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美国住院儿童中儿童银屑病的心血管合并症

Cardiovascular comorbidities of pediatric psoriasis among hospitalized children in the United States.

作者信息

Kwa Lauren, Kwa Michael C, Silverberg Jonathan I

机构信息

Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Departments of Dermatology, Preventive Medicine, and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

出版信息

J Am Acad Dermatol. 2017 Dec;77(6):1023-1029. doi: 10.1016/j.jaad.2017.08.034. Epub 2017 Sep 28.

Abstract

BACKGROUND

Psoriasis has been shown to be associated with cardiovascular disease in adults. Little is known about cardiovascular risk in pediatric psoriasis.

OBJECTIVE

To determine if there is an association between pediatric psoriasis and cardiovascular comorbidities.

METHODS

Data were analyzed from the 2002-2012 Nationwide Inpatient Sample, which included 4,884,448 hospitalized children aged 0-17 years. Bivariate and multivariate survey logistic regression models were created to calculate the odds of psoriasis on cardiovascular comorbidities.

RESULTS

In multivariate survey logistic regression models adjusting for age, sex, and race/ethnicity, pediatric psoriasis was significantly associated with 5 of 10 cardiovascular comorbidities (adjusted odds ratio [95% confidence interval]), including obesity (3.15 [2.46-4.05]), hypertension (2.63 [1.93-3.59]), diabetes (2.90 [1.90-4.42]), arrhythmia (1.39 [1.02-1.88]), and valvular heart disease (1.90 [1.07-3.37]). The highest odds of cardiovascular risk factors occurred in blacks and Hispanics and children ages 0-9 years, but there were no sex differences.

LIMITATIONS

The study was limited to hospitalized children. We were unable to assess the impact of psoriasis treatment or family history on cardiovascular risk.

CONCLUSION

Pediatric psoriasis is associated with higher odds of multiple cardiovascular comorbidities among hospitalized patients. Strategies for mitigating excess cardiovascular risk in pediatric psoriasis need to be determined.

摘要

背景

银屑病已被证明与成人心血管疾病有关。关于儿童银屑病的心血管风险知之甚少。

目的

确定儿童银屑病与心血管合并症之间是否存在关联。

方法

对2002 - 2012年全国住院患者样本的数据进行分析,该样本包括4884448名0 - 17岁的住院儿童。建立双变量和多变量调查逻辑回归模型,以计算银屑病与心血管合并症的关联几率。

结果

在调整年龄、性别和种族/民族的多变量调查逻辑回归模型中,儿童银屑病与10种心血管合并症中的5种显著相关(调整后的优势比[95%置信区间]),包括肥胖(3.15[2.46 - 4.05])、高血压(2.63[1.93 - 3.59])、糖尿病(2.90[1.90 - 4.42])、心律失常(1.39[1.02 - 1.88])和心脏瓣膜病(1.90[1.07 - 3.37])。心血管危险因素的最高几率出现在黑人和西班牙裔以及0 - 9岁的儿童中,但没有性别差异。

局限性

该研究仅限于住院儿童。我们无法评估银屑病治疗或家族史对心血管风险的影响。

结论

儿童银屑病与住院患者多种心血管合并症的较高几率相关。需要确定减轻儿童银屑病过度心血管风险的策略。

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