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. 2018 Feb;78(2):315-322.e1.
doi: 10.1016/j.jaad.2017.10.050. Epub 2017 Nov 8.

Psoriasis and the risk of diabetes: A prospective population-based cohort study

Marilyn T Wan  1 , Daniel B Shin  1 , Rebecca A Hubbard  2 , Megan H Noe  1 , Nehal N Mehta  3 , Joel M Gelfand  4
Affiliations

Psoriasis and the risk of diabetes: A prospective population-based cohort study

Marilyn T Wan et al. J Am Acad Dermatol. 2018 Feb.

Abstract

Background: Data evaluating the impact of objectively measured psoriasis severity on type 2 diabetes mellitus (T2DM) risk are lacking.

Objective: To determine the risk for T2DM in patients with psoriasis compared with that in adults without psoriasis, stratified by categories of directly assessed body surface area (BSA) affected by psoriasis.

Methods: A prospective, population-based, cohort study from the United Kingdom in which 8124 adults with psoriasis and 76,599 adults without psoriasis were followed prospectively for approximately 4 years.

Results: There were 280 incident cases of diabetes in the psoriasis group (3.44%) and 1867 incident cases of diabetes in those without psoriasis (2.44%). After adjustment for age, sex and body mass index, the hazard ratios for development of incident diabetes were 1.21 (95% confidence interval [CI], 1.01-1.44), 1.01 (95% CI, 0.81-1.26), and 1.64 (95% CI, 1.23-2.18) in the groups with 2% or less of their BSA affected, 3% to 10% of their BSA affected, and 10% or more of their BSA affected compared with in the groups without psoriasis, respectively (P = .004 for trend). Worldwide, we estimate an additional 125,650 new diagnoses of T2DM per year in patients with psoriasis as compared with in those without psoriasis.

Limitations: Relatively short-term follow-up and exclusion of prevalence cases, which may have masked associations in patients with less extensive psoriasis.

Conclusion: Clinicians may measure BSA affected by psoriasis to target diabetes prevention efforts for patients with psoriasis.

Keywords: body surface area; cohort study; diabetes; epidemiology; psoriasis.

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Conflict of interest statement

Conflicts of Interest

In the previous 12 months, Dr. Gelfand served as a consultant for BMS, Coherus (DSMB), Dermira, GSK, Janssen Biologics, Menlo Therapeutics, Novartis Corp, Regeneron, Dr Reddy’s labs, Sanofi and Pfizer Inc., receiving honoraria; and receives research grants (to the Trustees of the University of Pennsylvania) from Abbvie, Janssen, Novartis Corp, Regeneron, Sanofi, Celgene, and Pfizer Inc.; and received payment for continuing medical education work related to psoriasis that was supported indirectly by Lilly, Valeant, and Abbvie. Dr. Gelfand is a co-patent holder of resiquimod for treatment of cutaneous T cell lymphoma

Dr. Mehta is a full-time US government employee and has received research grants to NIH from Abbvie, Celgene, Novartis and Janssen.

We confirm that this manuscript has not been published elsewhere and is not under consideration by another journal. Supported in part by a grant (K24 AR064310) from NIH/NIAMS (JMG) and a medical dermatology fellowship from the National Psoriasis Foundation (MTW). This study does not require IRB review.

Figures

Figure 1
Figure 1
Exposed Population Selection.
Figure 2
Figure 2
Kaplan-Meier survival estimates of time to T2DM diagnosis for psoriasis cohort stratified according to the Body Surface Area (BSA): ≤2% (mild), 3–10% (moderate), and >10%(severe); and matched patients without psoriasis.
See this image and copyright information in PMC

Comment in

  • Psoriasis steigert das Diabetesrisiko.
    Schwarz P. Schwarz P. MMW Fortschr Med. 2018 May;160(9):33. doi: 10.1007/s15006-018-0524-y. MMW Fortschr Med. 2018. PMID: 29754349 Review. German. No abstract available.

References

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