新疆维吾尔族寻常型银屑病伴发代谢相关性疾病分析

目的分析新疆维吾尔族寻常型银屑病患者伴发代谢相关性疾病的情况。方法对2010年1月—2013年3月新疆维吾尔自治区人民医院皮肤科住院的106例维吾尔族寻常型银屑病患者伴发代谢相关性疾病的临床资料进行回顾性分析,并与300例同期健康体检者伴发代谢相关性疾病的情况作比较。结果新疆维吾尔族寻常型银屑病患者伴发高血压、Ⅱ型糖尿病、高尿酸血症、代谢综合症和肥胖的几率均高于健康对照组;银屑病组中男性患代谢综合症(22.22%)和高尿酸血症(30.00%)均高于女性患者(6.25%,6.25%,P0.05)。对照组性别方面差异无统计学意义(P0.05)。银屑病合并各种代谢相关性疾病与无代谢相关性疾病比较,在年龄方面差异有统计学意义,合并代谢性疾病的患者年龄更大。在病程、发病年龄和文化程度方面差异无统计学意义。在严重程度方面组间差异有统计学意义,且代谢相关性疾病的发生随着严重程度的增加而增加。同时合并有多种代谢相关性疾病的银屑病患者,合并的代谢相关性疾病数量越多,银屑病的严重程度越重。结论新疆维吾尔族寻常型银屑病患者常伴发高血压、Ⅱ型糖尿病、高尿酸血症、代谢综合征及肥胖等代谢相关性疾病。男性较女性患者更易伴发高代谢综合征和高尿酸血症,合并代谢性疾病的患者年龄更大,代谢相关性疾病的发生随着严重程度的增加而增加,合并的代谢相关性疾病数量越多,银屑病的严重程度越重。因此应重视银屑病患者健康宣教。     

银屑病与代谢综合征相关性研究进展

银屑病是一种常见的慢性炎症反应性皮肤病。目前的研究发现其与一系列心血管危险因素相关,包括:肥胖、高血压、血脂异常、胰岛素抵抗。而这些因素属于代谢综合征。银屑病与代谢综合征之间可能存在着共同的炎症反应途径和遗传易感性,其中包括炎症因子、脂肪因子、易感基因等。本文对银屑病与代谢综合征的联系做一综述,应在银屑病患者中更加关注代谢综合征的相关表现。     

寻常性银屑病亚临床关节炎的临床研究

目的初步研究寻常性银屑病患者亚临床关节炎的发生率、临床特征及实验室指标,分析寻常性银屑病患者发生亚临床关节炎可能的相关危险因素,为临床识别早期关节性银屑病提供参考。方法根据入排标准筛出50例寻常性银屑病患者,并对其双肘关节、双膝关节和双踝关节及跟腱进行高频超声检查,其中超声结果异常者再行磁共振成像(MRI)检查,确认存在亚临床关节炎症改变。对10例有关节炎(有亚临床关节炎组)和40例无关节炎(无亚临床关节炎组)受试者的临床特征和实验室指标进行统计学分析。结果寻常性银屑病患者亚临床关节炎的发生率为20%。临床特征中,有亚临床关节炎组患者的年龄(P=0.000)、银屑病病程(P=0.004)、皮损初发年龄(P=0.001)、有吸烟史(P=0.010)明显高于无亚临床关节炎组患者。两组患者在实验室指标方面差异无统计学意义。寻常性银屑病患者发生亚临床关节炎可能的影响因素是患者年龄(OR=1.185,P=0.001)、银屑病病程(OR=1.119,P=0.010)、皮损初发年龄(OR=1.113,P=0.006)。结论寻常性银屑病患者中亚临床关节炎的发生率低。年龄、银屑病病程、皮损初发年龄可能是寻常性银屑病患者发生亚临床关节炎的危险因素。     

