寻常性银屑病、泛发性脓疱型银屑病与血脂、血糖、血压的相关性
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摘要
目的以较大样本量为基础,通过病例对照研究回顾性分析寻常性银屑病(psoriasis vulgaris,PsV)、泛发性脓疱型银屑病(generalized pustular psoriasis, GPP)与血脂、血糖、血压的相关性。方法研究对象包含511例PsV患者、82例GPP患者以及543例年龄性别匹配的健康对照,检测其血脂、血糖、血压相应参数并记录,将数据进行统计分析。结果 PsV组与对照组相比,甘油三酯(TG)水平升高(P<0.01),总胆固醇(TCH)水平升高(P<0.05),高密度脂蛋白胆固醇(HDL)水平降低(P<0.01),低密度脂蛋白胆固醇(LDL)水平两者差异无统计学意义(P=0.09)。GPP组与对照组相比HDL水平降低(P<0.01),空腹血糖(FPG)水平升高(P<0.01)。将血脂、空腹血糖、血压按代谢综合征诊断标准定义后,发现PsV组空腹血糖升高(P<0.01)、血压升高(P<0.01)的比例高于对照组。GPP组空腹血糖升高(P<0.01)比例高于对照组。结论寻常性银屑病患者与健康对照相比存在血脂异常,且出现高血糖及高血压的风险增加。泛发性脓疱型银屑病患者与健康对照相比可能存在血糖升高风险。
Objective To assess the relationship between psoriasis vulgaris(PsV),generalized pustular psoriasis(GPP) and serum lipids, blood glucose, blood pressure via case-control study based on a large sample size. Methods The study subjects included 511 PsV patients, 82 GPP patients and 543 age-and gender-matched healthy controls. The parameters of serum lipids, blood glucose, and blood pressure were recorded and the data were statistically analyzed. Results Compared with healthy controls, triglyceride(TG)(P<0.05), total cholesterol(TCH)(P<0.05) and low level of high density lipoprotein(HDL)(P<0.01)of patients in PsV had increased. There was no statistically significant difference between the two groups of low density lipoprotein(LDL)(P=0.09). The level of HDL(P<0.01) was lower,whereas that of fasting plasma glucose(FPG)(P<0.01) was higher in GPPs than healthy controls. After serum lipid, FPG and blood pressure were designed by the diagnostic criteria of metabolic syndrome,Pearson test showed that the prevalence of elevated FPG(P<0.01) and elevated BP(P<0.01) were higher in PsV groups than controls. The prevalence of elevated FPG(P<0.01) were higher in GPP patients than controls. Conclusion Patients with psoriasis vulgaris is associated with dyslipidemia, and have high risk of hyperglycemia, and hypertension compared with healthy controls. Patients with generalized pustular psoriasis may have higher risk of hyperglycemia than healthy controls.
Objective To assess the relationship between psoriasis vulgaris(PsV),generalized pustular psoriasis(GPP) and serum lipids, blood glucose, blood pressure via case-control study based on a large sample size. Methods The study subjects included 511 PsV patients, 82 GPP patients and 543 age-and gender-matched healthy controls. The parameters of serum lipids, blood glucose, and blood pressure were recorded and the data were statistically analyzed. Results Compared with healthy controls, triglyceride(TG)(P<0.05), total cholesterol(TCH)(P<0.05) and low level of high density lipoprotein(HDL)(P<0.01)of patients in PsV had increased. There was no statistically significant difference between the two groups of low density lipoprotein(LDL)(P=0.09). The level of HDL(P<0.01) was lower,whereas that of fasting plasma glucose(FPG)(P<0.01) was higher in GPPs than healthy controls. After serum lipid, FPG and blood pressure were designed by the diagnostic criteria of metabolic syndrome,Pearson test showed that the prevalence of elevated FPG(P<0.01) and elevated BP(P<0.01) were higher in PsV groups than controls. The prevalence of elevated FPG(P<0.01) were higher in GPP patients than controls. Conclusion Patients with psoriasis vulgaris is associated with dyslipidemia, and have high risk of hyperglycemia, and hypertension compared with healthy controls. Patients with generalized pustular psoriasis may have higher risk of hyperglycemia than healthy controls.
引文
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[11] Shenoy C, Shenoy MM, Rao GK. Dyslipidemia in dermatological disorders[J]. N Am J Med Sci, 2015, 7(10):421-428.
[12] Salihbegovic EM, Hadzigrahic N, Suljagic E, et al. Psoriasis and dyslipidemia[J]. Mater Sociomed, 2015, 27(1): 15-17.
[13] Wellen KE,Hotamisligil GS. Inflammation, stress, and diabetes[J]. J Clin Invest,2005, 115(5): 1111-1119.
[14] Al-Mutairi N, Shabaan D. Effects of tumor necrosis factor α inhibitors extend beyond psoriasis: insulin sensitivity in psoriasis patients with type 2 diabetes mellitus[J]. Cutis, 2016, 97(3): 235-241.
[15] Jacob L,Kostev K. Psoriasis risk in patients with type 2 diabetes in German primary care practices[J]. Prim Care Diabetes, 2017, 11(1): 52-56.
[16] Pereira RR,Amladi ST, Varthakavi PK. A study of the prevalence of diabetes, insulin resistance, lipid abnormalities, and cardiovascular risk factors in patients with chronic plaque psoriasis[J]. Indian J Dermatol, 2011, 56(5): 520-526.
[17] Wan MT, Shin DB, Hubbard RA, et al. Psoriasis and the risk of diabetes: A prospective population-based cohortstudy[J]. J Am Acad Dermatol, 2018, 78(2): 315-322.
