医学
银屑病
人口
全国健康与营养检查调查
队列
肾脏疾病
内科学
队列研究
糖尿病
共病
疾病
皮肤病科
环境卫生
内分泌学
作者
Yevgeniy R. Semenov,C. Herbosa,Andrew T. Rogers,Amy Huang,Shawn G. Kwatra,Bernard A. Cohen,Milan J. Anadkat,Jonathan I. Silverberg
标识
DOI:10.1016/j.jaad.2019.08.011
摘要
Background
Psoriasis is a multifactorial disease that has been associated with multiple systemic disorders. Despite its role in mediating cardiovascular, metabolic, and pulmonary disorders, few studies have examined the independent mortality risk associated with psoriasis. Objective
To determine the independent relationship between psoriasis and all-cause mortality in a nationally representative sample of the US population. Methods
Retrospective population-based cohort study of adults and adolescents older than 10 years (N = 13 031) who participated in National Health and Nutrition Examination Surveys (2003-2006 and 2009-2010). Psoriasis status was determined from a self-reported medical history questionnaire. Mortality data are linked from national databases. Results
Psoriasis was present in 2.7% of the study population. Over an average median follow-up of 52.3 months, psoriasis was significantly associated with increased mortality risk (HR, 1.99; 95% CI, 1.01-3.93; P = .047) with adjustment for demographics, smoking, and comorbidities including cardiovascular disease, diabetes, chronic obstructive pulmonary disease, cancer, chronic kidney disease, and stroke. These comorbidities mediated 15.5%, 5.9%, 8.7%, 11.7%, 4.2%, and 4.7% of the association between psoriasis and mortality, respectively. Conclusion
Psoriasis is independently associated with an increased risk of mortality. This relationship is partially mediated by an increased prevalence of the cardiovascular, infectious, and neoplastic disorders seen among patients with psoriasis.
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