规范银屑病药物治疗

正银屑病是免疫介导的系统性疾病。根据流行病学调查资料,估计我国有超过六百万患者,中、重度银屑病患者罹患代谢综合征和动脉粥样硬化性心血管疾病的风险增加。银屑病严重影响患者的生活质量。根据银屑病的临床特征,可分为寻常性、关节病型、脓疱型及红皮病型,不规范的治疗常常导致寻常性转化为脓疱型及红皮病型,危及患者生命。     

关节病性银屑病与代谢综合征关联的系统评价

银屑病是皮肤科常见的一种慢性、复发性炎症性疾病,关节病性银屑病是合并关节炎症状的银屑病,可累及外周及中轴关节。有报道,约三分之一银屑病患者罹患关节病性银屑病［1］。流行病学调查发现,银屑病患者患心血管疾病及代谢综合征的风险比一般人群增加［2-4］,且在重型银屑病及关节病性患者中,风险更高［5］。针对此发现,近年来多项研究对关节病性银屑病患者中代谢综合征的患病率进行了调查,我们旨在通过对相关文献进行Meta分析,比较合并关节炎及无关节炎银屑病患者代谢综合征的患病风险……     

寻常性银屑病患者甲损害临床及代谢特征分析

目的探讨寻常性银屑病患者甲损害特点及与临床表现、实验室指标和代谢综合征的相关性。方法选取80例寻常性银屑病患者,收集患者的人口学指标、临床及实验室检查结果,分析患者的甲损害特点,并分析甲损害与患者临床特征、实验室指标及代谢综合征的关系。结果 80例患者中,甲损害患者38例(47.50%),趾甲损害患者16例(20.00%)。与无甲损害患者相比,有甲损害的患者病程较长、病情较重,差异有统计学意义(P0.05);有甲损害的患者头皮、上肢、躯干及下肢的皮损面积比例较高,差异有统计学意义(P0.05);甲损害与头皮皮损面积具有相关性(P0.05)。两组患者白细胞、中性粒细胞、淋巴细胞升高比例和代谢指标升高的患者比例差异均无统计学意义(P0.05)。结论寻常性银屑病患者多存在甲损害,与银屑病病程长短、疾病严重程度密切相关,甲损害与头皮皮损面积相关。     

银屑病合并代谢综合征的机制

银屑病(psoriasis)是一种免疫介导的慢性复发性炎症性皮肤病,临床上常伴发多种并发症,加大了治疗的难度和风险。近年来多项研究证实,银屑病与代谢综合征的临床指征密切相关,银屑病患者是代谢综合征的高风险人群,代谢综合征又增加了银屑病的复发几率和严重程度。银屑病合并代谢综合征的发病机制涉及遗传学、胰岛素抵抗、氧化应激、内质网应激、炎性因子、脂肪因子、肠道菌群等多种因素,这些因素导致银屑病合并代谢综合征的治疗需区别于常规治疗方案,否则将加剧疾病的发展。本文对银屑病合并代谢综合征的机制进行总结,旨在为相关临床研究和动物实验提供参考。     

银屑病患者血清C3的表达及其与银屑病的相关性

目的:明确银屑病患者血清C3与银屑病发生及代谢紊乱的相关性。方法:收集63例未系统治疗的寻常型银屑病患者(体重正常或偏瘦者30例,超重或肥胖者33例)及健康对照30名,t检验分析体重正常或偏瘦的银屑病患者血清C3与正常对照组间的差异,pearson或spermen相关性分析银屑病患者血清C3与体重指数、PASI评分、血脂、血糖、血压及代谢综合征的之间的相关性。结果:超重或肥胖的银屑病患者,体重正常或偏瘦的银屑病患者及健康对照中血清C3水平分别为1.37±0.21g/L,1.12±0.14 g/L,1.07±0.10 g/L。银屑病患者血清C3水平与体重指数、PASI评分、甘油三脂、及代谢综合征的发生显著正相关(均P0.05),与高密度脂蛋白水平显著负相关(P0.05)。结论:血清C3可能与银屑病的发生及代谢紊乱相关。     

