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银屑病与癌症对全因死亡率风险的交互作用:一项基于美国国家健康与营养检查调查(NHANES)数据的前瞻性队列研究

Interaction Effect of Psoriasis and Cancer on the Risk of All-Cause Mortality: A Prospective Cohort Study of NHANES Data.

作者信息

Si Zixiang, Zhao Honglei, Ying Jieya

机构信息

From the Department of Dermatology, Hangzhou Third People's Hospital, Hangzhou, Zhejiang, China.

Department of Dermatology, Beilun People's Hospital, Ningbo, Zhejiang, China.

出版信息

Indian J Dermatol. 2024 Jul-Aug;69(4):317-327. doi: 10.4103/ijd.ijd_1095_23. Epub 2024 Aug 19.

Abstract

BACKGROUND

The relationship between psoriasis, cancer, and mortality has been reported in observational studies. Considering the high heterogeneity in systematic review and meta-analysis and inconsistent results in previous studies, the association between psoriasis, cancer, and mortality warrants more investigation. The primary objective of this study was to explore the joint impact of psoriasis and cancer on mortality in a representative cohort of adults residing in the United States.

METHODS

We analysed comprehensive data obtained from the National Health and Nutrition Examination Study conducted during the periods of 2003-2006 and 2009-2014. Multivariable logistic regression analyses were performed to assess the relationship between psoriasis and cancer. The vital status of participants was tracked until 31 December 2019. A four-level variable combining information on psoriasis and cancer was created, and survival probability was evaluated using the Kaplan-Meier curve and Cox regression analysis. Hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were calculated to analyse the association between psoriasis/cancer and all-cause mortality.

RESULTS

In total, this study included 15,234 participants, among whom 418 had psoriasis and 1213 had cancer. The findings from the logistic regression analyses indicated a heightened risk of cancer among individuals with psoriasis in comparison to those without psoriasis. Moreover, the risk of skin cancer was higher in participants with psoriasis compared to those without psoriasis. Compared with individuals without cancer and psoriasis, the all-cause mortality HRs were 1.25 (95% CI: 0.87-1.78) for individuals with psoriasis only, 1.48 (95% CI: 1.20-1.82) for participants with cancer only, and 2.28 (95% CI: 1.12-4.63) for individuals with both psoriasis and cancer.

CONCLUSION

The results of our study demonstrated a noteworthy and positive correlation between psoriasis, cancer, and all-cause mortality. These findings indicate that individuals who have both psoriasis and cancer face an increased likelihood of mortality.

摘要

背景

观察性研究已报道了银屑病、癌症和死亡率之间的关系。鉴于系统评价和荟萃分析中的高度异质性以及既往研究结果不一致,银屑病、癌症和死亡率之间的关联值得进一步研究。本研究的主要目的是在美国有代表性的成年人群队列中探讨银屑病和癌症对死亡率的联合影响。

方法

我们分析了2003 - 2006年和2009 - 2014年期间进行的美国国家健康与营养检查调查获得的综合数据。进行多变量逻辑回归分析以评估银屑病和癌症之间的关系。对参与者的生命状态进行追踪直至2019年12月31日。创建了一个结合银屑病和癌症信息的四级变量,并使用Kaplan - Meier曲线和Cox回归分析评估生存概率。计算风险比(HRs)及其相应的95%置信区间(CIs)以分析银屑病/癌症与全因死亡率之间的关联。

结果

本研究共纳入15234名参与者,其中418人患有银屑病,1213人患有癌症。逻辑回归分析结果表明,与无银屑病者相比,银屑病患者患癌症的风险更高。此外,与无银屑病者相比,银屑病患者患皮肤癌的风险更高。与无癌症和银屑病的个体相比,仅患有银屑病的个体全因死亡率HR为1.25(95%CI:0.87 - 1.78),仅患有癌症的参与者为1.48(95%CI:1.20 - 1.82),同时患有银屑病和癌症的个体为2.28(95%CI:1.12 - 4.63)。

结论

我们的研究结果表明银屑病、癌症和全因死亡率之间存在显著的正相关。这些发现表明同时患有银屑病和癌症的个体死亡可能性增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb54/11407579/c7d644f3d2dc/IJD-69-317-g001.jpg

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