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日本银屑病患者冠状动脉钙化的患病率:与双侧耳垂斜线折痕密切相关。

Prevalence of coronary artery calcification in Japanese patients with psoriasis: A close correlation with bilateral diagonal earlobe creases.

机构信息

Department of Dermatology, Asahikawa Medical University, Asahikawa, Japan.

出版信息

J Dermatol. 2017 Oct;44(10):1122-1128. doi: 10.1111/1346-8138.13895. Epub 2017 May 2.

Abstract

Psoriasis is a multifactorial inflammatory disorder, in which the inflammation affects not only the skin but also the other internal organs, and can induce cardiovascular and cerebrovascular involvements. However, few predictive factors of cardiovascular diseases have been clarified in patients with psoriasis. This study was performed to verify whether diagonal earlobe creases (ELC) can reflect the hidden comorbidities in Japanese psoriatic patients. Prevalence and subtypes of ELC were analyzed in patients with psoriatic and with non-psoriatic skin diseases, and the correlation with coronary artery calcification (CAC) or fatty liver (FL) detected by computed tomography. Prevalence of CAC was approximately twice higher than data of a Japanese resident-based study previously reported. Generally, prevalence of ELC in a psoriatic group and mean age of psoriatic groups accompanied by ELC were higher and younger than those of a non-psoriatic skin disease group, respectively. Statistically significant differences were detected in the mean age of total or male subjects accompanied by bilateral ELC with complete and incomplete length. Bilateralism of ELC was closely correlated with prevalence of CAC and CAC on multiple branches in psoriatic patients (P = 6.6e-6 and odds ratio [OR] = 14.1, P = 0.00884 and OR = 10.7, respectively), but not with that of FL. On the contrary, body mass index of more than 25 was closely correlated with prevalence of FL, but not that of CAC. Comorbidities of psoriatic patients are frequently unnoticed. ELC, an apparatus-related feature, can be a useful predictive factor for hidden coronary artery involvements in psoriatic patients.

摘要

银屑病是一种多因素炎症性疾病,其炎症不仅影响皮肤,还影响其他内脏器官,并可诱发心血管和脑血管并发症。然而,在银屑病患者中,尚未明确心血管疾病的预测因素。本研究旨在验证耳垂斜线折(ELC)是否可以反映日本银屑病患者的隐匿性合并症。分析了银屑病患者和非银屑病性皮肤病患者的 ELC 患病率和亚型,并与计算机断层扫描检测到的冠状动脉钙化(CAC)或脂肪肝(FL)进行了相关性分析。CAC 的患病率约为先前报道的基于日本居民的研究数据的两倍。通常,银屑病组的 ELC 患病率和伴有 ELC 的银屑病组的平均年龄均高于非银屑病性皮肤病组,且分别低于后者。在伴有双侧 ELC 的总人群或男性人群中,双侧 ELC 完全和不完全长度的平均年龄存在统计学差异。ELC 的双侧性与银屑病患者 CAC 的患病率以及 CAC 的多个分支密切相关(P = 6.6e-6 和优势比[OR] = 14.1,P = 0.00884 和 OR = 10.7),但与 FL 的患病率无关。相反,BMI 超过 25 与 FL 的患病率密切相关,而与 CAC 无关。银屑病患者的合并症经常被忽视。ELC 作为一种与仪器相关的特征,可能是预测银屑病患者隐匿性冠状动脉受累的有用指标。

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