Psoriasis, cardiovascular risk factors and metabolic disorders: sex-specific findings of a population-based study.
Journal
Journal of the European Academy of Dermatology and Venereology : JEADV
ISSN: 1468-3083
Titre abrégé: J Eur Acad Dermatol Venereol
Pays: England
ID NLM: 9216037
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
20
07
2019
accepted:
01
10
2019
pubmed:
5
12
2019
medline:
30
1
2021
entrez:
5
12
2019
Statut:
ppublish
Résumé
Scientific evidence suggests an association between psoriasis and cardiovascular and metabolic diseases. However, there are hardly any sex-specific results from population-based studies reporting the prevalence of cardiovascular risk factors in patients with psoriasis and point estimates of the association between psoriasis and cardiovascular and metabolic disorders. Aims are to evaluate the sex-specific prevalence of psoriasis and cardiovascular risk factors, and to estimate sex-specific associations between psoriasis and diabetes type 2 (DM) and metabolic syndrome (MetS). We used data of 3723 participants (45-75 years, 54.1% women) without coronary heart disease and missing data (psoriasis, DM, MetS) from the Heinz Nixdorf Recall study. Standardized information on health outcomes and risk factors was assessed. We performed descriptive statistics and multiple regression analyses to calculate prevalence rate ratios (PR) and 95% confidence intervals (95% CI). The prevalence of psoriasis was 3.8% (n = 143), with no differences between sex. We observed more often metabolic and cardiovascular risk factors in women with psoriasis compared to women without psoriasis. Interestingly, in men, this pattern was partly reversed. Multiple regression analyses revealed distinctly elevated PRs for DM for both women and men with psoriasis (fully adjusted PR: 2.43; 95% CI: 1.17-5.07, resp. 2.09; 1.16-3.76). Regarding the MetS, the results were inconsistent, showing a positive association between psoriasis and MetS in women (1.84; 1.14-2.98), but a negative association in men, even though with a wide 95% CI (0.69; 0.42-1.12). The results of our cross-sectional, population-based analysis show a distinct association between psoriasis and DM, whereas for the MetS the results contrasted between men and women, translating in women with MetS showing a higher and in men a lower chance to be psoriatic. Our results emphasize the urgent need for sex-specific research, studying the effects of psoriasis on metabolic disorders as well as effective sex tailored prevention measures.
Sections du résumé
BACKGROUND
BACKGROUND
Scientific evidence suggests an association between psoriasis and cardiovascular and metabolic diseases. However, there are hardly any sex-specific results from population-based studies reporting the prevalence of cardiovascular risk factors in patients with psoriasis and point estimates of the association between psoriasis and cardiovascular and metabolic disorders.
OBJECTIVE
OBJECTIVE
Aims are to evaluate the sex-specific prevalence of psoriasis and cardiovascular risk factors, and to estimate sex-specific associations between psoriasis and diabetes type 2 (DM) and metabolic syndrome (MetS).
METHODS
METHODS
We used data of 3723 participants (45-75 years, 54.1% women) without coronary heart disease and missing data (psoriasis, DM, MetS) from the Heinz Nixdorf Recall study. Standardized information on health outcomes and risk factors was assessed. We performed descriptive statistics and multiple regression analyses to calculate prevalence rate ratios (PR) and 95% confidence intervals (95% CI).
RESULTS
RESULTS
The prevalence of psoriasis was 3.8% (n = 143), with no differences between sex. We observed more often metabolic and cardiovascular risk factors in women with psoriasis compared to women without psoriasis. Interestingly, in men, this pattern was partly reversed. Multiple regression analyses revealed distinctly elevated PRs for DM for both women and men with psoriasis (fully adjusted PR: 2.43; 95% CI: 1.17-5.07, resp. 2.09; 1.16-3.76). Regarding the MetS, the results were inconsistent, showing a positive association between psoriasis and MetS in women (1.84; 1.14-2.98), but a negative association in men, even though with a wide 95% CI (0.69; 0.42-1.12).
