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Psoriasis appears to increase risk for diabetes
Patients with psoriasis appear to be at increased risk for developing new-onset diabetes, according to data presented at the European Society of Cardiology Congress in Munich.
Using a Danish nationwide cohort study composed of more than 4 million patients, including approximately 50,000 patients with psoriasis who were followed for 13 years, Usman Khalid, a pre-graduate research student at Gentofte Hospital, Ole Ahlehoff, MD, PhD, of Copenhagen University Hospital in Gentofte, Denmark, and colleagues sought to identify the risk associated with new-onset diabetes in patients with mild to severe psoriasis.
The patients (aged ≥10 years on Jan. 1, 1997) were followed until incident diabetes, death or Dec. 31, 2009. Those with a history of diabetes and/or psoriasis at baseline (n=96,551) were excluded from the study.
According to a press release, the overall rate ratios of new-onset diabetes per 1,000 observational years were 3.67 (95% CI, 3.65-3.69) in the reference population who did not have psoriasis, 6.93 (95% CI, 6.63-7.25) for patients with mild psoriasis and 9.65 (95% CI, 8.68-10.73) for patients with severe psoriasis.
Moreover, the risk for new-onset diabetes increased in all patients with psoriasis vs. patients without psoriasis (RR=1.56; 95% CI, 1.5-1.63). Data also revealed that the risk increased with the severity of psoriasis. Compared with patients without psoriasis, patients with mild psoriasis were 1.5 times more likely to develop diabetes (RR=1.49; 95% CI, 1.43-1.56) and patients with severe psoriasis were more than twice as likely to develop diabetes (RR=2.13; 95% CI, 1.91-2.37), according to data.
“The results add to current evidence of increased risk of cardiovascular and metabolic disease in patients with psoriasis,” Ahlehoff said in a press release. “More needs to be done to increase awareness in this large group of patients on what steps they can take to decrease their risk factors for cardiovascular disease.”
For more information:
Khalid U. #2216. Presented at: the European Society of Cardiology Congress; Aug. 25-29, 2012; Munich.
Disclosure: Dr. Ahlehoff reports no relevant financial disclosures.
Perspective
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The Danish nationwide cohort study showing an association with increased risk of incident diabetes is an intriguing one. Psoriasis has been associated with higher rates of myocardial infarction, stroke, and mortality from cardiovascular disease, as well as hypertension and obesity. There have been multiple epidemiologic studies demonstrating higher prevalence of metabolic syndrome in psoriasis patients. Psoriasis patients often suffer from depression, and more frequently smoke and drink alcohol to excess, which may negatively compound the health status of these patients. This study highlights risk of diabetes development in individuals with psoriasis. How much of the effect is associated with obesity and metabolic syndrome is an interesting question. Physicians should be award of these risks in psoriasis patients and consider screening evaluations in affected patients. This work also raises the question of whether early psoriasis therapy can mediate the development of these comorbidities.