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Psoriasis, fracture risk and bone mineral density: the HUNT Study, Norway
Author(s) -
Modalsli E.H.,
Åsvold B.O.,
Romundstad P.R.,
Langhammer A.,
Hoff M.,
Forsmo S.,
Naldi L.,
Saunes M.
Publication year - 2017
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.15123
Subject(s) - medicine , psoriasis , femoral neck , osteoporosis , odds ratio , bone mineral , body mass index , hip fracture , population , confidence interval , hazard ratio , physical therapy , dermatology , environmental health
Summary Background An association between psoriasis and osteoporosis has been reported. Objectives To investigate, in a large prospective population‐based Norwegian study, whether psoriasis is associated with increased risk of forearm or hip fracture; to investigate the cross‐sectional association between psoriasis and bone mineral density ( BMD ) T‐score in a subpopulation. Methods Hospital‐derived fracture data from Nord‐Trøndelag County (1995–2013) were linked to psoriasis information, BMD measurements and lifestyle factors from the third survey of the Nord‐Trøndelag Health Study 2006–08 ( HUNT 3); socioeconomic data from the National Education Database; and use of medication from the Norwegian Prescription Database. Results Among 48 194 participants in HUNT 3, we found no increased risk of forearm or hip fracture in 2804 patients with self‐reported psoriasis [overall age‐ and sex‐adjusted hazard ratio 1·03, 95% confidence interval ( CI ) 0·82–1·31]. No clear association was found between psoriasis and mean BMD T‐score; overall age‐ and sex‐adjusted differences in total hip, femoral neck and lumbar spine BMD T‐scores were 0·02 (95% CI −0·11 to 0·14), 0·05 (95% CI −0·06 to 0·17) and 0·07 (95% CI −0·09 to 0·24), respectively. No clear association was found between psoriasis and prevalent osteoporosis in either total hip, femoral neck or lumbar spine; overall age‐ and sex‐adjusted odds ratio was 0·77 (95% CI 0·54–1·10). Associations did not change substantially after adjustment for education, smoking, systemic steroid use and body mass index. Conclusions We found no association between psoriasis and risk of fracture. The study did not indicate reduced BMD T‐score or higher prevalence of osteoporosis among patients with psoriasis.