The bidirectional association between type 2 diabetes and psoriasis: Two retrospective cohort studies
Journal
Indian Journal of Dermatology, Venereology and Leprology
Journal Volume
86
Journal Issue
4
Pages
366-374
Date Issued
2020
Author(s)
Abstract
Background: Inflammation plays a crucial role in both type 2 diabetes mellitus (T2DM) and psoriasis pathogenesis; thus, a bidirectional association between them is likely suspected. Aims: We investigated the possible bidirectional association between T2DM and psoriasis. Methods: Using the Taiwan National Health Insurance Research Database, we conducted two retrospective cohort studies. The analysis of psoriasis onset in relation to T2DM status included 31,697 patients with diabetes and 126,788 nondiabetic control subjects (Analysis 1). The analysis of T2DM onset in relation to psoriasis status included 1,947 psoriatic patients and 7,788 nonpsoriatic control subjects (Analysis 2). The follow-up period was from 2000 to the date of the outcome of interest, date of death, or December 31, 2013. Cox proportional models were used to estimate the relative hazards. Results: In Analysis 1, Kaplan-Meier (KM)-based cumulative incidence of psoriasis was higher in the T2DM cohort than that in the non-T2DM cohort (1.2% vs. 0.7%). The covariate-adjusted hazard ratio (HR) was 1.40 [95% confidence interval (CI), 1.20-1.63] for patients with T2DM. Analysis 2 revealed KM-based cumulative T2DM incidences of 18.7% and 13.1% in psoriatic and nonpsoriatic subjects, respectively. The adjusted HR for incident T2DM was higher in patients with psoriasis (1.38; 95% CI, 1.20-1.58). Limitation: This article may not represent the population worldwide and patient selection bias may exist. Conclusion: Our results provide evidence for a bidirectional T2DM-psoriasis association. T2DM and psoriasis are common worldwide; thus, our findings have public health implications for the early identification and management of these comorbid diseases. ? 2020 Indian Journal of Dermatology, Venereology and Leprology | Published by Wolters Kluwer-Medknow.
SDGs
Other Subjects
adult; age; alcohol liver disease; Article; cerebrovascular disease; chronic kidney failure; chronic obstructive lung disease; cohort analysis; controlled study; coronary artery disease; depression; disease association; female; follow up; gender; gout; hepatitis C; human; hyperlipidemia; hypertension; incidence; income; major clinical study; male; middle aged; non insulin dependent diabetes mellitus; obesity; psoriasis; retrospective study; aged; case control study; Kaplan Meier method; non insulin dependent diabetes mellitus; proportional hazards model; psoriasis; Taiwan; Adult; Aged; Case-Control Studies; Diabetes Mellitus, Type 2; Female; Follow-Up Studies; Humans; Incidence; Kaplan-Meier Estimate; Male; Middle Aged; Proportional Hazards Models; Psoriasis; Retrospective Studies; Taiwan
Publisher
Scientific Scholar
Type
journal article