Synergistic Effect of Psoriasis and Metabolic Syndrome on Risk of All-Cause and Cardiovascular Mortality in US Adults: A Nationwide Cohort Study.

IF 3.7 4区医学 Q1 DERMATOLOGY Clinical and Experimental Dermatology Pub Date : 2024-08-17 DOI:10.1093/ced/llae340

Xiufang Kong, Wei Wang

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Abstract

Background: Metabolic syndrome (MetS) is a common comorbidity in psoriasis. However, the associations between MetS, psoriasis, and mortality remain largely unclear.

Objectives: To investigate the synergistic effect of MetS and psoriasis on total and cardiovascular disease (CVD) mortality in a representative sample of US adults.

Methods: 14,930 participants from the 2003-2006 & 2009-2014 National Health and Nutrition Examination Survey were included in this prospective, nationwide cohort study. Participants were stratified into the psoriasis-/MetS- (reference) group, psoriasis-/MetS+ group, psoriasis+/MetS- group, and psoriasis+/MetS+ group.

Results: Overall, 14,930 participants, including 50.71% males and mean age of 43 years, were included in the final analysis. The weighted percentages of participants in the psoriasis-/MetS- group, psoriasis-/MetS+ group, psoriasis+/MetS- group and psoriasis+/MetS+ group were 72.77%, 24.36%, 1.94%, and 0.93%, respectively. A total of 874 deaths (246 CVD-related) occurred during a median follow-up of 110 months. Compared to the reference group, the hazard ratios (95% confidence intervals) in psoriasis-/MetS+, psoriasis+/MetS- and psoriasis+/MetS+ groups were 1.788 (1.486-2.152), 0.858 (0.431-1.707), and 2.050 (1.028-4.092), respectively, for all-cause mortality, and 1.856 (1.350-2.552), 1.229 (0.292-5.181) and 4.571 (1.724-12.119), respectively, for CVD mortality. Subgroup analysis showed that this association was not influenced by participants' age, sex, physical activity, smoking, estimated glomerular filtration rate, and urinary albumin/creatinine ratio. Similar results were obtained in the sensitivity analysis of the main results.

Conclusions: Presence of comorbid MetS significantly increases all-cause and CVD mortality in psoriasis patients. Dermatologists can potentially aid in reducing mortality rate in psoriasis patients through targeted screening for MetS.

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银屑病和代谢综合征对美国成年人全因和心血管死亡风险的协同效应：全国队列研究

背景：代谢综合征（MetS）是银屑病的常见合并症。然而，代谢综合征、银屑病和死亡率之间的关系在很大程度上仍不清楚：方法：这项前瞻性的全国性队列研究纳入了 2003-2006 年和 2009-2014 年全国健康与营养调查的 14930 名参与者。参与者被分为银屑病-/MetS-（参考）组、银屑病-/MetS+组、银屑病+/MetS-组和银屑病+/MetS+组：共有 14,930 名参与者参与了最终分析，其中男性占 50.71%，平均年龄为 43 岁。银屑病-/MetS-组、银屑病-/MetS+组、银屑病+/MetS-组和银屑病+/MetS+组的加权比例分别为72.77%、24.36%、1.94%和0.93%。在中位随访110个月期间，共有874人死亡（246人死于心血管疾病）。与参照组相比，银屑病-/MetS+组、银屑病+/MetS-组和银屑病+/MetS+组的危险比（95% 置信区间）分别为 1.788（1.486-2.152）、0.858（0.全因死亡率分别为 1.788（1.486-2.152）、0.858（0.431-1.707）和 2.050（1.028-4.092），心血管疾病死亡率分别为 1.856（1.350-2.552）、1.229（0.292-5.181）和 4.571（1.724-12.119）。亚组分析表明，这种关联不受参与者年龄、性别、体力活动、吸烟、估计肾小球滤过率和尿白蛋白/肌酐比值的影响。主要结果的敏感性分析也得出了类似的结果：结论：银屑病患者合并 MetS 会显著增加全因死亡率和心血管疾病死亡率。皮肤科医生可以通过有针对性地筛查 MetS 来帮助降低银屑病患者的死亡率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Dermatology 医学-皮肤病学

CiteScore

3.20

自引率

2.40%

发文量

389

审稿时长

3-8 weeks

期刊介绍： Clinical and Experimental Dermatology (CED) is a unique provider of relevant and educational material for practising clinicians and dermatological researchers. We support continuing professional development (CPD) of dermatology specialists to advance the understanding, management and treatment of skin disease in order to improve patient outcomes.