{"title":"Synergistic effect of psoriasis and metabolic syndrome on risk of all-cause and cardiovascular mortality in US adults: a nationwide cohort study.","authors":"Xiufang Kong, Wei Wang","doi":"10.1093/ced/llae340","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome (MetS) is a common comorbidity in psoriasis. However, the associations between MetS, psoriasis and mortality remain largely unclear.</p><p><strong>Objectives: </strong>To investigate the synergistic effect of MetS and psoriasis on total and cardiovascular disease (CVD) mortality in a representative sample of US adults.</p><p><strong>Methods: </strong>In total, 14 930 participants from the 2003-2006 and 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.</p><p><strong>Results: </strong>Overall, 14 930 participants, 50.71% were male, with a mean age of 43 years, were included in the final analysis. The weighted percentages of participants in the psoriasis-/MetS-, psoriasis-/MetS+, psoriasis+/MetS- and psoriasis+/MetS+ groups were 72.77%, 24.36%, 1.94% and 0.93%, respectively. In total, 874 deaths (246 of which were related to CVD) occurred during a median follow-up of 110 months. Compared with the reference group, the hazard ratios in the psoriasis-/MetS+, psoriasis+/MetS- and psoriasis+/MetS+ groups were 1.788 [95% confidence interval (CI) 1.486-2.152], 0.858 (95% CI 0.431-1.707) and 2.050 (95% CI 1.028-4.092), respectively, for all-cause mortality, and 1.856 (1.350-2.552), 1.229 (95% CI 0.292-5.181) and 4.571 (95% CI 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, or urinary albumin/creatinine ratio. Similar results were obtained in the sensitivity analysis of the main results.</p><p><strong>Conclusions: </strong>Presence of comorbid MetS significantly increases all-cause and CVD mortality in patients with psoriasis. Dermatologists can potentially aid in reducing mortality rates in patients with psoriasis through targeted screening for MetS.</p>","PeriodicalId":10324,"journal":{"name":"Clinical and Experimental Dermatology","volume":" ","pages":"113-119"},"PeriodicalIF":3.7000,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Experimental Dermatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ced/llae340","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 0
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: In total, 14 930 participants from the 2003-2006 and 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, 50.71% were male, with a mean age of 43 years, were included in the final analysis. The weighted percentages of participants in the psoriasis-/MetS-, psoriasis-/MetS+, psoriasis+/MetS- and psoriasis+/MetS+ groups were 72.77%, 24.36%, 1.94% and 0.93%, respectively. In total, 874 deaths (246 of which were related to CVD) occurred during a median follow-up of 110 months. Compared with the reference group, the hazard ratios in the psoriasis-/MetS+, psoriasis+/MetS- and psoriasis+/MetS+ groups were 1.788 [95% confidence interval (CI) 1.486-2.152], 0.858 (95% CI 0.431-1.707) and 2.050 (95% CI 1.028-4.092), respectively, for all-cause mortality, and 1.856 (1.350-2.552), 1.229 (95% CI 0.292-5.181) and 4.571 (95% CI 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, or 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 patients with psoriasis. Dermatologists can potentially aid in reducing mortality rates in patients with psoriasis through targeted screening for MetS.
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.
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