Department of Dermatology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Ann Rheum Dis. 2012 Aug;71(8):1267-72. doi: 10.1136/annrheumdis-2011-201273. Epub 2012 May 5.
Both overall and central obesity have been associated with the risk of psoriasis in a prospective study. Data on the association between obesity and psoriatic arthritis (PsA) have been sparse and no evidence on obesity measures and the risk of incident PsA is available now. This study aimed to evaluate the association between obesity and the risk of incident PsA in a large cohort of women.
89,049 participants were included from the Nurses Health Study II over a 14-year period (1991-2005). Information on body mass index (BMI), weight change and measures of central obesity (waist circumference, hip circumference and waist-hip ratio) was collected during the follow-up. The incidence of clinician-diagnosed PsA was ascertained and confirmed by supplementary questionnaires.
146 incident PsA cases were identified during 1,231,693 person-years of follow-up. Among all participants, BMI was monotonically associated with an increased risk of incident PsA. Compared with BMI less than 25.0, the RR was 1.83 for BMI 25.0-29.9 (95% CI 1.15 to 2.89), 3.12 for BMI 30.0-34.9 (95% CI 1.90 to 5.11) and 6.46 for BMI over 35.0 (95% CI 4.11 to 10.16). There was a graded positive association between weight change from age 18 years, measures of central obesity and risk of PsA (p for trend <0.001). The analysis among participants developing psoriasis during follow-up revealed a similar association (p for trend <0.01), indicating an increased risk of PsA associated with obesity among patients with psoriasis.
This study provides further evidence linking obesity with the risk of incident PsA among US women.
前瞻性研究表明，整体肥胖和中心型肥胖均与银屑病风险相关。关于肥胖与银屑病关节炎（PsA）之间关联的数据较为有限，目前尚无关于肥胖指标与新发 PsA 风险的证据。本研究旨在评估大型女性队列中肥胖与新发 PsA 风险之间的关联。
在 14 年的随访期间（1991-2005 年），共纳入了护士健康研究 II 中的 89049 名参与者。在随访期间收集了体重指数（BMI）、体重变化以及中心型肥胖（腰围、臀围和腰臀比）的相关信息。通过补充问卷确定并确认临床诊断的 PsA 发病情况。
在 1231693 人年的随访中，共发现 146 例新发 PsA 病例。在所有参与者中，BMI 与新发 PsA 的风险呈单调相关。与 BMI<25.0 相比，BMI 为 25.0-29.9 时 RR 为 1.83（95%CI 1.15 至 2.89），BMI 为 30.0-34.9 时 RR 为 3.12（95%CI 1.90 至 5.11），BMI 超过 35.0 时 RR 为 6.46（95%CI 4.11 至 10.16）。从 18 岁开始的体重变化、中心型肥胖的测量指标与 PsA 风险之间存在明显的正相关关系（趋势检验 p<0.001）。在随访期间发生银屑病的参与者中进行的分析也揭示了类似的关联（趋势检验 p<0.01），表明肥胖与银屑病患者的 PsA 风险增加有关。
本研究进一步证明了肥胖与美国女性新发 PsA 风险之间存在关联。
