A positive association between psoriasis and diabetes mellitus type 2 (DM) is indicated by cross-sectional study data published in the Journal of the European Academy of Dermatology and Venereology. Psoriasis was also associated with increased prevalence of metabolic syndrome (MetS) among women, although results among men were inconclusive.
Investigators analyzed baseline data from the ongoing Heinz Nixdorf Recall (HNR) study, a population-based cohort of city residents in Western Germany. Between 2000 and 2003, the HNR study sent recruitment letters to randomly selected individuals from the resident lists of Essen, Bochum, and Mülheim. Responders participated in computer-assisted face-to-face interviews, which captured medical history, family history of coronary heart disease, smoking status, and socioeconomic status. Participants also attended an in-person baseline visit, at which blood pressure and venous blood samples were collected. For the present analysis, participant-reported histories of psoriasis, DM, MetS, and smoking were captured. Participants with coronary heart disease and missing data regarding psoriasis, DM, and MetS were excluded from analyses. Multiple regression analyses were performed to calculate prevalence rate ratios (PRs) for certain comorbidities in patients with and without psoriasis. Analyses were adjusted for age, smoking status, blood pressure, body mass index (BMI), physical activity, socioeconomic status, triglycerides, and intake of lipid-lowering drugs.
Data from 3723 HNR participants were used in analyses, in whom 143 (3.8%) reported either a diagnosis of psoriasis or intake of psoriasis-relevant medication. Mean (SD) cohort age was 59 (±8) years, and 54.1% were women. The overall prevalence of hypertension was 35.3%. Hypertension was more prevalent in men with psoriasis than in men without psoriasis (49.3% vs 43.1%), though the same trend was not observed among women. Women with psoriasis displayed more metabolic and cardiovascular risk factors than their counterparts without psoriasis, including waist circumference ≥88 cm, BMI >30, and increased triglyceride levels. In fully adjusted regression models, psoriasis was associated with increased prevalence of diabetes among both men (PR, 2.09; 95% CI, 1.16-3.76) and women (PR, 2.43; 95% CI, 1.17-5.07). A positive association was also observed between psoriasis and MetS in women (PR, 1.84; 95% CI, 1.14-2.98). In men, however, results were inconclusive (PR, 0.69; 95% CI, 0.42-1.12).
Study limitations were noted by the researchers as the small absolute number of patients with psoriasis and that diagnosis of psoriasis was self-reported.
These study results suggest that psoriasis may be associated with DM in patients with psoriasis. An association may also exist between psoriasis and MetS, though results were inconclusive. Further study in a prospective setting is necessary to expound on these cross-sectional results. “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,” investigators wrote.
Disclosure: Two study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.
Sondermann W, Djeudeu Deudjui DA, Körber A, et al. Psoriasis, cardiovascular risk factors and metabolic disorders: sex-specific findings of a population-based study [published online December 3, 2019]. J Eur Acad Dermatol Venereol. doi: 10.1111/jdv.16029