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1.
Br J Dermatol ; 180(1): 94-99, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-29904911

RESUMEN

BACKGROUND: Metabolic syndrome has been associated with psoriasis in cross-sectional studies, but data from prospective studies are sparse. OBJECTIVES: To examine prospectively whether metabolic syndrome and its components are associated with the risk of incident psoriasis in a large population-based study using objective measurements of cardiovascular disease risk factors. METHODS: We used data from two consecutive surveys of the HUNT Study, Norway (HUNT2, 1995-1997, and HUNT3, 2006-2008). In total 34 996 women and men aged ≥ 20 years without psoriasis in HUNT2 were followed up in HUNT3, and 374 incident cases of psoriasis were identified. We used Cox regression to estimate the adjusted relative risk (RR) of incident psoriasis with its 95% confidence interval (CI). RESULTS: Metabolic syndrome was associated with an RR for psoriasis of 1·66 (95% CI 1·30-2·14). To explore the influence of adiposity on this association, we first excluded waist circumference from the definition of metabolic syndrome (adjusted RR 1·54, 95% CI 1·14-2·07) and then adjusted for body mass index (RR 1·33, 95% CI 0·97-1·81). Analyses of the separate components of metabolic syndrome showed positive associations with risk of psoriasis for waist circumference, triglycerides and high-density lipoprotein (HDL) cholesterol, but not for blood pressure or blood glucose. There was also an increased risk of psoriasis for high total cholesterol. The increased risk associated with high triglycerides, HDL cholesterol and total cholesterol was attenuated after adjusting for body mass index. CONCLUSIONS: In this large prospective study from a general population, we found that metabolic syndrome was associated with increased risk of incident psoriasis, and our results suggest that this positive association could, at least partly, be attributed to adiposity.


Asunto(s)
Adiposidad/fisiología , Síndrome Metabólico/epidemiología , Psoriasis/epidemiología , Adulto , Índice de Masa Corporal , Femenino , Humanos , Incidencia , Masculino , Síndrome Metabólico/complicaciones , Persona de Mediana Edad , Noruega/epidemiología , Estudios Prospectivos , Psoriasis/etiología , Medición de Riesgo , Factores de Riesgo , Encuestas y Cuestionarios/estadística & datos numéricos
2.
J Eur Acad Dermatol Venereol ; 33(6): 1164-1171, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30451320

RESUMEN

BACKGROUND: Hidradenitis suppurativa (HS) substantially affects health-related quality-of-life outcomes. Most treatment options are supported by low quality of evidence without validated outcomes. OBJECTIVE: The aim of this study was to evaluate the efficacy of surgical and medical interventions using physician- and patient-reported outcomes registered in HISREG. METHODS: Data were extracted for all adult patients registered in HISREG between January 2013 and April 2016. Primary endpoints included Dermatology Life Quality Index (DLQI) scores, pain as measured using a numeric rating scale (NRS), Sartorius score and Hurley classification. Minimum clinically important differences (MCIDs) for DLQI and NRS pain were analysed. Secondary endpoints included comparisons among different treatment groups, safety and complications of various treatments. RESULTS: Two hundred and fifty-five patients were included in the study: 31, 188, and 36 patients had Hurley stages I, II and III disease, respectively. Treatment with CO2 lasers was the most common treatment modality. One hundred and forty-nine patients (58.4%) were treated with surgical intervention, 87 (34.1%) received antibiotics and/or anti-inflammatory treatments, and 19 (7.5%) were treated with both surgery and medical intervention. No patients received biologic treatment. In patients with surgical treatments, Sartorius scores were significantly improved compared with baseline (P = 0.001), 83 patients (55%) achieved a DLQI MCID, and 75 patients (49.7%) achieved an NRS pain MCID. In patients with medical treatments, Sartorius scores were not significantly improved compared with baseline (P = 0.582); 25 patients (28%) achieved a DLQI MCID and 28 patients (31%) achieved an NRS pain MCID. In patients treated with surgical and medical combination, 9 (48%) achieved DLQI and NRS pain MCIDs and Sartorius scores were significantly improved. CONCLUSIONS: CO2 laser treatment is more effective than the non-biologic medical treatments in this analysis based on physician- and patient-derived outcomes. The study provides limited evidence for the combination of medical and surgical therapies in patients with HS.


