| Background: Psoriasis is a common inflammatory cutaneous disorder characterized by red scaly patches. The prevalevence of psoriasis is about 0.123% in Chinese Han population. So far, there have been about 4 million psoriasis patients in China. Clinically, psoriasis vulgaris is the most common category in psoriasis, accounting for over 90% of the total number of patients. The exact pathogenesis of psoriasis remains unclear. It is agreed generally that the psoriasis is a complex disease which arises from genetic and environmental factors. The predisposing genes may be grouped into two parts: HLA-associated and non-HLA-associated predisposing genes. Psoriasis can have a significant impact on a patient's quality of life and is associated with loss of productivity, depression, psoriasis arthritis, Crohn disease and an increased prevalence of malignancy and cardiovascular disease. Emerging comorbidities of psoriasis include cardiovascular disease and metabolic syndrome. Psoriasis patients have an increased prevalence of the core components of metabolic syndrome, including obesity, dyslipidemia and insulin resistance. The relationship between psoriasis and comorbidities such as metabolic syndrome and cardiovascular disease is likely linked to the underlying chronic inflammatory nature of psoriasis. The molecular mechanisms involved in psoriasis-associated dysregulation of metabolic function are believed to be due, in large part, to the action of increased levels of proinflammatory factors, such as tumor necrosis factor-alpha and IL23. Several studies showed the systemic complications may have the same genetic changes with psoriasis, for example, HLA-B27 in psoriasis, arthritis, and spondyloarthropathies or mutual gene loci on chromosome 16q21 as in psoriasis and Crohn disease (CD). Contrary to abroad study, few studies on epidemiology of comorbidities with psoriasis patients in Chinese Han have been published.Objectives: To study comorbidities with psoriasis patients in Chinese Han.Method: Data were collected from a database of 2,005 patients with psoriasis including 1,563 outpatients and 442 inpatients. Outpatients were questioned by uniform questionnaire and inpatients by the retrospective survey from case history. Statistical analysis was preformed by chi-square test, Student's t-test, Statistical Package for Social Sciences (SPSS) and Alkhateeb's method.Results: (1) Of the 2,005 psoriasis patients, there were 1223 (61.0%) females and 782(39.0%) males, with a female: male ratio of 1.56:1. The mean age of the patients was 43.15±17.16 years-old. The mean age at onset of disease was 31.13±15.77 years-old. The mean disease duration was 12.02±11.39 years. The peak age of initial onset was 20-29 ages for male and 10-19 ages for female. (2) There were more than 20 comorbidities with psoriatics in our study, such as diabetes mellitus type 2, hyperlipemia, hypertension, coronary artery disease (CAD), arthritis, vitiligo, hyperthyroidism, hypothyroidism, alopecia areata, systemic lupus erythematosus(SLE), poly-infections, chronic gastroenteritis, hepatopathy, nephrosis, anaemia, tumour, allergic rhinitis, asthma, schizophrenia and other dermatosis. (3) Compared with the general population, patients with psoriasis were more likely to be affected by hypertension (P < 0.05), coronary artery disease (P < 0.05), hyperlipemia (P < 0.05), diabetes mellitus type 2 (P < 0.05), arthritis (P < 0.05), vitiligo (P < 0.05) and SLE (P < 0.05). (4) The prevalence of hospitalized psoriasis patients with comorbidities was higher than that of outpatients, including poly-infections, hyperlipemia, tumour, gastroenteritis, coronary artery disease, allergic rhinitis, nephropathy (P < 0.05). (5) There was a male preponderance of co-existing hyperlipemia and hepatopathy (P < 0.05), with a female preponderance of co-existing anaemia, hyperthyroidism and hypothyroidism (P < 0.05).Conclusion: Psoriasis appears to be associated with metabolic syndrome, cardiovascular disease and autoimmune diseases in Chinese Han. |
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