Dreiher J, Weitzman D, Shapiro J, Davidovici B, Cohen A D
Hospital Division, Clalit Health Services, Tel-Aviv, Israel.
Br J Dermatol. 2008 Sep;159(4):956-60. doi: 10.1111/j.1365-2133.2008.08749.x. Epub 2008 Jul 15.
Previous reports have demonstrated an association between psoriasis and the metabolic syndrome. Chronic obstructive pulmonary disease (COPD) has also been associated with the metabolic syndrome.
To assess the association between psoriasis and COPD in a population-based case-control study.
A case-control study was performed utilizing the database of Clalit Health Services, a large healthcare provider organization in Israel. Patients over the age of 20 years who were diagnosed with psoriasis ('cases') were compared with a sample of age- and gender-matched enrollees without psoriasis ('controls') regarding the prevalence of COPD. Group matching was performed. Data on health-related lifestyles and other comorbidities were collected. Chi(2) tests, t-tests and logistic regression models were used to compare between study groups.
The study included 12,502 psoriasis cases and 24,287 controls. The prevalence of COPD was significantly higher in patients with psoriasis [5.7% vs. 3.6%, P < 0.001, odds ratio (OR) 1.63, 95% confidence interval (CI) 1.47-1.81]. A multivariate logistic regression model demonstrated that psoriasis was significantly associated with COPD, after controlling for confounders, including age, sex, socioeconomic status, smoking and obesity (adjusted OR 1.27, 95% CI 1.13-1.42, P < 0.001).
In this large, population-based case-control study, psoriasis was found to be associated with COPD. Dermatologists caring for patients with psoriasis should be aware of this association, consult an internist or pulmonologist, and advise the patients to stop smoking and reduce additional risk factors for COPD.
既往报告显示银屑病与代谢综合征之间存在关联。慢性阻塞性肺疾病（COPD）也与代谢综合征有关。
在一项基于人群的病例对照研究中评估银屑病与COPD之间的关联。
利用以色列一家大型医疗服务机构Clalit Health Services的数据库进行病例对照研究。将20岁以上被诊断为银屑病的患者（“病例组”）与年龄和性别匹配的无银屑病参保者样本（“对照组”）就COPD的患病率进行比较。进行组间匹配。收集与健康相关的生活方式及其他合并症的数据。采用卡方检验、t检验和逻辑回归模型对研究组进行比较。
该研究纳入了12502例银屑病病例和24287例对照。银屑病患者中COPD的患病率显著更高[5.7% 对3.6%，P < 0.001，比值比（OR）1.63，95%置信区间（CI）1.47 - 1.81]。多变量逻辑回归模型显示，在控制了包括年龄、性别、社会经济地位、吸烟和肥胖等混杂因素后，银屑病与COPD显著相关（调整后OR 1.27，95% CI 1.13 - 1.42，P < 0.001）。
在这项大型的基于人群的病例对照研究中，发现银屑病与COPD有关。诊治银屑病患者的皮肤科医生应了解这种关联，咨询内科医生或肺科医生，并建议患者戒烟及降低COPD的其他危险因素。