NB-UVB照射治疗寻常性银屑病疗效及相关因素分析

目的观察窄谱中波紫外线NB-UVB治疗寻常性银屑病的疗效,并对相关因素进行探讨。方法104例寻常性银屑病患者予8周NB-UVB照射治疗,观察疗效及与年龄、性别等相关因素的关系。结果痊愈率28.85%,显效率为25.96%。不同年龄段患者有效率分别为≤20岁100%,21～50岁67.8%,>50岁28.2%,男性和女性患者疗效差异无统计学意义(P>0.05),治疗有效患者1年复发率为47.7%。结论NB-UVB是治疗寻常性银屑病的有效方法,疗效随年龄增加而下降,照射治疗不能防止复发。     

代谢综合征、抑郁及性激素水平对银屑病患者勃起功能障碍的影响

目的:观察银屑病患者发生勃起功能障碍(ED)的一般情况,研究代谢综合征、抑郁、血浆睾酮水平与银屑病患者发生ED的相关性。方法:用国际勃起功能评分表(IIEF-5)对57例银屑病患者及79例正常男性性功能进行评价,并用抑郁自评量表(CES-D)对参与者抑郁情绪进行评价。同时记录参与者的年龄、身高、体重、血压、血脂、血糖、血清睾酮。结果:IIEF-5评分结果显示57例银屑病患者中30例(52.6%)有ED,79例正常男性中29例(36.7%)有ED。年龄校正的结果显示银屑病组发生ED比例较高,OR值为2.29(95%CI 1.06~4.98)。单因素分析结果显示银屑病患者年龄、代谢综合征、抑郁症是ED发生的危险因素;多因素分析结果显示抑郁症是ED发生的独立危险因素。结论:银屑病患者ED发生率较高,银屑病患者ED的调查可以作为一项临床常规开展项目。     

Psoriasis and the metabolic syndrome

Previous reports have shown a possible association between psoriasis and obesity, ischaemic heart disease, hypertension or diabetes mellitus. However, most of these studies were uncontrolled and were based on small sample sizes. We therefore investigated the association between psoriasis and the metabolic syndrome in a case control study. Case patients were defined as patients with a diagnosis of psoriasis vulgaris. Control patients were subjects who underwent hernioplasty or appendectomy. We used data mining techniques utilizing the database of the southern district of Clalit Health Services. The proportions of patients with diseases that belong to the metabolic syndrome were compared between case and control patients by univariate analyses. chi2 tests were used to compare categorical parameters between the groups. Logistic regression models were used to measure the association between psoriasis and the metabolic syndrome. A total of 340 patients with psoriasis and 6643 controls were included in the study. The mean age of case patients was 47.7 years (SD 10.7 years). There were 50.3% men and 49.7% women. Ischaemic heart disease was present in 23.5% of the patients with psoriasis, compared with 17.2% of the controls (p=0.003). Diabetes mellitus was present in 27.9% of the patients with psoriasis, compared with 19.5% of the controls (p <0.001). Hypertension was present in 44.4% of the patients with psoriasis, compared with 37.2% of the controls (p=0.007). Obesity was present in 29.4% of the patients with psoriasis, compared with 23.5% of the controls (p=0.012). Dyslipidaemia was present in 50.9% of the patients with psoriasis, compared with 44.2% of the controls (p=0.015). The association between psoriasis and the metabolic syndrome was pronounced after the age of 50 years and in men. Multivariate models adjusting for age and gender demonstrated that psoriasis was associated with an increased risk for ischaemic heart disease (odds ratio (OR) 1.4 95% confidence interval (CI) 1.0-1.8), diabetes mellitus (OR 1.5 95% CI 1.2-2.0), hypertension (OR 1.3 95% CI 1.0-1.7), obesity (OR 1.3 95% CI 1.0-1.7) and dyslipidaemia (OR 1.2 95% CI 1.0-1.6). Our findings demonstrate a possible association between psoriasis and the metabolic syndrome. Further studies are needed to establish this observation.     

