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Psoriasis and the risk of incident diabetes mellitus: a population‐based study
Author(s) -
Brauchli Y.B.,
Jick S.S.,
Meier C.R.
Publication year - 2008
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/j.1365-2133.2008.08814.x
Subject(s) - psoriasis , medicine , odds ratio , population , incidence (geometry) , diabetes mellitus , confidence interval , body mass index , observational study , dermatology , endocrinology , physics , environmental health , optics
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.