[18] Zhang C, Zhu K, Zhou H, et al. Metabolic abnormalities are absent in patients with generalized pustularpsoriasis[J]. J Dermatol Sci, 2015, 78(3): 239-240.
[19] Benjegerdes KE, Hyde K, Kivelevitch D, et al. Pustular psoriasis: pathophysiology and current treatment perspectives[J]. Psoriasis (Auckl), 2016, 12(6): 131-144.
[20] Armstrong AW,Harskamp CT, Armstrong EJ. The association between psoriasis and hypertension: a systematic review and meta-analysis of observational studies[J]. J Hypertens, 2013, 31(3): 433-442.
[21] Takeshita J, Wang S, Shin DB, et al. Effect of psoriasis severity on hypertension control: a population-based study in the United Kingdom[J]. JAMA Dermatol, 2015,151(2): 161-169.
[22] 段茜, 程燕, 储蕾, 等. 银屑病与高血压病的相关性分析[J]. 中国皮肤性病学杂志,2015,29(2): 143-147.
[23] Casagrande SS, Menke A, Cowie CC. No association between psoriasis and diabetes in the U.S. population[J].Diabetes Res Clin Pract,2014,104(3): e58-60.
[2] Gelfand JM, Yeung H. Metabolic syndrome in patients with psoriatic disease[J]. J Rheumatol Suppl, 2012, 89: 24-28.
[3] Grundy SM,Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement[J]. Circulation, 2005, 112(17):2735-2752.
[4] Takeshita J, Grewal S, Langan SM, et al. Psoriasis and comorbid diseases: Epidemiology[J]. J Am Acad Dermatol,2017, 76(3): 377-390.
[5] Gui XY,Yu XL,Jin HZ, et al. Prevalence of metabolic syndrome in Chinese psoriasis patients: A hospital-based cross-sectional study[J]. J Diabetes Investig,2018, 9(1): 39-43.
[6] Girisha BS, Thomas N. Metabolic syndrome in psoriasis among Urban South Indians: a case control study using SAM-NCEP criteria[J]. J Clin Diagn Res,2017, 11(2): WC01-WC04.
[7] TaheriSarvtin M, Hedayati MT, Shokohi T, et al. Serum lipids and lipoproteins in patients with psoriasis[J]. Arch Iran Med, 2014, 17(5): 343-346.
[8] 李峰,晋红中,别志欣,等. 银屑病血脂特点分析[J]. 中国麻风皮肤病杂志,2016,32(7):416-418.
[9] Ma C, Schupp CW, Armstrong EJ, et al. Psoriasis and dyslipidemia: a population-based study analyzing the National Health and Nutrition Examination Survey (NHANES)[J]. J Eur Acad Dermatol Venereol, 2014, 28(8): 1109-1112.
[10] Paiva-Lopes MJ, Delgado Alves J. Psoriasis-associated vascular disease: the role of HDL[J]. J Biomed Sci, 2017, 24(1): 73.
[11] Shenoy C, Shenoy MM, Rao GK. Dyslipidemia in dermatological disorders[J]. N Am J Med Sci, 2015, 7(10):421-428.
[12] Salihbegovic EM, Hadzigrahic N, Suljagic E, et al. Psoriasis and dyslipidemia[J]. Mater Sociomed, 2015, 27(1): 15-17.
[13] Wellen KE,Hotamisligil GS. Inflammation, stress, and diabetes[J]. J Clin Invest,2005, 115(5): 1111-1119.
[14] Al-Mutairi N, Shabaan D. Effects of tumor necrosis factor α inhibitors extend beyond psoriasis: insulin sensitivity in psoriasis patients with type 2 diabetes mellitus[J]. Cutis, 2016, 97(3): 235-241.
[15] Jacob L,Kostev K. Psoriasis risk in patients with type 2 diabetes in German primary care practices[J]. Prim Care Diabetes, 2017, 11(1): 52-56.
[16] Pereira RR,Amladi ST, Varthakavi PK. A study of the prevalence of diabetes, insulin resistance, lipid abnormalities, and cardiovascular risk factors in patients with chronic plaque psoriasis[J]. Indian J Dermatol, 2011, 56(5): 520-526.
[17] Wan MT, Shin DB, Hubbard RA, et al. Psoriasis and the risk of diabetes: A prospective population-based cohortstudy[J]. J Am Acad Dermatol, 2018, 78(2): 315-322.
[18] Zhang C, Zhu K, Zhou H, et al. Metabolic abnormalities are absent in patients with generalized pustularpsoriasis[J]. J Dermatol Sci, 2015, 78(3): 239-240.
[19] Benjegerdes KE, Hyde K, Kivelevitch D, et al. Pustular psoriasis: pathophysiology and current treatment perspectives[J]. Psoriasis (Auckl), 2016, 12(6): 131-144.
[20] Armstrong AW,Harskamp CT, Armstrong EJ. The association between psoriasis and hypertension: a systematic review and meta-analysis of observational studies[J]. J Hypertens, 2013, 31(3): 433-442.
[21] Takeshita J, Wang S, Shin DB, et al. Effect of psoriasis severity on hypertension control: a population-based study in the United Kingdom[J]. JAMA Dermatol, 2015,151(2): 161-169.
[22] 段茜, 程燕, 储蕾, 等. 银屑病与高血压病的相关性分析[J]. 中国皮肤性病学杂志,2015,29(2): 143-147.
[23] Casagrande SS, Menke A, Cowie CC. No association between psoriasis and diabetes in the U.S. population[J].Diabetes Res Clin Pract,2014,104(3): e58-60.