Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Arthritis Rheumatol. 2014 Feb;66(2):304-10. doi: 10.1002/art.38227.
Psoriasis is a systemic inflammatory disorder associated with an increased risk of cardiovascular disease. Hypercholesterolemia is a major risk factor for cardiovascular disease, and patients with psoriasis or psoriatic arthritis (PsA) have been shown to have elevated cholesterol levels. However, it is not known whether hypercholesterolemia is associated with an increased risk of psoriasis or psoriasis with PsA. We undertook this study to determine whether a history of hypercholesterolemia is associated with the risk of developing incident psoriasis and psoriasis with PsA in a cohort of US women.
We included a total of 95,540 participants from the Nurses' Health Study II (1991-2005). Information on personal history of physician-diagnosed hypercholesterolemia and related medication use was collected during the followup period. Clinician-diagnosed psoriasis and psoriasis with PsA were ascertained and confirmed using supplementary questionnaires. Hazard ratios (HRs) were calculated with 95% confidence intervals (95% CIs).
During 1,320,765 person-years of followup, we documented 646 participants with incident psoriasis, 165 of whom had concomitant PsA. Hypercholesterolemia was associated with elevated risks of incident psoriasis (HR 1.25 [95% CI 1.04-1.50]) and psoriasis with PsA (HR 1.58 [95% CI 1.13-2.23]) in multivariate-adjusted models. Participants with hypercholesterolemia lasting for ≥7 years were at a higher risk of developing psoriasis (HR 1.29 [95% CI 1.03-1.61]) (P for trend = 0.0002) and psoriasis with PsA (HR 1.68 [95% CI 1.12-2.52]) (P for trend = 0.002). These associations persisted among participants who never took cholesterol-lowering medications. There was no association between cholesterol-lowering drugs and risk of psoriasis or psoriasis with PsA.
Our study provides evidence that hypercholesterolemia, a well-known cardiovascular risk factor, is also associated with an elevated risk of psoriasis and psoriasis with PsA.
银屑病是一种与心血管疾病风险增加相关的系统性炎症性疾病。高胆固醇血症是心血管疾病的一个主要危险因素，患有银屑病或银屑病关节炎（PsA）的患者胆固醇水平升高。然而，尚不清楚高胆固醇血症是否与银屑病或银屑病伴 PsA 的发病风险增加有关。我们进行这项研究是为了确定高胆固醇血症史是否与美国女性队列中发生银屑病和银屑病伴 PsA 的风险相关。
我们共纳入了来自护士健康研究 II 期（1991-2005 年）的 95540 名参与者。在随访期间收集了个人高胆固醇血症病史和相关药物使用情况的信息。使用补充问卷确定和确认临床医生诊断的银屑病和银屑病伴 PsA。使用 95%置信区间（95%CI）计算风险比（HR）。
在 1320765 人年的随访期间，我们记录了 646 名新发银屑病患者，其中 165 名伴有并发 PsA。多变量调整模型显示，高胆固醇血症与新发银屑病（HR 1.25[95%CI 1.04-1.50]）和银屑病伴 PsA（HR 1.58[95%CI 1.13-2.23]）的风险增加相关。高胆固醇血症持续≥7 年的参与者发生银屑病（HR 1.29[95%CI 1.03-1.61]）（趋势 P 值=0.0002）和银屑病伴 PsA（HR 1.68[95%CI 1.12-2.52]）（趋势 P 值=0.002）的风险更高。这些关联在从未服用过降脂药物的参与者中仍然存在。降脂药物与银屑病或银屑病伴 PsA 的风险之间没有关联。
我们的研究提供了证据表明，高胆固醇血症，一种已知的心血管疾病危险因素，也与银屑病和银屑病伴 PsA 的发病风险增加有关。
