Cohen A D, Sherf M, Vidavsky L, Vardy D A, Shapiro J, Meyerovitch J
Research and Health Planning Department, Health Planning and Policy Division, Clalit Health Services, Omer/Tel Aviv, Israel.
Dermatology. 2008;216(2):152-5. doi: 10.1159/000111512. Epub 2008 Jan 23.
Previous reports have shown an association between inflammatory diseases such as systemic lupus erythematosus or rheumatoid arthritis and the metabolic syndrome. Recent data demonstrate that psoriasis is an inflammatory disease, suggesting that psoriasis may be one of the components of the metabolic syndrome.
To assess the association between psoriasis and the metabolic syndrome.
A cross-sectional study was performed utilizing the database of the Clalit Health Services. Case patients were defined as patients with a diagnosis of psoriasis vulgaris. Controls were randomly selected from the list of Clalit Health Services enrollees. The proportions of components of the metabolic syndrome (ischemic heart disease, hypertension, diabetes, obesity and dyslipidemia) were compared between case and control patients by univariate analyses. chi(2) tests were used to compare categorical parameters between the groups. Logistic and linear regression models served to measure the association between psoriasis and the metabolic syndrome.
The study included 16,851 patients with psoriasis and 48,681 controls. In the case group, there were 8,449 men (50.1%) and 8,402 women (49.9%), with a mean age of 42.7 years (SD = 20.3, range = 2-111). Diabetes mellitus was present in 13.8% of the patients with psoriasis as compared to 7.3% of the controls (p < 0.001). Hypertension occurred in 27.5% of the patients with psoriasis and in 14.4% of the controls (p < 0.001). Obesity was present in 8.4% of the patients with psoriasis as opposed to 3.6% of the controls (p < 0.001). Ischemic heart disease was observed in 14.2% of the patients with psoriasis as compared to 7.1% of the controls (p < 0.001). Multivariate models adjusting for age, gender and smoking status of the patients demonstrated that psoriasis was associated with the metabolic syndrome (OR = 1.3, 95% CI = 1.1-1.4), ischemic heart disease (OR = 1.1, 95% CI = 1.0-1.2), diabetes mellitus (OR = 1.2, 95% CI = 1.0-1.3), hypertension (OR = 1.3, 95% CI = 1.2-1.5) and obesity (OR = 1.7, 95% CI = 1.5-1.9).
The study is designed as a case-control study, thus an association alone was proven and not causality.
Our findings demonstrate a possible association between psoriasis and the metabolic syndrome. Appropriate treatment of the metabolic syndrome may be an important part of the management of patients with psoriasis.
既往报告显示，系统性红斑狼疮或类风湿关节炎等炎症性疾病与代谢综合征之间存在关联。近期数据表明，银屑病是一种炎症性疾病，提示银屑病可能是代谢综合征的组成部分之一。
评估银屑病与代谢综合征之间的关联。
利用克拉利特医疗服务数据库进行了一项横断面研究。病例患者定义为诊断为寻常型银屑病的患者。对照从克拉利特医疗服务参保人员名单中随机选取。通过单因素分析比较病例组和对照组患者代谢综合征各组分（缺血性心脏病、高血压、糖尿病、肥胖和血脂异常）的比例。采用卡方检验比较两组间的分类参数。逻辑回归和线性回归模型用于衡量银屑病与代谢综合征之间的关联。
该研究纳入了16851例银屑病患者和48681例对照。病例组中，男性8449例（50.1%），女性8402例（49.9%），平均年龄42.7岁（标准差=20.3，范围=2-111岁）。银屑病患者中糖尿病的患病率为13.8%，而对照组为7.3%（p<0.001）。银屑病患者中高血压的发生率为27.5%，对照组为14.4%（p<0.001）。银屑病患者中肥胖的患病率为8.4%，而对照组为3.6%（p<0.001）。银屑病患者中缺血性心脏病的发生率为14.2%，对照组为7.1%（p<0.001）。对患者的年龄、性别和吸烟状况进行校正的多变量模型表明，银屑病与代谢综合征（比值比=
