Dermatology in India
Increased risk of diabetes mellitus in relation to the severity of psoriasis, concomitant medication, and comorbidity: a nationwide population-based cohort study.
Lee MS, Lin RY, Lai MS.
J Am Acad Dermatol. 2014 Apr;70(4):691-8. doi: 10.1016/j.jaad.2013.11.023. Epub 2014 Jan 9.
Introduction: Diabetes Mellitus doesn’t necessarily occur in patients with psoriasis but some clinical caracteristics as well as treatments psoriasis patients take appear to increase the risk.
What we know:
- The link between psoriasis and metabolic syndrome is a well-established one.
- Metabolic syndrome is diagnosed with the presence of three out of five of the following medical conditions:
- abdominal (central) obesity
- elevated blood pressure
- elevated fasting plasma glucose
- high serum triglycerides
- high-density cholesterol (HDL) levels.
- Metabolic syndrome carries a higher risk of developing DM (diabetes mellitus).
Hypothesis: Patients with psoriasis have a higher risk of developing DM. The risks vary depending on the severity of psoriasis, comorbidities, and concomitant medications.
Methods: the authors conducted a cohort study with 14,158 adults with psoriasis and adults without psoriasis using data from the Taiwan National Health Insurance Research Database.
Results of the study show (after adjusting for comorbidities and concomitant medications), that psoriasis is independantly associated with an increased risk of DM:
- if severe the odds are 2.06 times higher [95% confidence interval, 1.58-2.68]
- if mild the odds are 1.28 times higher [95% confidence interval, 1.05-1.55])
- Other independent risk factors include age, Cushing disease, and the increased cumulative doses of thiazide and methotrexate.
Conclusion: the severity of psoriasis as well as some medications are linked with the risk of developing type 2 diabetes mellitus.
Contributors
Dr Christophe Hsu – dermatologist. Geneva, Switzerland
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