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银屑病、心血管危险因素和代谢紊乱:一项基于人群的研究的性别特异性发现。

Psoriasis, cardiovascular risk factors and metabolic disorders: sex-specific findings of a population-based study.

机构信息

Department of Dermatology, Venereology and Allergology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.

Institute of Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany.

出版信息

J Eur Acad Dermatol Venereol. 2020 Apr;34(4):779-786. doi: 10.1111/jdv.16029. Epub 2019 Dec 3.

Abstract

BACKGROUND

Scientific evidence suggests an association between psoriasis and cardiovascular and metabolic diseases. However, there are hardly any sex-specific results from population-based studies reporting the prevalence of cardiovascular risk factors in patients with psoriasis and point estimates of the association between psoriasis and cardiovascular and metabolic disorders.

OBJECTIVE

Aims are to evaluate the sex-specific prevalence of psoriasis and cardiovascular risk factors, and to estimate sex-specific associations between psoriasis and diabetes type 2 (DM) and metabolic syndrome (MetS).

METHODS

We used data of 3723 participants (45-75 years, 54.1% women) without coronary heart disease and missing data (psoriasis, DM, MetS) from the Heinz Nixdorf Recall study. Standardized information on health outcomes and risk factors was assessed. We performed descriptive statistics and multiple regression analyses to calculate prevalence rate ratios (PR) and 95% confidence intervals (95% CI).

RESULTS

The prevalence of psoriasis was 3.8% (n = 143), with no differences between sex. We observed more often metabolic and cardiovascular risk factors in women with psoriasis compared to women without psoriasis. Interestingly, in men, this pattern was partly reversed. Multiple regression analyses revealed distinctly elevated PRs for DM for both women and men with psoriasis (fully adjusted PR: 2.43; 95% CI: 1.17-5.07, resp. 2.09; 1.16-3.76). Regarding the MetS, the results were inconsistent, showing a positive association between psoriasis and MetS in women (1.84; 1.14-2.98), but a negative association in men, even though with a wide 95% CI (0.69; 0.42-1.12).

CONCLUSION

The results of our cross-sectional, population-based analysis show a distinct association between psoriasis and DM, whereas for the MetS the results contrasted between men and women, translating in women with MetS showing a higher and in men a lower chance to be psoriatic. Our results emphasize the urgent need for sex-specific research, studying the effects of psoriasis on metabolic disorders as well as effective sex tailored prevention measures.

摘要

背景

科学证据表明银屑病与心血管和代谢疾病之间存在关联。然而,基于人群的研究几乎没有提供关于银屑病患者心血管风险因素的患病率和银屑病与心血管和代谢紊乱之间关联的点估计的性别特异性结果。

目的

评估银屑病和心血管风险因素的性别特异性患病率,并估计银屑病与 2 型糖尿病(DM)和代谢综合征(MetS)之间的性别特异性关联。

方法

我们使用了来自 Heinz Nixdorf 召回研究的 3723 名参与者(45-75 岁,54.1%为女性)的数据,这些参与者没有冠心病且无数据缺失(银屑病、DM、MetS)。评估了健康结果和风险因素的标准化信息。我们进行了描述性统计和多元回归分析,以计算患病率比(PR)和 95%置信区间(95%CI)。

结果

银屑病的患病率为 3.8%(n=143),男女之间无差异。我们观察到患有银屑病的女性比没有银屑病的女性更常出现代谢和心血管风险因素。有趣的是,在男性中,这种模式部分逆转。多元回归分析显示,银屑病女性和男性的 DM 的 PR 明显升高(完全调整后的 PR:女性 2.43;95%CI:1.17-5.07,男性 2.09;1.16-3.76)。关于 MetS,结果不一致,女性中银屑病与 MetS 之间存在正相关(1.84;1.14-2.98),而男性中则存在负相关,尽管 95%CI 较宽(0.69;0.42-1.12)。

结论

我们的横断面、基于人群的分析结果表明,银屑病与 DM 之间存在明显关联,而对于 MetS,男女之间的结果相反,这意味着患有 MetS 的女性发生银屑病的几率更高,而男性则更低。我们的结果强调了迫切需要进行性别特异性研究,研究银屑病对代谢紊乱的影响以及针对不同性别的有效预防措施。

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