JAAD：牛皮癣与糖尿病和严重心血管疾病有关
牛皮癣又叫“银屑病”，是一种常见的慢性发炎性皮肤病，具有顽固性和复发性的特点，牛皮癣临床上皮损特征是红色丘疹或斑块上覆有多层银白色鳞屑，有明显的季节性，多数患者病情春冬季加重，夏季缓解。
全世界百分之2 到百分之4 的人口受到牛皮癣影响，这些研究结果将有助于改善这些患者的整体健康，据估计，约有580到750万名美国人受到牛皮癣影响。
根据一篇新的研究建议，牛皮癣和二种可能相当严重的健康问题：糖尿病和动脉粥样硬化有关。这篇研究名为「The association between psoriasis, diabetes mellitus, and atherosclerosis in Israel: A case-control study」，发表于2007年4月的Journal of the American Academy of Dermatology中。
之前的研究就已经提出这样的趋势，而这份报告则是以以色列的牛皮癣患者进行研究，以确定这个趋势。结果研究人员发现牛皮癣患者与没有牛皮癣的患者相较之下，发生糖尿病及动脉粥样硬化的机率更高。因此研究人员呼吁，医学界应该重视牛皮癣患者较高的糖尿病及动脉粥样硬化发生率，并加以预防治疗。
（编译/姜欣慧） (资料来源 : Bio.com)
原始出处:
JAAD Journal of the American Academy of Dermatology
|
Volume 56, Issue 4, Pages 629-634 (April 2007) |
The association between psoriasis, diabetes mellitus, and atherosclerosis in Israel: A case-control study
a
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Accepted 18 September 2006 published online 12 December 2006.
Tel Aviv and Ramat Hasharon, Israel
Background
Previous reports demonstrated an association between psoriasis and other diseases including heart failure and diabetes mellitus.
Objectives
Our aim was to describe the association between psoriasis, diabetes mellitus, and atherosclerosis in Israel.
Methods
A cross-sectional study was performed utilizing the database of Maccabi Healthcare Services (MHS), a large health provider organization in Israel. Case patients were defined as subjects who were diagnosed with psoriasis. Patients with diabetes and atherosclerosis were identified by using the MHS diabetes and cardiovascular registries, respectively. The control group included MHS enrollees without psoriasis. The proportion of diabetes and atherosclerosis among case and control groups was compared. Chi-square tests were used to compare categorical parameters. Logistic regression models were used for multivariate analyses.
Results
The study included 46,095 patients with psoriasis (case patients) and 1,579,037 subjects without psoriasis (control patients). The age-adjusted proportion of diabetes was significantly higher in psoriasis patients as compared with the control group (odds ratio [OR] 1.27, 95% confidence interval [CI] 1.1-1.48). The age-adjusted proportion of atherosclerosis was significantly higher in psoriasis patients as compared with the control group (OR 1.28, 95% CI 1.04-1.59). In patients with psoriasis, a multivariate logistic regression model demonstrated an association between diabetes and the multiple use of very potent topical steroids (P < .05) or use of systemic medication for psoriasis (methotrexate, cyclosporine or acitretin) (P < .001). A similar model demonstrated an association between atherosclerosis and the use of phototherapy (P < .001).
Limitations
Our study was based on a computerized database. The diagnosis of psoriasis was based on digitally transmitted data. Therefore overestimation (false-positive cases) and underestimation (false-negative cases) of psoriasis patients may exist, thereby being a source for information bias. A second limitation is selection bias that may occur due to the possibility that reporting of both psoriasis and associated illnesses is higher in individuals who are seeking medical care. A third limitation concerns the causal effect between occurrence of psoriasis and atherosclerosis or diabetes. The dataset of MHS records diagnoses only from 1997 and does not record the date of disease onset.
Conclusions
Our study supports previous reports for an association between psoriasis and atherosclerosis and psoriasis and diabetes. Further study is needed to support this observation.
Abbreviations used: CI, confidence interval, CVD, cardiac vascular disease, IHD, ischemic heart disease, MHS, Maccabi Healthcare Services, OR, odds ratio, PVD, peripheral vascular disease
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