Abstract
Background: Psoriatic arthritis (PsA) is a progressive and often destructive joint disease affecting approximately 20% of people with psoriasis. Objectives: To investigate associations between obesity, changes in body mass index (BMI), alcohol intake and smoking status and the development of PsA in people with psoriasis. Methods: We undertook a cohort study involving incident cases of psoriasis identified from the U.K. Clinical Practice Research Datalink between 1998 and 2014. The associations between smoking, alcohol and BMI and development of PsA were assessed using generalized additive models. Additionally, the risks associated with a change in BMI during follow-up were investigated using distributed lag nonlinear models. Results: We identified 90 189 incident cases of psoriasis (42% male, mean age 51 years), of whom 1409 had a subsequent record of PsA diagnosis. BMIs of 25·0–29·9, 30·0–34·9 and ≥ 35·0 kg m −2 were significantly associated with an increased risk of developing PsA compared with BMIs < 25·0 kg m −2: adjusted odds ratios (95% confidence intervals) 1·79 (1·46–2·19), 2·10 (1·67–2·63) and 2·68 (2·09–3·43), respectively. Reducing BMI over a 10-year period (linearly) was associated with a reduction in the risk of developing PsA compared with BMI remaining constant over the same period. Increased risks of developing PsA were associated with moderate drinking but not with former or heavy drinking or with current or past smoking status. Conclusions: In this incident psoriasis cohort, increased BMI and moderate drinking, but not heavy drinking or smoking status, were associated with an increased risk of PsA in people with psoriasis. Importantly, we have shown that reducing weight may result in a reduction in the risk of developing PsA.
| Original language | English |
|---|---|
| Pages (from-to) | 1-7 |
| Number of pages | 7 |
| Journal | British Journal of Dermatology |
| Early online date | 18 Jun 2019 |
| DOIs | |
| Publication status | E-pub ahead of print - 18 Jun 2019 |
ASJC Scopus subject areas
- Dermatology
Cite this
Modifiable risk factors and the development of psoriatic arthritis in people with psoriasis. / PROMPT Study Group.
In: British Journal of Dermatology, 18.06.2019, p. 1-7.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Modifiable risk factors and the development of psoriatic arthritis in people with psoriasis
AU - PROMPT Study Group
AU - Green, A
AU - Shaddick, G
AU - Charlton, R
AU - Snowball, J
AU - Nightingale, A
AU - Smith, C
AU - Tillett, W
AU - McHugh, N
N1 - © 2019 British Association of Dermatologists.
PY - 2019/6/18
Y1 - 2019/6/18
N2 - Background: Psoriatic arthritis (PsA) is a progressive and often destructive joint disease affecting approximately 20% of people with psoriasis. Objectives: To investigate associations between obesity, changes in body mass index (BMI), alcohol intake and smoking status and the development of PsA in people with psoriasis. Methods: We undertook a cohort study involving incident cases of psoriasis identified from the U.K. Clinical Practice Research Datalink between 1998 and 2014. The associations between smoking, alcohol and BMI and development of PsA were assessed using generalized additive models. Additionally, the risks associated with a change in BMI during follow-up were investigated using distributed lag nonlinear models. Results: We identified 90 189 incident cases of psoriasis (42% male, mean age 51 years), of whom 1409 had a subsequent record of PsA diagnosis. BMIs of 25·0–29·9, 30·0–34·9 and ≥ 35·0 kg m −2 were significantly associated with an increased risk of developing PsA compared with BMIs < 25·0 kg m −2: adjusted odds ratios (95% confidence intervals) 1·79 (1·46–2·19), 2·10 (1·67–2·63) and 2·68 (2·09–3·43), respectively. Reducing BMI over a 10-year period (linearly) was associated with a reduction in the risk of developing PsA compared with BMI remaining constant over the same period. Increased risks of developing PsA were associated with moderate drinking but not with former or heavy drinking or with current or past smoking status. Conclusions: In this incident psoriasis cohort, increased BMI and moderate drinking, but not heavy drinking or smoking status, were associated with an increased risk of PsA in people with psoriasis. Importantly, we have shown that reducing weight may result in a reduction in the risk of developing PsA.
AB - Background: Psoriatic arthritis (PsA) is a progressive and often destructive joint disease affecting approximately 20% of people with psoriasis. Objectives: To investigate associations between obesity, changes in body mass index (BMI), alcohol intake and smoking status and the development of PsA in people with psoriasis. Methods: We undertook a cohort study involving incident cases of psoriasis identified from the U.K. Clinical Practice Research Datalink between 1998 and 2014. The associations between smoking, alcohol and BMI and development of PsA were assessed using generalized additive models. Additionally, the risks associated with a change in BMI during follow-up were investigated using distributed lag nonlinear models. Results: We identified 90 189 incident cases of psoriasis (42% male, mean age 51 years), of whom 1409 had a subsequent record of PsA diagnosis. BMIs of 25·0–29·9, 30·0–34·9 and ≥ 35·0 kg m −2 were significantly associated with an increased risk of developing PsA compared with BMIs < 25·0 kg m −2: adjusted odds ratios (95% confidence intervals) 1·79 (1·46–2·19), 2·10 (1·67–2·63) and 2·68 (2·09–3·43), respectively. Reducing BMI over a 10-year period (linearly) was associated with a reduction in the risk of developing PsA compared with BMI remaining constant over the same period. Increased risks of developing PsA were associated with moderate drinking but not with former or heavy drinking or with current or past smoking status. Conclusions: In this incident psoriasis cohort, increased BMI and moderate drinking, but not heavy drinking or smoking status, were associated with an increased risk of PsA in people with psoriasis. Importantly, we have shown that reducing weight may result in a reduction in the risk of developing PsA.
UR - http://www.scopus.com/inward/record.url?scp=85071630813&partnerID=8YFLogxK
U2 - 10.1111/bjd.18227
DO - 10.1111/bjd.18227
M3 - Article
SP - 1
EP - 7
JO - British Journal of Dermatology
JF - British Journal of Dermatology
SN - 0007-0963
ER -