Psoriasis is a common chronic inflammatory disease that affects approximately 125 million people worldwide. A new study of the entire Danish population confirms previous reports of increased risk of diabetes mellitus in patients with psoriasis and shows that risk increases with severity of psoriasis.
Psoriasis, atherosclerosis, and early steps in the development of diabetes mellitus are characterised by chronic inflammation, i.e. a chronic state of alert. “This chronic state of alert may explain the increased risk of cardiovascular diseases and diabetes mellitus seen in these patients,” said Dr Ahlehoff.
The study comprised more than 4 million people, including approximately 50,000 patients with psoriasis, who were followed for 13 years.
The overall rates of new-onset diabetes mellitus per 1,000 observational years were 3.67 (CI=3.65-3.69) in the reference population who did not have psoriasis, 6.93 (CI=6.63-7.25) for patients with mild psoriasis and 9.65 (CI=8.68-10.73) for patients with severe psoriasis.
The risk of new-onset diabetes mellitus was increased in all patients with psoriasis compared to people who did not have psoriasis. Risk increased with the severity of psoriasis. Compared to people without psoriasis, patients with mild psoriasis were 1.5 times more likely to acquire new-onset diabetes mellitus [rate ratio (RR)=1.49; CI=1.43-1.56] and patients with severe psoriasis were more than twice as likely [RR=2.13; CI=1.91-2.37].
The results remained significant after adjustment for potential confounders, including age, sex, socioeconomic status, use of medication, and comorbidity.
Dr Ahlehoff said: “The major conclusion of the study was that psoriasis was associated with increased risk of diabetes mellitus and the risk was highest in patients with severe psoriasis.”
“The results add to current evidence of increased risk of cardiovascular and metabolic disease in patients with psoriasis,” he added. “More needs to be done to increase awareness in this large group of patients on what steps they can take to decrease their risk factors for cardiovascular disease.”
Dr Ahlehoff continued: “Studies are urgently required to examine the impact of aggressive psoriasis treatment on cardiometabolic outcomes.”