Psoriasis and diabetes: a population-based cross-sectional study

Background Previous reports have shown an association between psoriasis and the metabolic syndrome, but there are only a few studies on the association between psoriasis and diabetes. Objectives To study the association between psoriasis and diabetes. Methods A cross‐sectional study was performed utilizing the database of Clalit Health Services (CHS). Patients who were diagnosed with psoriasis were compared with CHS enrolees without psoriasis regarding the prevalence of diabetes. Patients with diabetes were identified using the CHS chronic diseases registry. Chi‐squared tests were used to compare categorical parameters. Logistic regression models were used for multivariate analyses. Results The study included 16 851 patients with psoriasis and 74 987 subjects without psoriasis (control patients). The proportion of diabetes was significantly higher in patients above 35 years (P < 0.05). The age‐adjusted proportion of diabetes was significantly higher in psoriasis patients as compared to the control group [odds ratio (OR), 1.38, P < 0.05] and was similar in men and women (OR, 1.32, 1.45, respectively). A multivariate logistic regression model showed that psoriasis was significantly associated with diabetes, independently of age and gender (OR, 1.58, P < 0.001). Conclusions Our study supports previous reports of an association between psoriasis and diabetes. Dermatologists taking care of patients with psoriasis should be aware of this association and advise the patients to reduce additional risk factors such as smoking, hypertension or dyslipidemia.     

Analysis of Cardiovascular Risk Factors and Metabolic Syndrome in Korean Patients with Psoriasis

Background

In previous studies, psoriasis has been reported to be associated with metabolic syndrome.

Objective

The purpose of this study was to evaluate risk factors for metabolic syndrome in psoriasis patients and to compare the prevalence of metabolic syndrome in psoriasis and control groups.

Methods

All patients (n=490) and controls (n=682) were investigated for cardiovascular risk factors, including central obesity, hypertension, fasting plasma glucose levels, and blood levels of triglycerides and high-density lipoprotein (HDL).

Results

We found no statistical association between psoriasis and the prevalence of metabolic syndrome when controlling for age and gender. Among individual components of metabolic syndrome, only increased triglyceride levels was significantly prevalent in patients psoriasis. The incidence of other factors such as central obesity, hypertension, fasting plasma glucose and HDL in the psoriasis group were similar to or lower than those in the control group. Although psoriasis patients with metabolic syndrome had severe and large plaque-type psoriasis, the association of metabolic syndrome with the severity or clinical subtype of psoriasis was not significant after adjusting for age and gender.

Conclusion

Our results suggest that there is no close correlation between psoriasis and metabolic syndrome in Korean patients.     

Prevalence of metabolic syndrome in patients with psoriasis: a hospital-based case-control study

BACKGROUND: Psoriasis is a chronic inflammatory disease associated with an increased cardiovascular risk. Metabolic syndrome is a significant predictor of cardiovascular events. OBJECTIVE: To investigate the prevalence of metabolic syndrome in patients with psoriasis. METHODS: We performed a hospital-based case-control study on 338 adult patients with chronic plaque psoriasis and 334 patients with skin diseases other than psoriasis. RESULTS: Metabolic syndrome was significantly more common in psoriatic patients than in controls (30.1% vs. 20.6%, odds ratio 1.65, 95% confidence interval 1.16-2.35; P = 0.005) after the age of 40 years. Psoriatic patients also had a higher prevalence of hypertriglyceridaemia and abdominal obesity, whereas hyperglycaemia, arterial hypertension and high-density lipoprotein cholesterol plasma levels were similar. Although psoriasis patients were more frequently smokers, the association of psoriasis with metabolic syndrome was independent from smoking. There was no correlation between severity of psoriasis and prevalence of metabolic syndrome. Psoriatic patients with metabolic syndrome were older and had a longer disease duration compared with psoriatic patients without metabolic syndrome. CONCLUSION: Psoriatic patients have a higher prevalence of metabolic syndrome, which can favour cardiovascular events. We suggest psoriatic patients should be encouraged to correct aggressively their modifiable cardiovascular risk factors.     

