Department of Pharmacy and Pharmacology, Bath, UK.
Department of Mathematical Sciences, University of Bath, Bath, UK.
Rheumatology (Oxford). 2019 Jan 1;58(1):144-148. doi: 10.1093/rheumatology/key286.
To determine the risk of type 2 diabetes (T2D) and cardiovascular diseases in PsA patients compared with the general population and patients with psoriasis.
Incident PsA patients aged 18-89 years were identified in the UK Clinical Practice Research Datalink between 1998 and 2014 and were matched (1:4 ratio) to a general population cohort and psoriasis cohort. The incidence of T2D, cerebrovascular disease, ischaemic heart disease and peripheral vascular disease (PVD) was calculated for each study cohort. Conditional Poisson regression was used to calculate adjusted relative risks.
We identified 6783 incident cases of PsA. The risk of T2D was significantly higher in the PsA cohort than in the general population and the psoriasis cohorts [adjusted relative risk 1.40 (CI95 1.15, 1.70) and adjusted relative risk 1.53 (CI95 1.19, 1.97), respectively]. The incidence of ischaemic heart disease, peripheral vascular disease and the three cardiovascular outcomes combined in the PsA cohort was significantly higher than in the general population. No significant differences in risk were observed between the PsA and psoriasis cohorts for any cardiovascular outcome.
The development of T2D in an incident population of PsA is significantly higher than in psoriasis alone or in a general population, whereas the increased risk of cardiovascular disease in PsA and psoriasis is similar.
与普通人群和银屑病患者相比，确定银屑病关节炎（PsA）患者发生 2 型糖尿病（T2D）和心血管疾病的风险。
在 1998 年至 2014 年间，英国临床实践研究数据库中确定了年龄在 18-89 岁的新发 PsA 患者，并与普通人群队列和银屑病队列进行了匹配（1:4 比例）。计算了每个研究队列中 T2D、脑血管疾病、缺血性心脏病和外周血管疾病（PVD）的发生率。使用条件泊松回归计算调整后的相对风险。
我们确定了 6783 例新发 PsA 病例。与普通人群和银屑病队列相比，PsA 队列发生 T2D 的风险显著更高[调整后的相对风险 1.40（95%CI95 1.15，1.70）和调整后的相对风险 1.53（95%CI95 1.19，1.97）]。与普通人群相比，PsA 队列中缺血性心脏病、外周血管疾病和三种心血管结局的发生率显著更高。在任何心血管结局方面，PsA 和银屑病队列之间的风险均无显著差异。
在新发 PsA 人群中，T2D 的发生风险明显高于银屑病单独或普通人群，而 PsA 和银屑病患者心血管疾病的风险增加相似。
