Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
J Am Acad Dermatol. 2018 Feb;78(2):315-322.e1. doi: 10.1016/j.jaad.2017.10.050. Epub 2017 Nov 8.
Data evaluating the impact of objectively measured psoriasis severity on type 2 diabetes mellitus (T2DM) risk are lacking.
To determine the risk for T2DM in patients with psoriasis compared with that in adults without psoriasis, stratified by categories of directly assessed body surface area (BSA) affected by psoriasis.
A prospective, population-based, cohort study from the United Kingdom in which 8124 adults with psoriasis and 76,599 adults without psoriasis were followed prospectively for approximately 4 years.
There were 280 incident cases of diabetes in the psoriasis group (3.44%) and 1867 incident cases of diabetes in those without psoriasis (2.44%). After adjustment for age, sex and body mass index, the hazard ratios for development of incident diabetes were 1.21 (95% confidence interval [CI], 1.01-1.44), 1.01 (95% CI, 0.81-1.26), and 1.64 (95% CI, 1.23-2.18) in the groups with 2% or less of their BSA affected, 3% to 10% of their BSA affected, and 10% or more of their BSA affected compared with in the groups without psoriasis, respectively (P = .004 for trend). Worldwide, we estimate an additional 125,650 new diagnoses of T2DM per year in patients with psoriasis as compared with in those without psoriasis.
Relatively short-term follow-up and exclusion of prevalence cases, which may have masked associations in patients with less extensive psoriasis.
Clinicians may measure BSA affected by psoriasis to target diabetes prevention efforts for patients with psoriasis.
缺乏评估银屑病严重程度对 2 型糖尿病（T2DM）风险影响的相关数据。
通过直接评估受银屑病影响的身体表面积（BSA）类别，确定与无银屑病成人相比，银屑病患者罹患 T2DM 的风险。
一项来自英国的前瞻性、基于人群的队列研究，对 8124 例银屑病患者和 76599 例无银屑病成人进行了约 4 年的前瞻性随访。
银屑病组中有 280 例（3.44%）和无银屑病组中有 1867 例（2.44%）发生了 280 例糖尿病事件。在调整年龄、性别和体重指数后，与无银屑病组相比，BSA 受累 2%或以下、3%至 10%、10%或以上的银屑病患者发生糖尿病事件的风险比分别为 1.21（95%可信区间 [CI]，1.01-1.44）、1.01（95% CI，0.81-1.26）和 1.64（95% CI，1.23-2.18）（趋势 P 值=0.004）。我们估计，与无银屑病患者相比，全球每年银屑病患者因 T2DM 而新增诊断的人数将增加 125650 例。
随访时间相对较短，排除了患病率病例，这可能掩盖了轻度银屑病患者的相关性。
临床医生可以测量受银屑病影响的 BSA，以针对银屑病患者开展糖尿病预防工作。
