Quantifying cardiovascular disease risk factors in patients with psoriasis: a meta-analysis

Authors

  • I.M. Miller,

    Corresponding author
    1. Department of Dermatology, Roskilde Hospital, 4000 Roskilde, Denmark
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  • T. Skaaby,

    1. Department of Development and Health, Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark
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  • C. Ellervik,

    1. Department of Diagnostic Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark
    2. Department of Clinical Biochemistry, Naestved Hospital, Naestved, Denmark
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  • G.B.E. Jemec

    1. Department of Dermatology, Roskilde Hospital, 4000 Roskilde, Denmark
    2. Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen N, Denmark
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  • Funding sources This study was co-financed by the Danish Government, Danish Agency for Science, Technology and Innovation, and LEO Pharma.
  • Conflicts of interest I.M.M. has received a grant under the Industrial PhD Programme (co-financed grants by the Danish Agency for Science, Technology and Innovation and LEO Pharma). G.B.E.J. has received consulting fees from Abbott Laboratories, Merck, Pfizer and Dumex-Alpharma, lecture fees from Galderma and Pfizer, and grant support from Abbott Laboratories, Photocure and LEO Pharma; he has received equipment on loan from Michelson Diagnostics and reimbursement for travel expenses from Abbott Laboratories, Galderma and Photocure. T.S. and C.E. declare no conflicts of interest.

Summary

Background

In a previous meta-analysis on categorical data we found an association between psoriasis and cardiovascular disease and associated risk factors.

Objectives

To quantify the level of cardiovascular disease risk factors in order to provide additional data for the clinical management of the increased risk.

Methods

This was a meta-analysis of observational studies with continuous outcome using random-effects statistics. A systematic search of studies published before 25 October 2012 was conducted using the databases Medline, EMBASE, International Pharmaceutical Abstracts, PASCAL and BIOSIS.

Results

We included 59 studies with up to 18 666 cases and 50 724 controls. Psoriasis cases had a higher total cholesterol [weighted mean difference 8·83 mg dL−1, 95% confidence interval (CI) 2·94–14·72, = 0·003 (= 0·23 mmol L−1)], higher low-density lipoprotein cholesterol [9·90 mg dL−1, 95% CI 1·56–18·20, = 0·020 (= 0·25 mmol L−1)], higher triglyceride [16·32 mg dL−1, 95% CI 12·02–20·63, < 0·001 (= 0·18 mmol L−1)], a higher systolic blood pressure (4·77 mmHg, 95% CI 1·62–7·92, = 0·003), a higher diastolic blood pressure (2·99 mmHg, 95% CI 0·60–5·38, = 0·014), higher body mass index (0·73 kg m−2, 95% CI 0·37–1·09, < 0·001), higher waist circumference (3·61 cm, 95% CI 2·12–5·10, < 0·001), higher fasting glucose [3·52 mg dL−1, 95% CI 0·64–6·41, = 0·017 (= 0·20 mmol L−1)], higher nonfasting glucose [11·70 mg dL−1, 95% CI 11·24–12·15, < 0·001 (= 0·65 mmol L−1)] and a higher HbA1c [1·09 mmol mol−1, 95% CI 0·87–1·31, < 0·001 (= 2·2%)].

Conclusions

From a preventive medicine perspective, the weighted mean differences between cases and controls are significant, and therefore relevant to the clinical management of patients with psoriasis.

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