Estimation of tissue and serum lipocalin-2 in psoriasis vulgaris and its relation to metabolic syndrome

Adipose tissue is now considered an endocrine organ secreting different cytokines known as adipocytokines. Lipocalin-2 has been recently identified as an adipokine present in the circulation, it is related to insulin resistance, obesity, atherosclerotic diseases and type 2 diabetes. Lipocalin-2 and psoriasis are assumed to be closely associated with the metabolic syndrome. The aim of the present study is to estimate the level of lipocalin-2 in the serum and tissue of psoriatic patients and to correlate these levels with markers of metabolic syndrome, CRP and disease severity. This study was done on 30 patients of psoriasis and 30 healthy controls. All patients and controls were subjected to clinical examination. Serum, tissue levels of lipocalin-2 and C-reactive protein (CRP) were measured by enzyme linked immunosorbent assay technique. Metabolic syndrome parameters including anthropometric measures, lipid profiles, blood sugar and blood pressure were studied. Patients with psoriasis showed significant association with metabolic syndrome parameters than controls. Tissue lipocalin-2 was significantly higher than serum levels in psoriasis patients. A significant difference was detected in tissue levels of lipocalin-2 and not in the serum between patients and controls. Both tissue and serum lipocalin-2 correlated with CRP. Although there was a correlation between tissue and serum levels of lipocalin-2 in patients, there was no correlation between both of them with metabolic syndrome and related disorders. Our results revealed that patients with psoriasis are at increased risk of metabolic and cardiovascular complications, tissue lipocalin-2 is more specific to psoriasis than serum lipocalin-2. Lipocalin-2 has no role in determining severity of the disease. Neither tissue nor serum lipocalin-2 conveys cardiovascular risk in psoriasis patients.     

银屑病患者410例合并代谢综合征分析

目的观察银屑病合并代谢综合征(metabolicsyndrome,MS)的患病情况并分析相关危险因素。方法对本院2010年1月-12月诊治的410例银屑病和同期诊治的490例无免疫系统疾病的带状疱疹患者MS发病率、身高、体质量、血压、空腹血糖、三酰甘油和高密度脂蛋白等临床资料进行分析。结果银屑病组MS患病率(37.56%)较带状疱疹对照组(21.02%)高(P<0.05);银屑病组女性MS患病率(53.00%)高于男性患病率(32.58%)(P<0.05),对照组无性别差异(P>0.05);银屑病组BMI,FPG,SBP,DBP和TG检测值明显高于对照组,HDL-C明显低于对照组,差异均有统计学意义(P均<0.05)。结论银屑病患者MS的患病率较高,且存在一定的诱发危险因素,应重视银屑病患者健康宣教。     

寻常型银屑病复发相关因素分析及自我管理干预研究

目的：明确寻常型银屑病相关复发因素，建立科学有效的自我管理模式。方法：收集 2017年3月至2018年12月皮肤科门诊就诊的寻常型银屑病复诊患者，填写调查问卷，通过Logistic 回归法分析相关影响因素，根据影响因素制定个体化健康教育处方。将复诊的患者随机分为对照组和干预组，分别实施常规健康教育和个体化健康教育处方的临床干预，3个月后比较有效率，6个月后比较复发率。结果：共计213例银屑病复诊患者完成调查问卷，其中177例为复发患者，呼吸道感染、吸烟、紧张焦虑、睡眠障碍、寒冷、干燥、中断治疗与复发相关性大。98例(干预组54例，对照组44例)银屑病复发患者参与随机干预试验，干预组有效率和复发率分别为87.03%和11.1%，对照组分别为88.63%和36.4%，其中复发率差异有统计学意义（P<0.05）。结论：银屑病患者复发与自我管理能力密切相关，个体化健康教育处方有助于提高银屑病患者的疗效，降低复发率。     