CONCLUSION
CONCLUSIONS
The results of our cross-sectional, population-based analysis show a distinct association between psoriasis and DM, whereas for the MetS the results contrasted between men and women, translating in women with MetS showing a higher and in men a lower chance to be psoriatic. Our results emphasize the urgent need for sex-specific research, studying the effects of psoriasis on metabolic disorders as well as effective sex tailored prevention measures.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
779-786Subventions
Organisme : The German Ministry of Education and Science
ID : 01EG0401
Organisme : The German Ministry of Education and Science
ID : 01GI0856
Organisme : The German Ministry of Education and Science
ID : 01GI0860
Organisme : The German Ministry of Education and Science
ID : 01GS0820_WB2-C
Organisme : The German Ministry of Education and Science
ID : 01ER1001D
Organisme : The German Ministry of Education and Science
ID : 01GI0205
Organisme : the Deutsche Forschungsgemeinschaft
ID : SI 236/8-1
Organisme : the Deutsche Forschungsgemeinschaft
ID : SI 236/9-1
Organisme : the Deutsche Forschungsgemeinschaft
ID : SI 236/10-1
Organisme : the Deutsche Forschungsgemeinschaft
ID : JO 170/8-1
Organisme : the Deutsche Forschungsgemeinschaft
ID : ER155/6-1
Organisme : the Deutsche Forschungsgemeinschaft
ID : KN885/3-1
Organisme : the Deutsche Forschungsgemeinschaft
ID : HO 3314/2-1
Organisme : the Deutsche Forschungsgemeinschaft
ID : HO 3314/2-1
Organisme : the Deutsche Forschungsgemeinschaft
ID : ER155/6-2
Organisme : the Deutsche Forschungsgemeinschaft
ID : HO 3314/2-3
Organisme : the Deutsche Forschungsgemeinschaft
ID : EI 969/2-3
Organisme : the Deutsche Forschungsgemeinschaft
ID : INST 58219/32-1
Organisme : the Deutsche Forschungsgemeinschaft
ID : PE 2309/2-1
Organisme : the Ministry of Innovation, Science and Research, North Rhine-Westphalia
Informations de copyright
© 2019 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.
Références
Reich K, Thaci D, Mrowietz U, Kamps A, Neureither M, Luger T. Efficacy and safety of fumaric acid esters in the long-term treatment of psoriasis-a retrospective study (FUTURE). J Dtsch Dermatol Ges 2009; 7: 603-611.
Rachakonda TD, Schupp CW, Armstrong AW. Psoriasis prevalence among adults in the United States. J Am Acad Dermatol 2014; 70: 512-516.
Gelfand JM, Weinstein R, Porter SB, Neimann AL, Berlin JA, Margolis DJ. Prevalence and treatment of psoriasis in the United Kingdom: a population-based study. Arch Dermatol 2005; 141: 1537-1541.
Davidovici BB, Sattar N, Prinz J et al. Psoriasis and systemic inflammatory diseases: potential mechanistic links between skin disease and co-morbid conditions. J Invest Dermatol 2010; 130: 1785-1796.
Muller-Ladner U, Alten R, Heiligenhaus A et al. “TRECID”, TNFalpha related chronic inflammatory diseases - a new multiple diseases bridging concept. Dtsch Med Wochenschr 2009; 134: 2132-2136.
Kaye JA, Li L, Jick SS. Incidence of risk factors for myocardial infarction and other vascular diseases in patients with psoriasis. Br J Dermatol 2008; 159: 895-902.
Miller IM, Ellervik C, Yazdanyar S, Jemec GB. Meta-analysis of psoriasis, cardiovascular disease, and associated risk factors. J Am Acad Dermatol 2013; 69: 1014-1024.
Phan C, Sigal ML, Lhafa M et al. Metabolic comorbidities and hypertension in psoriasis patients in France. Comparisons with French national databases. Ann Dermatol Venereol 2016; 143: 264-274.
