏疾病（1.28;1.11-1.48）和风湿病（2.04;1.71-2.42）的较高患病率相关。趋势分析显示银屑病严重程度与上述合并症有显著相关性（p < 0.05）。随着疾病严重程度的增加，银屑病患者的总体医疗合并症和特定合并症的负担更大。医生在为牛皮癣患者提供全面护理时，尤其是那些病情较严重的患者，应意识到这些关联。
Despite the growing literature on co-morbidity risks in psoriasis, there remains a critical knowledge gap on the degree to which objectively measured psoriasis severity may affect the prevalence of major medical co-morbidities. To examine the prevalence of major medical co-morbidities in patients with mild, moderate, and severe psoriasis, classified objectively based on body surface area involvement, compared to patients without psoriasis. Population-based, cross-sectional study. United Kingdom-based electronic medical records. 9,035 patients aged 25 to 64 years with psoriasis and 90,350 age- and practice-matched patients without psoriasis. Psoriasis diagnosis and severity, based on body surface area involvement, as determined by provider-based questionnaires. Prevalence of major co-morbidities comprising the Charlson co-morbidity index. Among patients with psoriasis, 51.8%, 35.8%, and 12.4% respectively had mild, moderate, and severe disease. Mean Charlson co-morbidity index was increasingly higher in patients with mild (0.375 vs. 0.347), moderate (0.398 vs. 0.342), and severe psoriasis (0.450 vs. 0.348) compared to respective controls (each p < 0.05). Psoriasis overall was associated with higher prevalence of chronic pulmonary disease (adjusted odds ratio 1.08; 95% CI, 1.02–1.15), diabetes (1.22; 1.11–1.35), diabetes with systemic complications (1.34; 1.11–1.62), mild liver disease (1.41; 1.12–1.76), myocardial infarction (1.34; 1.07–1.69), peptic ulcer disease (1.27; 1.03–1.58), peripheral vascular disease (1.38; 1.07–1.77), renal disease (1.28; 1.11–1.48), and rheumatologic disease (2.04; 1.71–2.42). Trend analysis revealed significant associations between psoriasis severity and each of above co-morbidities (each p < 0.05). The burdens of overall medical co-morbidity and of specific co-morbid diseases are greater among psoriasis patients with increasing disease severity. Physicians should be aware of these associations in providing comprehensive care to patients with psoriasis, especially those presenting with more severe disease.
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影响因子：
120.7
作者：
Gelfand, Joel M.;Neimann, Andrea L.;Troxel, Andrea B.
通讯作者：
Troxel, Andrea B.
影响因子：
10.3
作者：
Dommasch, E. D.;Shin, D. B.;Gelfand, J. M.
通讯作者：
Gelfand, J. M.
DOI：
10.1111/j.1365-2133.2010.09941.x
发表时间：
2010-09
期刊：
The British journal of dermatology
影响因子：
--
作者：
Abuabara K;Azfar RS;Shin DB;Neimann AL;Troxel AB;Gelfand JM
通讯作者：
Gelfand JM
DOI：
10.1111/j.1468-3083.2011.04009.x
发表时间：
2012-01-01
影响因子：
9.2
作者：
Chiang, Y. -Y.;Lin, H. -W.
通讯作者：
Lin, H. -W.
影响因子：
10.3
作者：
Gulliver, W.
通讯作者：
Gulliver, W.