Maglio Cristina, Peltonen Markku, Rudin Anna, Carlsson Lena M S
Department of Molecular and Clinical Medicine, Institute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
Department of Rheumatology and Inflammation Research, Institute of Medicine, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
Obesity (Silver Spring). 2017 Dec;25(12):2068-2073. doi: 10.1002/oby.21955.
The aim of this study was to assess the effect of bariatric surgery (vertical gastroplasty, gastric banding, or gastric bypass) compared with usual care on the incidence of psoriasis and psoriatic arthritis (PsA) in the Swedish Obese Subjects study.
This report includes 1,991 subjects who underwent bariatric surgery and 2,018 controls with obesity from the SOS study; none of them had psoriasis or PsA at baseline. Information about psoriasis and PsA diagnosis was retrieved through the Swedish National Patient Register and questionnaires.
During follow-up for up to 26 years, bariatric surgery was associated with a lower incidence of psoriasis compared with usual care (number of events = 174; hazard ratio 0.65; 95% CI: 0.47-0.89; P = 0.008). Both smoking and a longer duration of obesity were independently associated with a higher risk for psoriasis. No significant difference was detected among the three surgical procedures in terms of lowering the risk of developing psoriasis. The association between bariatric surgery and psoriasis incidence was not influenced by baseline confounders. No significant difference in the risk of developing PsA (number of events = 46) was detected when comparing the surgery and the control groups.
This study shows that bariatric surgery is associated with a lower risk of developing psoriasis compared with usual care.
本研究旨在评估在瑞典肥胖受试者研究中，与常规治疗相比，减肥手术（垂直胃成形术、胃束带术或胃旁路术）对银屑病和银屑病关节炎（PsA）发病率的影响。
本报告纳入了1991例接受减肥手术的受试者以及2018例来自瑞典肥胖受试者（SOS）研究的肥胖对照者；他们在基线时均无银屑病或PsA。通过瑞典国家患者登记系统和问卷调查获取银屑病和PsA诊断信息。
在长达26年的随访期间，与常规治疗相比，减肥手术与较低的银屑病发病率相关（事件数=174；风险比0.65；95%置信区间：0.47-0.89；P=0.008）。吸烟和较长的肥胖持续时间均与较高的银屑病风险独立相关。在降低银屑病发病风险方面，三种手术方法之间未检测到显著差异。减肥手术与银屑病发病率之间的关联不受基线混杂因素的影响。比较手术组和对照组时，未检测到发生PsA（事件数=46）风险的显著差异。
本研究表明，与常规治疗相比，减肥手术与较低的银屑病发病风险相关。
