Medical Comorbidity Associated With Psoriasis in Adults

A Population-based Study

Y-W. Yang; J.J. Keller; H-C. Lin

Disclosures

The British Journal of Dermatology. 2011;165(5):1037-1043. 

In This Article

Abstract and Introduction

Abstract

Background Most publications to date on comorbidities associated with psoriasis have focused on cardiovascular and metabolic diseases. Few comprehensive investigations of medical comorbidities in a cohort of patients with psoriasis appear in the literature.
Objectives To examine the prevalence of comorbidities in adult patients with psoriasis, including a comparison of comorbid prevalence vs. that in controls without psoriasis, in a nationally representative dataset in Taiwan.
Methods There were 1685 adult patients with psoriasis in the study group and 5055 randomly selected subjects in the comparison group. We used conditional logistic regression analyses to examine the risk of 29 comorbidities for these two groups after adjusting for monthly income, geographical region of residence and the level of urbanization of each patient's community of residence.
Results After adjusting for several potential confounders, patients with psoriasis had higher odds of comorbid congestive heart failure [odds ratio (OR) 1·63], ischaemic heart disease (OR 1·51), renal failure (OR 1·45), uncomplicated diabetes (OR 1·37), liver diseases (OR 1·34), hepatitis B or C (OR 1·34), complicated diabetes (OR 1·32), hyperlipidaemia (OR 1·28), hypertension (OR 1·24) and peptic ulcer (OR 1·22) than did patients without psoriasis. However, patients with mild psoriasis had higher odds of comorbidity only with uncomplicated diabetes (OR 1·55), asthma (OR 1·30), liver diseases (OR 1·30) and peptic ulcer (OR 1·26) than patients without psoriasis.
Conclusions We conclude that psoriasis is associated with a variety of medical comorbidities including cardiovascular diseases, metabolic diseases, renal failure, liver diseases, viral hepatitis B or C, asthma and peptic ulcers.

Introduction

Psoriasis is a T-cell-mediated disease that causes inflammation of the skin and sometimes the joints (psoriatic arthritis). A genetic predisposition has been well established but family patterns remain poorly elucidated; symptoms are often affected by environmental factors.[1] Recently, increasing evidence has suggested associations between psoriasis and a variety of medical comorbidities, including ischaemic heart disease, hypertension, dysplipidaemia, type 2 diabetes mellitus and obesity.[2–4] Patients with more severe psoriasis exhibit a greater likelihood of having comorbid conditions than those with mild psoriasis.[2,5]

It is well known that psoriasis is associated with reduced health-related quality of life. Patients with psoriasis frequently experience significant impairment of their physical, psychological and social functioning to a degree comparable with that of other major medical illnesses,[6,7] which may be partly attributed to comorbidities. Research has also revealed a great economic burden associated with psoriasis – especially severe psoriasis – consequential to reduced work productivity and increased medical expenses.[8] A recent study using a national psoriasis cohort showed that medical comorbidities can impose further economic burden on patients with psoriasis.[9]

Most research to date on comorbidities associated with psoriasis has focused on cardiovascular and metabolic diseases.[2–5] Few comprehensive investigations into a wide array of medical comorbidities in a cohort of patients with psoriasis appear in the literature. Moreover, previous studies on this issue were conducted mostly on caucasians, while such reports on Asian people remain scarce. Therefore, the objective of this study is to examine the prevalence of a wide set of comorbidities in adult patients with psoriasis, and to compare these prevalences with those in control subjects without psoriasis, in a nationally representative dataset in Taiwan.

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