Psoriasis, fracture risk and bone mineral density: the HUNT Study, Norway
Psoriasis, fracture risk and bone mineral density: the HUNT Study, Norway
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DOI：
10.1111/bjd.15123
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发表时间：
2017-05-01
影响因子：
10.3
通讯作者：
Saunes, M.
中科院分区：
文献类型：
--
作者：
Modalsli, E. H.;Asvold, B. O.;Saunes, M.
背景银屑病与骨质疏松症之间的关联已被报道。目的：在挪威一项基于人群的大型前瞻性研究中，调查牛皮癣是否与前臂或髋部骨折风险增加相关；在一个亚人群中调查银屑病与骨密度（BMD） t评分之间的横断面关系。方法将1995-2013年Nord-TrOndelag县医院来源的骨折数据与2006- 2008年Nord-TrOndelag健康研究（HUNT3）第三次调查中的牛皮癣信息、骨密度测量和生活方式因素联系起来；来自国家教育数据库的社会经济数据；以及使用挪威处方数据库中的药物。结果在HUNT3的48194名参与者中，我们发现2804名自我报告的牛皮癣患者前臂或髋部骨折的风险没有增加[总年龄和性别调整后的风险比为103,95%可信区间（CI）为082-131]。银屑病与平均BMD t评分无明显相关性；总髋部、股骨颈和腰椎BMD t评分经年龄和性别调整后的差异分别为002 （95% CI -011至014）、005 （95% CI -006至017）和007 （95% CI -009至024）。牛皮癣与全髋、股骨颈和腰椎的骨质疏松症之间没有明显的关联；年龄和性别调整后的总优势比为077 （95% CI 054-110）。在调整教育程度、吸烟、全身类固醇使用和体重指数后，相关性没有显著变化。结论银屑病与骨折风险无相关性。该研究并未表明银屑病患者骨密度t评分降低或骨质疏松症患病率升高。关于这个话题我们已经知道了什么？牛皮癣和骨质疏松症之间的关联已被报道。这项研究补充了什么？在这项以人群为基础的前瞻性研究中，我们发现银屑病患者骨折风险没有增加。在横断面分析中，我们发现银屑病与骨密度或骨质疏松症之间没有令人信服的联系。回复这篇文章链接评论：拉莫特。中华皮肤科杂志2017；176:1117-1118简单的语言摘要在线提供
BackgroundAn association between psoriasis and osteoporosis has been reported.ObjectivesTo investigate, in a large prospective population-based Norwegian study, whether psoriasis is associated with increased risk of forearm or hip fracture; to investigate the cross-sectional association between psoriasis and bone mineral density (BMD) T-score in a subpopulation.MethodsHospital-derived fracture data from Nord-TrOndelag County (1995-2013) were linked to psoriasis information, BMD measurements and lifestyle factors from the third survey of the Nord-TrOndelag Health Study 2006-08 (HUNT3); socioeconomic data from the National Education Database; and use of medication from the Norwegian Prescription Database.ResultsAmong 48 194 participants in HUNT3, we found no increased risk of forearm or hip fracture in 2804 patients with self-reported psoriasis [overall age- and sex-adjusted hazard ratio 103, 95% confidence interval (CI) 082-131]. No clear association was found between psoriasis and mean BMD T-score; overall age- and sex-adjusted differences in total hip, femoral neck and lumbar spine BMD T-scores were 002 (95% CI -011 to 014), 005 (95% CI -006 to 017) and 007 (95% CI -009 to 024), respectively. No clear association was found between psoriasis and prevalent osteoporosis in either total hip, femoral neck or lumbar spine; overall age- and sex-adjusted odds ratio was 077 (95% CI 054-110). Associations did not change substantially after adjustment for education, smoking, systemic steroid use and body mass index.ConclusionsWe found no association between psoriasis and risk of fracture. The study did not indicate reduced BMD T-score or higher prevalence of osteoporosis among patients with psoriasis.What's already known about this topic?An association between psoriasis and osteoporosis has been reported.What does this study add?In this large population-based prospective study we found no increased risk of fracture among people with psoriasis. In the cross-sectional analyses, we found no convincing association between psoriasis and bone mineral density or osteoporosis.Respond to this article Linked Comment: Ramot. Br J Dermatol 2017; 176:1117-1118 Plain language summary available online