Asunto(s)
Hidradenitis Supurativa/cirugía , Hidradenitis Supurativa/terapia , Sistema de Registros , Adulto , Antibacterianos/uso terapéutico , Antiinflamatorios/uso terapéutico , Procedimientos Quirúrgicos Dermatologicos/efectos adversos , Femenino , Humanos , Terapia por Láser , Masculino , Persona de Mediana Edad , Calidad de Vida , Países Escandinavos y Nórdicos/epidemiología , Índice de Severidad de la Enfermedad
3.
J Eur Acad Dermatol Venereol ; 32(5): 776-782, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29397035

RESUMEN

BACKGROUND: Studies have examined the associations between psoriasis and cardiovascular diseases and their risk factors, but the results are conflicting, especially in the general population. OBJECTIVES: To investigate the association of psoriasis, and in particular psoriasis severity, with objectively measured cardiovascular disease risk factors and cardiovascular morbidity in a large population-based cross-sectional study. METHODS: We linked data on 50 245 persons in the HUNT3 Study, Norway, with information from the National Prescription Database to obtain information on use of psoriasis medication. A total of 2894 persons reported to have psoriasis; 2643 were classified as mild; and 251 as moderate/severe psoriasis. We used linear and logistic regression to estimate adjusted associations with 95% confidence intervals (CIs) between psoriasis and cardiovascular disease risk factors and morbidity. RESULTS: We observed a positive association between psoriasis and objective measures of body mass index (BMI), waist circumference and high-sensitivity C-reactive protein, but no clear association with blood pressure and blood lipids. People with moderate/severe psoriasis had an odds ratio for being overweight of 1.94 (95% CI 1.42, 2.67), whereas the odds ratio for metabolic syndrome was 1.91 (95% CI 1.47, 2.49). Psoriasis was also positively associated with self-reported diabetes, myocardial infarction and angina pectoris. CONCLUSIONS: In this population-based study, we found that psoriasis was positively associated with measures of adiposity, as well as with a clustering of cardiovascular disease risk factors. Overall, these associations were strongest for people with moderate/severe psoriasis.


Asunto(s)
Índice de Masa Corporal , Proteína C-Reactiva/metabolismo , Psoriasis/epidemiología , Circunferencia de la Cintura , Adulto , Anciano , Angina de Pecho/epidemiología , Estudios Transversales , Diabetes Mellitus/epidemiología , Femenino , Humanos , Masculino , Síndrome Metabólico/epidemiología , Persona de Mediana Edad , Infarto del Miocardio/epidemiología , Noruega/epidemiología , Sobrepeso/epidemiología , Factores de Riesgo , Índice de Severidad de la Enfermedad , Adulto Joven
4.
J Eur Acad Dermatol Venereol ; 31(12): 2062-2068, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28662282

RESUMEN

BACKGROUND: While a number of observational hospital-based studies have reported an association between psoriasis and depression, less is known about the clinical diversity of psoriasis and depressive symptoms. OBJECTIVE: To investigate the associations of inverse psoriasis, psoriasis severity and psoriasis duration with depressive symptoms in a general population. METHODS: We linked data from the population-based third Nord-Trøndelag Health Study (HUNT3) to the Norwegian Prescription Database (NorPD) and Statistics Norway. Depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS). Associations between psoriasis and depressive symptoms (HADS ≥ 8) were estimated using logistic regression. RESULTS: Among 37 833 participants in HUNT3, we found a weak association between any psoriasis and the prevalence of depressive symptoms [fully adjusted odds ratio (OR) 1.12, 95% confidence interval (CI) 0.97-1.28]. The association with depressive symptoms was stronger when psoriasis was characterized by inverse anatomical distribution (OR 1.32, 95% CI 1.02-1.70), requirement of systemic psoriasis medication (OR 1.47, 95% CI 1.00-2.17) or long disease duration (OR 1.33, 95% CI 1.09-1.64). Conversely, when there was no inverse psoriasis distribution, no requirement of systemic medication, or shorter disease duration, psoriasis was not meaningfully associated with depressive symptoms. CONCLUSION: Overall, depressive symptoms do not seem to be a major concern among subjects with psoriasis in a general Norwegian population. However, among subjects with inverse anatomical distribution, requirement of systemic psoriasis medication or long disease duration, depressive symptoms may be particularly important to address when evaluating the burden of psoriasis.


Asunto(s)
Depresión/etiología , Psoriasis/complicaciones , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Noruega , Psoriasis/clasificación , Psoriasis/psicología , Índice de Severidad de la Enfermedad
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