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21-06-2012 | Immunology | Article

Patients with psoriasis at increased risk for developing diabetes

Abstract

Free abstract

MedWire News: Study findings suggest that psoriasis is an independent risk factor for the development of Type 2 diabetes.

"These data suggest that patients with psoriasis are at increased risk for developing diabetes even if they don't have common risk factors such as obesity," said study co-author Joel Gelfand (University of Pennsylvania, Philadelphia, USA) in a press statement.

The findings build on previous research demonstrating a diverse set of increased health risks for patients with psoriasis. "Patients with psoriasis should eat a healthy diet, get regular exercise, and see their physician for routine preventative health screenings such as checks of blood pressure, cholesterol, and blood sugar," added Gelfand.

For the study, lead researcher Rahat Azfar (University of Pennsylvania) and co-authors identified 108,132 patients living in the UK who had psoriasis, and matched them to 430,716 unexposed patients based on practice and time of visit.

Of the identified psoriasis patients, 101,870 were classified as having mild disease and 6229 as having severe disease. The most commonly prescribed medication among patients with severe psoriasis was methotrexate (60.5%).

Initial analysis showed that the risk for incident diabetes significantly increased in a dose-response manner with psoriasis severity (overall psoriasis hazard ratio [HR]=1.18; severe psoriasis HR=1.75).

After adjusting for age, gender, body mass index, hypertension, and hyperlipidemia, psoriasis was found to be an independent risk factor for incident diabetes (HR=1.14). This risk was found to be greatest among patients with severe disease (HR=1.46).

The findings also showed that the adjusted attributable risk for developing diabetes per 1000 patients with psoriasis was 0.9, 0.7, and 3.0 extra cases per year for all patients, patients with mild psoriasis, and patients with severe psoriasis, respectively.

Evaluation of treatment patterns among patients who developed incident diabetes revealed no significant difference in the use of oral hypoglycemic agents or insulin among patients with mild psoriasis. However, patients with severe psoriasis were significantly more likely to be prescribed oral hypoglycemic agents (odds ratio=1.53).

The researchers say the relationship between psoriasis and diabetes may be driven by chronic inflammation, as both conditions are associated with elevated levels of T-helper cell type 1-driven inflammatory markers.

"Both patients with psoriasis, especially those with severe psoriasis, and their treating physicians should be aware of the potential for systemic metabolic complications associated with this skin disease," said Azfar in a press statement.

The findings are published in the Archives of Dermatology.

By Ingrid Grasmo

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