Quantifying cardiovascular disease risk factors in patients with psoriasis: a meta-analysis

Br J Dermatol. 2013 Dec;169(6):1180-7. doi: 10.1111/bjd.12490.

Abstract

Background: In a previous meta-analysis on categorical data we found an association between psoriasis and cardiovascular disease and associated risk factors.

Objectives: To quantify the level of cardiovascular disease risk factors in order to provide additional data for the clinical management of the increased risk.

Methods: This was a meta-analysis of observational studies with continuous outcome using random-effects statistics. A systematic search of studies published before 25 October 2012 was conducted using the databases Medline, EMBASE, International Pharmaceutical Abstracts, PASCAL and BIOSIS.

Results: We included 59 studies with up to 18 666 cases and 50 724 controls. Psoriasis cases had a higher total cholesterol [weighted mean difference 8·83 mg dL(-1) , 95% confidence interval (CI) 2·94-14·72, P = 0·003 (= 0·23 mmol L(-1) )], higher low-density lipoprotein cholesterol [9·90 mg dL(-1) , 95% CI 1·56-18·20, P = 0·020 (= 0·25 mmol L(-1) )], higher triglyceride [16·32 mg dL(-1) , 95% CI 12·02-20·63, P < 0·001 (= 0·18 mmol L(-1) )], a higher systolic blood pressure (4·77 mmHg, 95% CI 1·62-7·92, P = 0·003), a higher diastolic blood pressure (2·99 mmHg, 95% CI 0·60-5·38, P = 0·014), higher body mass idex (0·73 kg m(-2) , 95% CI 0·37-1·09, P < 0·001), higher waist circumference (3·61 cm, 95% CI 2·12-5·10, P < 0·001), higher fasting glucose [3·52 mg dL(-1) , 95% CI 0·64-6·41, P = 0·017 (= 0·20 mmol L(-1) )], higher nonfasting glucose [11·70 mg dL(-1) , 95% CI 11·24-12·15, P < 0·001 (= 0·65 mmol L(-1) )] and a higher HbA1c [1·09 mmol mol(-1) , 95% CI 0·87-1·31, P < 0·001 (= 2·2%)].

Conclusions: From a preventive medicine perspective, the weighted mean differences between cases and controls are significant, and therefore relevant to the clinical management of patients with psoriasis.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Blood Glucose / metabolism
  • Blood Pressure / physiology
  • Body Mass Index
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / physiopathology
  • Case-Control Studies
  • Cholesterol, HDL / metabolism
  • Cholesterol, LDL / metabolism
  • Humans
  • Observational Studies as Topic
  • Psoriasis / blood
  • Psoriasis / complications*
  • Psoriasis / physiopathology
  • Risk Factors

Substances

  • Blood Glucose
  • Cholesterol, HDL
  • Cholesterol, LDL