Conflicts of interest None declared.
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Psoriasis and the risk of incident diabetes mellitus: a population-based study
Article first published online: 8 SEP 2008
DOI: 10.1111/j.1365-2133.2008.08814.x
© 2008 The Authors. Journal Compilation © 2008 British Association of Dermatologists
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How to Cite
Brauchli, Y.B., Jick, S.S. and Meier, C.R. (2008), Psoriasis and the risk of incident diabetes mellitus: a population-based study. British Journal of Dermatology, 159: 1331–1337. doi: 10.1111/j.1365-2133.2008.08814.x
Publication History
- Issue published online: 19 NOV 2008
- Article first published online: 8 SEP 2008
- Accepted for publication 7 June 2008
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Keywords:
- body mass index;
- diabetes mellitus;
- incidence;
- psoriasis
Summary
Background Cross-sectional studies, mostly in hospitalized patients, reported a possible positive association between psoriasis and diabetes mellitus (DM). However, information on the temporal relation is scarce, and incidence rates of new-onset DM in patients with psoriasis are lacking.
Objectives To assess and compare incidence rates of new-onset DM between patients with psoriasis and a comparison group without psoriasis, and to explore the role of psoriasis severity and body mass index (BMI).
Methods We conducted a follow-up study with a nested case–control analysis within the U.K.-based General Practice Research Database. The study population consisted of patients with a first-time diagnosis of psoriasis between 1994 and 2005 and a matched group of psoriasis-free patients. We used psoriasis duration and treatment as proxy for disease severity, and we applied conditional logistic regression to obtain odds ratios (ORs) with 95% confidence intervals (CIs).
Results Within the study population of 65 449 patients we identified 1061 incident cases of DM. Of these, 59% had a history of psoriasis, yielding a crude incidence rate ratio of 1·36 (95% CI 1·20–1·53). The adjusted OR for patients with ≥ 2 years disease duration and > 2 prescriptions per year for oral psoriasis treatment was 2·56 (95% CI 1·11–5·92). In an analysis restricted to patients with normal BMI, the adjusted OR was 2·02 (95% CI 1·31–3·10).
Conclusions In this large observational study the risk of incident DM was increased for patients with psoriasis as compared with a psoriasis-free comparison group. The risk increased with psoriasis duration and severity and was not driven by high BMI alone.