Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Kildegårdsvej 28, 2900, Hellerup, Denmark.
Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Br J Dermatol. 2019 Feb;180(2):321-328. doi: 10.1111/bjd.17091. Epub 2018 Oct 25.
The socioeconomic determinants of paediatric-onset psoriasis have not been previously investigated.
To identify whether a social gradient exists for paediatric-onset psoriasis, using measures of maternal socioeconomic position.
Data on paediatric-onset psoriasis from 36 003 Danish National Birth Cohort offspring were cross-linked with nationwide registry data on maternal age and three measures of maternal socioeconomic position: maternal educational attainment, maternal labour market attachment and equivalized household income. Univariable and multivariable logistic regression analyses were conducted to estimate the odds ratios (ORs) of psoriasis in the offspring, in cohort analyses for data from the year of enrolment and cross-sectional analyses from the year of the 11-year follow-up.
Maternal age at birth, maternal educational attainment and equivalized household income were inversely associated with psoriasis in the offspring. Low maternal educational attainment was associated with offspring psoriasis [adjusted OR 1·62, 95% confidence interval (CI) 1·20-2·18] after adjusting for maternal psoriasis and age in the cohort analysis. The crude OR of psoriasis in offspring of mothers in the highest quartile compared with mothers in the lowest quartile of equivalized household income was 0·57 (95% CI 0·43-0·76), and the adjusted OR was 0·59 (95% CI 0·44-0·80) after adjusting for maternal psoriasis and age. Similar results were observed for data on maternal socioeconomic position at enrolment and at follow-up.
A steep social gradient in paediatric-onset psoriasis was observed. Maternal socioeconomic position may play a role in early-life exposure to modifiable risk factors for psoriasis. Future studies may help to elucidate which biological factors mediate the social gradient observed in our study.
儿科发病银屑病的社会经济决定因素尚未得到研究。
使用母亲社会经济地位的衡量标准，确定儿科发病银屑病是否存在社会梯度。
对来自 36003 名丹麦国家出生队列的儿童发病银屑病数据与全国范围内的母亲年龄和母亲社会经济地位的三项衡量标准（母亲的教育程度、母亲的劳动力市场参与情况和家庭收入均等化）的全国性登记数据进行了交叉链接。对队列分析中登记年度的数据和 11 年随访年度的横断面分析进行了单变量和多变量逻辑回归分析，以估计后代患银屑病的优势比（OR）。
母亲的出生年龄、母亲的教育程度和家庭收入均等化与后代患银屑病呈负相关。在队列分析中，调整了母亲银屑病和年龄后，母亲教育程度低与后代患银屑病有关（调整后的 OR 1.62，95%置信区间 [CI] 1.20-2.18）。与收入均等化家庭收入最低四分位数的母亲的后代相比，收入均等化家庭收入最高四分位数的母亲的后代患银屑病的粗 OR 为 0.57（95%CI 0.43-0.76），调整后的 OR 为 0.59（95%CI 0.44-0.80），调整了母亲银屑病和年龄。在入学和随访时的母亲社会经济地位数据上也观察到了类似的结果。
在儿科发病银屑病中观察到了陡峭的社会梯度。母亲的社会经济地位可能在儿童期暴露于可改变的银屑病风险因素中起作用。未来的研究可能有助于阐明我们研究中观察到的社会梯度的生物学因素。
