牛皮癬又叫“銀屑病”,，是一種常見(jiàn)的慢性發(fā)炎性皮膚病,，具有頑固性和復(fù)發(fā)性的特點(diǎn)，牛皮癬臨床上皮損特征是紅色丘疹或斑塊上覆有多層銀白色鱗屑,，有明顯的季節(jié)性,，多數(shù)患者病情春冬季加重，夏季緩解,。
全世界百分之2 到百分之4 的人口受到牛皮癬影響,，這些研究結(jié)果將有助于改善這些患者的整體健康，據(jù)估計(jì),，約有580到750萬(wàn)名美國(guó)人受到牛皮癬影響,。
根據(jù)一篇新的研究建議，牛皮癬和二種可能相當(dāng)嚴(yán)重的健康問(wèn)題：糖尿病和動(dòng)脈粥樣硬化有關(guān),。這篇研究名為「The association between psoriasis, diabetes mellitus, and atherosclerosis in Israel: A case-control study」，發(fā)表于2007年4月的Journal of the American Academy of Dermatology中,。
之前的研究就已經(jīng)提出這樣的趨勢(shì),，而這份報(bào)告則是以以色列的牛皮癬患者進(jìn)行研究，以確定這個(gè)趨勢(shì),。結(jié)果研究人員發(fā)現(xiàn)牛皮癬患者與沒(méi)有牛皮癬的患者相較之下,，發(fā)生糖尿病及動(dòng)脈粥樣硬化的機(jī)率更高。因此研究人員呼吁,，醫(yī)學(xué)界應(yīng)該重視牛皮癬患者較高的糖尿病及動(dòng)脈粥樣硬化發(fā)生率,，并加以預(yù)防治療。
（編譯/姜欣慧） (資料來(lái)源 : Bio.com)
原始出處:
JAAD Journal of the American Academy of Dermatology
Volume 56, Issue 4, Pages 629-634 (April 2007)
The association between psoriasis, diabetes mellitus, and atherosclerosis in Israel: A case-control study
Jonathan Shapiro, MD, MHAa, Arnon D. Cohen, MD, MHAb, Michael David, MDc, Emilia Hodak, MDc, Gabi Chodik, MHAa, Anna Viner, MSCa, Eyal Kremer, MDa, Anthony Heymann, MD, MHAa
Accepted 18 September 2006 published online 12 December 2006.
Tel Aviv and Ramat Hasharon, Israel
Background
Previous reports demonstrated an association between psoriasis and other diseases including heart failure and diabetes mellitus.
Objectives
Our aim was to describe the association between psoriasis, diabetes mellitus, and atherosclerosis in Israel.
Methods
A cross-sectional study was performed utilizing the database of Maccabi Healthcare Services (MHS), a large health provider organization in Israel. Case patients were defined as subjects who were diagnosed with psoriasis. Patients with diabetes and atherosclerosis were identified by using the MHS diabetes and cardiovascular registries, respectively. The control group included MHS enrollees without psoriasis. The proportion of diabetes and atherosclerosis among case and control groups was compared. Chi-square tests were used to compare categorical parameters. Logistic regression models were used for multivariate analyses.
Results
The study included 46,095 patients with psoriasis (case patients) and 1,579,037 subjects without psoriasis (control patients). The age-adjusted proportion of diabetes was significantly higher in psoriasis patients as compared with the control group (odds ratio [OR] 1.27, 95% confidence interval [CI] 1.1-1.48). The age-adjusted proportion of atherosclerosis was significantly higher in psoriasis patients as compared with the control group (OR 1.28, 95% CI 1.04-1.59). In patients with psoriasis, a multivariate logistic regression model demonstrated an association between diabetes and the multiple use of very potent topical steroids (P < .05) or use of systemic medication for psoriasis (methotrexate, cyclosporine or acitretin) (P < .001). A similar model demonstrated an association between atherosclerosis and the use of phototherapy (P < .001).
Limitations
Our study was based on a computerized database. The diagnosis of psoriasis was based on digitally transmitted data. Therefore overestimation (false-positive cases) and underestimation (false-negative cases) of psoriasis patients may exist, thereby being a source for information bias. A second limitation is selection bias that may occur due to the possibility that reporting of both psoriasis and associated illnesses is higher in individuals who are seeking medical care. A third limitation concerns the causal effect between occurrence of psoriasis and atherosclerosis or diabetes. The dataset of MHS records diagnoses only from 1997 and does not record the date of disease onset.
Conclusions
Our study supports previous reports for an association between psoriasis and atherosclerosis and psoriasis and diabetes. Further study is needed to support this observation.
Abbreviations used: CI, confidence interval, CVD, cardiac vascular disease, IHD, ischemic heart disease, MHS, Maccabi Healthcare Services, OR, odds ratio, PVD, peripheral vascular disease
