study shows link between severity of psoriasis and increased risk of type 2 diabetes
People with psoriasis are at a higher risk of developing type 2 diabetes than those without psoriasis, and the risk increases considerably depending on the severity of the disease. Researchers at the Perelman School of Medicine at the University of Pennsylvania found that people with psoriasis who cover 10% of their body or more are 64% more likely to develop diabetes than people without psoriasis regardless of traditional risk factors. Applying the results of the study to the number of people with psoriasis worldwide would be equivalent to 125,650 new cases of psoriasis-related diabetes per year. They published their findings this month in the Journal of the American Academy of Dermatology .
Psoriasis is a disease of the immune system in which inflammation causes the skin cells to grow more rapidly than normal. They cause raised, red patches covered with silvery scales when they reach the surface of the skin and die. It occurs most often on the scalp, knees, elbows, hands and feet, but can also appear on the lower back, face, genitals, nails and other places. The American Academy of Dermatology estimates that psoriasis affects approximately 7.5 million Americans.
"The type of inflammation seen in psoriasis is known to promote insulin resistance, and psoriasis and diabetes share similar genetic mutations suggesting a biological basis for the connection between the two conditions we found in our study, "says the main author of the study. Dr. Gelfand, MSCE MD, Professor of Dermatology and Epidemiology at Penn. "We know that psoriasis is linked to higher rates of diabetes, but it's the first study to specifically look at how the severity of the disease affects the risk of a patient." The lead author of the study is Marilyn T. Wan, MBChB, MPH, postdoctoral researcher at Gelfand Lab.
To measure the severity of psoriasis, Gelfand and his team used body surface area (BSA), which measures the percentage of the body covered by psoriasis. Using a database in the UK, they surveyed GPs on psoriatic SAB and examined data on 8,124 adults with psoriasis and 76,599 adults without psoriasis over a four-year period. and body mass index and other risk factors for diabetes.
They found that patients with BSA of two percent or less had a relative risk of 1.21 for developing diabetes, which means that their risk is 21 percent higher than those without psoriasis. This risk has increased dramatically in patients with BSA of 10 percent or more. On average, 5.97 out of 1000 people will suffer from diabetes in a given year. In the patient population with BSA greater than 10 percent, this number increases to 12.22 per 1000 people. This group had a relative risk of 1.64, or 64% more than patients without psoriasis. In addition, they found that for every 10% increase in BSA above the initial 10%, the relative risk increased by 20%. In other words, patients with 20% BSA had a risk of developing type 2 diabetes that was 84% higher, patients with a 30% BSA a higher risk of 104%, and so on.
"These results are independent of the traditional risk factors for diabetes and still show a close connection between the increasing severity of psoriasis and the increasing risk of developing diabetes, which strongly advocates a causal relationship between both "
Gelfand says that BSA psoriasis should be routinely measured, and patients targeted for the prevention of diabetes, especially among those with a BSA of 10 percent or more. He adds that these findings add to the growing understanding of the additional risks associated with severe psoriasis, which, according to other Gelfand studies, may include major cardiovascular events, liver disease, and death.
Source:
http://www.uphs.upenn.edu/
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