The link between psoriasis and poor cardiovascular outcomes has been demonstrated in an increasing body of literature; a smaller number of research studies have also demonstrated a link between psoriasis and inflammatory bowel disease. One of the most recent studies to explore the correlation between psoriasis and cardiovascular health revealed a causal link for this association on the cellular level in what was described as a “paradigm-shifting” study. Now, a new study from researchers in New York and Pennsylvania adds to the body of literature on another link, this one between psoriasis and diabetes.
The researchers conducted a population-based cohort study of adults with and without psoriasis and evaluated who developed incident Type 2 diabetes mellitus during the study period. In all, 108,132 psoriasis patients and 430,716 control subjects were included.
According to the results of the researchers’ unadjusted analysis, “the risk of incident DM was increased among patients with psoriasis in a dose-response fashion with psoriasis severity (overall psoriasis HR, 1.18; 95% CI, 1.14-1.23; severe psoriasis HR, 1.75; 95% CI, 1.56-1.98).” These findings, which were reported in Archives of Dermatology, also demonstrated, in fully adjusted models that controlled for age, sex, BMI, HTN and hyperlipidemia, that psoriasis was “an independent risk factor for incident DM (HR, 1.14; 95% CI, 1.10-1.18), and this risk was greatest in patients with severe disease (HR, 1.46; 95% CI, 1.30-1.65).”
The researchers also note that the link was dose-dependent, with severe psoriasis leading to a higher risk for diabetes than mild psoriasis. Mechanistically, according to the researchers, “this relationship may be driven by chronic inflammation because both psoriasis and T2DM are associated with elevated levels of TH1-driven inflammatory markers, and because several studies have pointed to endogenous insulin resistance in patients with psoriasis.”
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