Rheumatology Division, Department of Internal Medicine, Hospital Universitario Central de Asturias (HUCA), Avenida de Roma s/n, 33011, Oviedo, Spain.
Dermatology Division, Department of Internal Medicine, Hospital Universitario Central de Asturias (HUCA), Avenida de Roma s/n, 33011, Oviedo, Spain.
Clin Rheumatol. 2018 Apr;37(4):1059-1064. doi: 10.1007/s10067-018-4042-1. Epub 2018 Feb 22.
Diabetes is a common cardiovascular risk factor in psoriatic arthritis (PsA). Although the prevalence of diabetes is high, the factors associated with it in PsA are poorly understood. We aimed to analyse the prevalence of type II diabetes and diabetes-associated factors in a hospital-based population with PsA. This cross-sectional study included 340 consecutive patients attended in a tertiary care hospital. The prevalence of diabetes was compared to that of 600 outpatients without inflammatory conditions. To analyse diabetes-associated factors, odds ratio (OR) values were calculated by conditional logistic regression analysis. Significant variables in the univariate analysis were then introduced in a multivariate analysis with a backward stepwise approach. Diabetes was more prevalent among PsA patients (13.8 vs. 5%, OR 2.8, 95% CI: 1.7-4.3, p < 0.0001). Diabetes-associated factors in the univariate analysis (p < 0.05) were the following: an age of onset of psoriasis > 40 years, an age of onset of arthritis > 40 years, a low educational level, family history of psoriasis, pustular psoriasis, high number of swollen joints during follow-up, hypertension, dyslipidemia, obesity, and cardiovascular events. After controlling for several confounders, diabetes was significantly associated with late-onset psoriasis (OR 8.2, 95% CI: 1.9-12.4, p = 0.002) and hypertension (OR 7.5, 95% CI: 1.5-13.3, p = 0.008). Diabetes risk should be carefully evaluated in patients with PsA whose psoriasis begins after 40 years.
糖尿病是银屑病关节炎（PsA）的常见心血管危险因素。尽管糖尿病的患病率很高，但 PsA 中与之相关的因素仍知之甚少。我们旨在分析以医院为基础的 PsA 人群中 II 型糖尿病的患病率和与糖尿病相关的因素。这项横断面研究纳入了在一家三级保健医院就诊的 340 例连续患者。将糖尿病的患病率与 600 例无炎症疾病的门诊患者进行了比较。为了分析与糖尿病相关的因素，通过条件逻辑回归分析计算了比值比（OR）值。在单变量分析中具有统计学意义的变量随后通过向后逐步方法引入多变量分析。PsA 患者的糖尿病患病率更高（13.8%比 5%，OR 2.8，95%CI：1.7-4.3，p<0.0001）。单变量分析中与糖尿病相关的因素（p<0.05）如下：银屑病发病年龄>40 岁、关节炎发病年龄>40 岁、教育程度低、银屑病家族史、脓疱型银屑病、随访期间肿胀关节数量多、高血压、血脂异常、肥胖和心血管事件。在控制了几个混杂因素后，糖尿病与晚发性银屑病（OR 8.2，95%CI：1.9-12.4，p=0.002）和高血压（OR 7.5，95%CI：1.5-13.3，p=0.008）显著相关。对于银屑病发病年龄>40 岁的 PsA 患者，应仔细评估糖尿病风险。