Armesto S, Coto-Segura P, Osuna CG, Camblor PM, Santos-Juanes J. Psoriasis and hypertension: a case-control study. J Eur Acad Dermatol Venereol 2012; 26: 785-788.
Cohen AD, Weitzman D, Dreiher J. Psoriasis and hypertension: a case-control study. Acta Derm Venereol 2010; 90: 23-26.
Qureshi AA, Choi HK, Setty AR, Curhan GC. Psoriasis and the risk of diabetes and hypertension: a prospective study of US female nurses. Arch Dermatol 2009; 145: 379-382.
Benson MM, Frishman WH. The heartbreak of psoriasis: a review of cardiovascular risk in patients with psoriasis. Cardiol Rev 2015; 23: 312-316.
Coumbe AG, Pritzker MR, Duprez DA. Cardiovascular risk and psoriasis: beyond the traditional risk factors. Am J Med 2014; 127: 12-18.
Armstrong EJ, Harskamp CT, Armstrong AW. Psoriasis and major adverse cardiovascular events: a systematic review and meta-analysis of observational studies. J Am Heart Assoc 2013; 2: e000062.
Balci DD, Balci A, Karazincir S et al. Increased carotid artery intima-media thickness and impaired endothelial function in psoriasis. J Eur Acad Dermatol Venereol 2009; 23: 1-6.
Gelfand JM, Dommasch ED, Shin DB et al. The risk of stroke in patients with psoriasis. J Invest Dermatol 2009; 129: 2411-2418.
Ahlehoff O, Gislason G, Lamberts M et al. Risk of thromboembolism and fatal stroke in patients with psoriasis and nonvalvular atrial fibrillation: a Danish nationwide cohort study. J Intern Med 2015; 277: 447-455.
Samarasekera EJ, Neilson JM, Warren RB, Parnham J, Smith CH. Incidence of cardiovascular disease in individuals with psoriasis: a systematic review and meta-analysis. J Invest Dermatol 2013; 133: 2340-2346.
Xu T, Zhang YH. Association of psoriasis with stroke and myocardial infarction: meta-analysis of cohort studies. Br J Dermatol 2012; 167: 1345-1350.
Chiang CH, Huang CC, Chan WL et al. Psoriasis and increased risk of ischemic stroke in Taiwan: a nationwide study. J Dermatol 2012; 39: 279-281.
Lai YC, Yew YW. Psoriasis as an independent risk factor for cardiovascular disease: an epidemiologic analysis using a national database. J Cutan Med Surg 2016; 20: 327-333.
Miller IM, Ellervik C, Zarchi K et al. The association of metabolic syndrome and psoriasis: a population- and hospital-based cross-sectional study. J Eur Acad Dermatol Venereol 2015; 29: 490-497.
Miller IM, Skaaby T, Ellervik C, Jemec GB. Quantifying cardiovascular disease risk factors in patients with psoriasis: a meta-analysis. Br J Dermatol 2013; 169: 1180-1187.
Setty AR, Curhan G, Choi HK. Obesity, waist circumference, weight change, and the risk of psoriasis in women: Nurses’ Health Study II. Arch Intern Med 2007; 167: 1670-1675.
Correia B, Torres T. Obesity: a key component of psoriasis. Acta Biomed 2015; 86: 121-129.
Duarte GV, Silva LP. Correlation between psoriasis’ severity and waist-to-height ratio. An Bras Dermatol 2014; 89: 846-847.
Lee A, Smith SD, Hong E, Garnett S, Fischer G. Association between pediatric psoriasis and waist-to-height ratio in the absence of obesity: a multicenter Australian Study. JAMA Dermatol 2016; 152: 1314-1319.
Gyldenlove M, Storgaard H, Holst JJ, Vilsboll T, Knop FK, Skov L. Patients with psoriasis are insulin resistant. J Am Acad Dermatol 2015; 72: 599-605.
