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21-03-2013 | Metabolism | Article

Psoriasis a risk factor for diabetes, cardiovascular disease


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medwireNews: Patients with psoriasis are at an increased risk for developing diabetes and cardiovascular disease, report researchers.

Notably, the risk for new-onset diabetes appears to increase with psoriasis severity, say Usman Khalid (Copenhagen University Hospital Gentofte, Hellerup, Denmark) and colleagues.

The researchers say their findings "would appear to underline the importance of regular evaluation of cardiovascular risk factors, including blood glucose levels, in these patients."

The results come from a nationwide study in which the researchers used data from the Danish National Prescriptions Registry, the Central Population Register, and the Danish National Patient Register. "In Denmark, all citizens have a unique and life-long personal civil registration number that enables individual level linkage of information across nationwide registers," explains the team.

As reported in Diabetes Care, the entire Danish population aged 10 years or older as of 1st January 1997 was followed up until 31 December 2009, and a total of 4,614,807 individuals with a maximum of 13 years of follow up were eligible for analysis.

During the study period, 45,829 people with mild psoriasis and 6784 with severe psoriasis were identified.

Comparison of these people with a reference population of 4,562,194 individuals showed that psoriasis was associated with a significantly increased risk for all-cause mortality, cardiovascular mortality, and new-onset diabetes.

The overall incidence rates per 1000 person-years for all-cause mortality in the reference population, and patients with mild and severe psoriasis were 12.57, 15.46, and 24.40, respectively. The corresponding rates for cardiovascular mortality were 5.54, 6.12, and 7.93, and for new-onset diabetes they were 3.67, 6.93, and 9.65.

Further analysis showed that the incidence rate ratios for new-onset diabetes were significantly increased in all patients with psoriasis compared with the general population, at 1.49 and 2.13 for mild and severe disease, respectively.

"Studies have demonstrated that psoriasis is associated with cardiovascular disorders probably due, in part, to shared inflammatory pathways," note Khalid and colleagues. "From this perspective… the results emphasize the importance of considering psoriasis a systemic inflammatory disorder rather than an isolated skin disease."

The researchers conclude: "Clinicians should be aware and may want to consider early screening and treatment of these risk factors."

By Sally Robertson, medwireNews Reporter

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