Psoriasis and cardiovascular risk factors: A case-control study on inpatients comparing psoriasis to dermatitis
Psoriasis and cardiovascular risk factors: A case-control study on inpatients comparing psoriasis to dermatitis
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DOI：
10.1016/j.jaad.2010.11.046
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发表时间：
2012-02-01
影响因子：
13.8
通讯作者：
David, Michael
中科院分区：
文献类型：
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作者：
Shapiro, Jonathan;Cohen, Arnon David;David, Michael
背景：以前的报告表明牛皮癣与心血管疾病（CVD）危险因素之间存在关联。然而，这些研究大多是基于门诊诊所的计算机化数据库，由于国际疾病分类第九版的编码问题，需要对牛皮癣的诊断进行验证。目的：我们试图研究银屑病住院患者与皮炎住院患者中银屑病与心血管疾病危险因素之间的关系。方法：使用来自以色列Rabin医学中心皮肤内科的计算机医学数据库进行病例对照研究。将诊断为牛皮癣的住院患者与诊断为皮炎的住院患者在吸烟、肥胖、糖尿病、高血压、高脂血症和心血管疾病方面的患病率进行比较。采用Logistic回归模型进行多变量分析。结果：本研究纳入1079例银屑病住院患者和1079例年龄和性别匹配的皮炎住院患者（对照组）。多因素logistic回归模型显示，牛皮癣是糖尿病（优势比[OR] 1.43； 95%可信区间[CI] 1.17-1.75）、高血压（OR 1.31; 95% CI 1.09-1.58）、肥胖（OR 1.32; 95% CI 0.99-1.76）和吸烟（OR 1.38; 95% CI 1.10-1.73）的独立危险因素。当纠正糖尿病、肥胖和高血压时，CVD的发展与牛皮癣没有显著相关性。局限性：我们的研究组仅由住院患者组成，这可能偏向于更多的老年严重银屑病患者，这些患者可能已经接受了包括免疫抑制剂在内的全身治疗。结论：我们的研究支持先前关于银屑病与CVD危险因素之间关联的报道，提示银屑病的炎症过程，而不是皮炎，可能对CVD危险因素的发展有全身性影响。[J] .中华皮肤科杂志，2012;33(6):562 - 568。
Background: Previous reports demonstrated an association between psoriasis and cardiovascular disease (CVD) risk factors. However, most of these studies were based on computerized databases of outpatient clinics, which, because of International Classification of Diseases, Ninth Revision coding issues, require validation of the diagnosis of psoriasis.Objective: We sought to study associations between psoriasis and CVD risk factors among psoriatic inpatients compared to inpatients with dermatitis:Methods: A case-control study was performed using computerized medical databases from the Department of Dermatology at Rabin Medical Center in Israel. Inpatients given the diagnosis of psoriasis were compared with inpatients given the diagnosis of forms of dermatitis for the prevalence of smoking, obesity, diabetes, hypertension, hyperlipidemia, and CVD. Logistic regression models were used for multivariate analyses.Results: The study included 1079 inpatients with psoriasis and 1079 age- and gender-matched inpatients with dermatitis (control patients). A multivariate logistic regression model demonstrated that psoriasis is an independent risk factor for diabetes (odds ratio [OR] 1.43; 95% confidence interval [CI] 1.17-1.75), hypertension (OR 1.31; 95% CI 1.09-1.58), obesity (OR 1.32; 95% CI 0.99-1.76), and smoking (OR 1.38; 95% CI 1.10-1.73). Development of CVD was not significantly associated with psoriasis when correcting for diabetes, obesity, and hypertension.Limitations: Our study group was composed of inpatients only, which may be biased toward more elderly patients with severe psoriasis who may have consumed systemic treatment including immunosuppressants.Conclusions: Our study supports previous reports of an association between psoriasis and CVD risk factors, suggesting that the inflammatory process in psoriasis, but not in dermatitis, may have a systemic impact resulting in development of CVD risk factors. (J Am Acad Dermatol 2012;66:252-8.)