Lonnberg AS, Skov L, Skytthe A, Kyvik KO, Pedersen OB, Thomsen SF. Association of psoriasis with the risk for type 2 diabetes mellitus and obesity. JAMA Dermatol 2016; 152: 761-767.
Dubreuil M, Rho YH, Man A et al. Diabetes incidence in psoriatic arthritis, psoriasis and rheumatoid arthritis: a UK population-based cohort study. Rheumatology (Oxford) 2014; 53: 346-352.
Goldenberg R, Punthakee Z. Definition, classification and diagnosis of diabetes, prediabetes and metabolic syndrome. Can J Diabetes 2013; 37(Suppl 1): S8-S11.
Danielsen K, Wilsgaard T, Olsen AO et al. Elevated odds of metabolic syndrome in psoriasis: a population-based study of age and sex differences. Br J Dermatol 2015; 172: 419-427.
Rodriguez-Zuniga MJM, Cortez-Franco F, Quijano-Gomero E. Association of psoriasis and metabolic syndrome in Latin America: a systematic review and meta-analysis. Actas Dermosifiliogr 2017; 108: 326-334.
Parodi A, Aste N, Calvieri C et al. Metabolic syndrome prevalence in psoriasis: a cross-sectional study in the Italian population. Am J Clin Dermatol 2014; 15: 371-377.
Langan SM, Seminara NM, Shin DB et al. Prevalence of metabolic syndrome in patients with psoriasis: a population-based study in the United Kingdom. J Invest Dermatol 2012; 132: 556-562.
Malkic Salihbegovic E, Hadzigrahic N, Cickusic AJ. Psoriasis and metabolic syndrome. Med Arch 2015; 69: 85-87.
Singh S, Young P, Armstrong AW. Relationship between psoriasis and metabolic syndrome: a systematic review. G Ital Dermatol Venereol 2016; 151: 663-677.
Kim SH, Reaven G. Sex differences in insulin resistance and cardiovascular disease risk. J Clin Endocrinol Metab 2013; 98: E1716-E1721.
Ervin RB. Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: United States, 2003-2006. Natl Health Stat Report, 2009: 1-7.
Moran A, Jacobs DR Jr, Steinberger J et al. Changes in insulin resistance and cardiovascular risk during adolescence: establishment of differential risk in males and females. Circulation 2008; 117: 2361-2368.
Willeit J, Kiechl S, Egger G et al. The role of insulin in age-related sex differences of cardiovascular risk profile and morbidity. Atherosclerosis 1997; 130: 183-189.
Moebus S, Balijepalli C, Losch C et al. Age- and sex-specific prevalence and ten-year risk for cardiovascular disease of all 16 risk factor combinations of the metabolic syndrome - A cross-sectional study. Cardiovasc Diabetol 2010; 9: 34.
Schmermund A, Mohlenkamp S, Stang A et al. Assessment of clinically silent atherosclerotic disease and established and novel risk factors for predicting myocardial infarction and cardiac death in healthy middle-aged subjects: rationale and design of the Heinz Nixdorf RECALL Study. Risk Factors, Evaluation of Coronary Calcium and Lifestyle. Am Heart J 2002; 144: 212-218.
Stang A, Moebus S, Mohlenkamp S et al. Algorithms for converting random-zero to automated oscillometric blood pressure values, and vice versa. Am J Epidemiol 2006; 164: 85-94.
Moebus S, Stang A, Mohlenkamp S et al. Association of impaired fasting glucose and coronary artery calcification as a marker of subclinical atherosclerosis in a population-based cohort-results of the Heinz Nixdorf Recall Study. Diabetologia 2009; 52: 81-89.
Moebus S, Hanisch JU, Aidelsburger P, Bramlage P, Wasem J, Jockel KH. Impact of 4 different definitions used for the assessment of the prevalence of the Metabolic Syndrome in primary healthcare: the German Metabolic and Cardiovascular Risk Project (GEMCAS). Cardiovasc Diabetol 2007; 6: 22.