Serum lipocalin-2 levels are increased in patients with psoriasis

The protein lipocalin (LCN)-2 is known to be related to insulin resistance, obesity and atherosclerotic diseases. Psoriasis is an inflammatory skin disease related to metabolic syndrome. The aim of this study was to examine the relationship between serum LCN2 levels and indicators for metabolic syndrome and inflammatory cytokine levels in patients with psoriasis. Serum LCN2 levels were measured in patients with psoriasis, atopic dermatitis (AD) or bullous pemphigoid (BP), and compared with those of healthy controls. Serum LCN2 levels were also compared with several indicators for metabolic syndrome, and with serum levels of interleukin (IL)-6 and tumour necrosis factor (TNF)-α, two markers of inflammation. Serum LCN2 levels in patients with psoriasis were significantly higher than those of healthy controls, but there was no significant correlation between serum LCN2 and body mass index. Serum LCN2 levels also correlated with serum IL-6 and TNF-α levels in patients with psoriasis. Serum LCN2 levels are a general indicator for increased inflammation in the patients with psoriasis.     

特殊类型银屑病伴发高尿酸血症相关因素分析

目的:探讨特殊型银屑病伴发高尿酸血症的相关因素。方法:对117例红皮病型、泛发性脓疱型或/及关节病型银屑病患者的临床资料进行回顾性分析;根据尿酸代谢过程、影响因素、银屑病的临床表现等确定分析指标15项,对高尿酸血症组、正常组间各指标先后进行单因素分析及多因素Logistic回归分析;同时分析特殊用药、病情演变与患者血尿酸水平变化间的关系。结果:特殊类型银屑病伴高尿酸血症发生率为31.62%;高尿酸血症组与正常组比较,性别、红皮病型损害、泛发性脓疱型损害及血甘油三酯增高间的差异均有统计学意义(P<0.05);红皮病型损害、男性、甘油三酯增高、泛发性脓疱型损害是影响高尿酸血症发生的重要因素,其相对危险度(RR)依次为8.93、6.83、2.86、0.31。结论:特殊型银屑病伴发高尿酸血症可能与性别、红皮病型损害、泛发性脓疱型损害、甘油三酯增高及特殊用药有关。     

Psoriasis and chronic obstructive pulmonary disease: a case-control study

Background Previous reports have demonstrated an association between psoriasis and the metabolic syndrome. Chronic obstructive pulmonary disease (COPD) has also been associated with the metabolic syndrome. Objectives To assess the association between psoriasis and COPD in a population‐based case–control study. Methods A case–control study was performed utilizing the database of Clalit Health Services, a large healthcare provider organization in Israel. Patients over the age of 20 years who were diagnosed with psoriasis (‘cases’) were compared with a sample of age‐ and gender‐matched enrollees without psoriasis (‘controls’) regarding the prevalence of COPD. Group matching was performed. Data on health‐related lifestyles and other comorbidities were collected. χ² tests, t‐tests and logistic regression models were used to compare between study groups. Results The study included 12 502 psoriasis cases and 24 287 controls. The prevalence of COPD was significantly higher in patients with psoriasis [5·7% vs. 3·6%, P < 0·001, odds ratio (OR) 1·63, 95% confidence interval (CI) 1·47–1·81]. A multivariate logistic regression model demonstrated that psoriasis was significantly associated with COPD, after controlling for confounders, including age, sex, socioeconomic status, smoking and obesity (adjusted OR 1·27, 95% CI 1·13–1·42, P < 0·001). Conclusions In this large, population‐based case–control study, psoriasis was found to be associated with COPD. Dermatologists caring for patients with psoriasis should be aware of this association, consult an internist or pulmonologist, and advise the patients to stop smoking and reduce additional risk factors for COPD.