Lehmann N, Erbel R, Mahabadi AA et al. Accelerated progression of coronary artery calcification in hypertension but also prehypertension. J Hypertens 2016; 34: 2233-2242.
Erbel R, Lehmann N, Mohlenkamp S et al. Subclinical coronary atherosclerosis predicts cardiovascular risk in different stages of hypertension: result of the Heinz Nixdorf Recall Study. Hypertension 2012; 59: 44-53.
Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013; 34: 2159-2219.
Chobanian AV, Bakris GL, Black HR et al. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension 2003; 42: 1206-1252.
Sterne JA, Davey Smith G. Sifting the evidence-what's wrong with significance tests? BMJ 2001; 322: 226-231.
Lash TL. Heuristic thinking and inference from observational epidemiology. Epidemiology 2007; 18: 67-72.
Puig L. Cardiometabolic comorbidities in psoriasis and psoriatic arthritis. Int J Mol Sci 2017; 19: pii: E58.
Yeung H, Takeshita J, Mehta NN et al. Psoriasis severity and the prevalence of major medical comorbidity: a population-based study. JAMA Dermatol 2013; 149: 1173-1179.
Augustin M, Glaeske G, Radtke MA, Christophers E, Reich K, Schafer I. Epidemiology and comorbidity of psoriasis in children. Br J Dermatol 2010; 162: 633-636.
Regitz-Zagrosek V, Kararigas G. Mechanistic pathways of sex differences in cardiovascular disease. Physiol Rev 2017; 97: 1-37.
Rochlani Y, Pothineni NV, Mehta JL. Metabolic syndrome: does it differ between women and men? Cardiovasc Drugs Ther 2015; 29: 329-338.
Ventura-Clapier R, Dworatzek E, Seeland U et al. Sex in basic research: concepts in the cardiovascular field. Cardiovasc Res 2017; 113: 711-724.
Regitz-Zagrosek V, Oertelt-Prigione S, Prescott E et al. Gender in cardiovascular diseases: impact on clinical manifestations, management, and outcomes. Eur Heart J 2016; 37: 24-34.
Danielsen K, Olsen AO, Wilsgaard T, Furberg AS. Is the prevalence of psoriasis increasing? A 30-year follow-up of a population-based cohort. Br J Dermatol 2013; 168: 1303-1310.
Danielsen K, Duvetorp A, Iversen L et al. Prevalence of psoriasis and psoriatic arthritis and patient perceptions of severity in Sweden, Norway and Denmark: results from the Nordic patient survey of psoriasis and psoriatic arthritis. Acta Derm Venereol 2019; 99: 18-25.
Grundy SM. Metabolic syndrome pandemic. Arterioscler Thromb Vasc Biol 2008; 28: 629-636.
Cohen AD, Dreiher J, Shapiro Y et al. Psoriasis and diabetes: a population-based cross-sectional study. J Eur Acad Dermatol Venereol 2008; 22: 585-589.
Love TJ, Qureshi AA, Karlson EW, Gelfand JM, Choi HK. Prevalence of the metabolic syndrome in psoriasis: results from the National Health and Nutrition Examination Survey, 2003-2006. Arch Dermatol 2011; 147: 419-424.
Jensen P, Thyssen JP, Zachariae C, Hansen PR, Linneberg A, Skov L. Cardiovascular risk factors in subjects with psoriasis: a cross-sectional general population study. Int J Dermatol 2013; 52: 681-683.
Olsen AO, Grjibovski A, Magnus P, Tambs K, Harris JR. Psoriasis in Norway as observed in a population-based Norwegian twin panel. Br J Dermatol 2005; 153: 346-351.
Gelfand JM, Stern RS, Nijsten T et al. The prevalence of psoriasis in African Americans: results from a population-based study. J Am Acad Dermatol 2005; 52: 23-26.
Gelfand JM, Neimann AL, Shin DB, Wang X, Margolis DJ, Troxel AB. Risk of myocardial infarction in patients with psoriasis. JAMA 2006; 296: 1735-1741.