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A Prospective Study of US Female Nurses

Abrar A. Qureshi, MD, MPH; Hyon K. Choi, MD, DrPH; Arathi R. Setty, MD, MPH; Gary C. Curhan, MD, ScD

Arch Dermatol. 2009;145(4):379-382.

Objective  To evaluate the independent association between psoriasis and risk of diabetes and hypertension.

Design  A prospective study of female nurses who were followed up from 1991 to 2005.

Setting  Nurses' Health Study II, a cohort of 116 671 US women aged 27 to 44 years in 1991.

Participants  The study included 78 061 women who responded to a question about a lifetime history of physician-diagnosed psoriasis in 2005. Women who reported a diagnosis of diabetes or hypertension at baseline were excluded.

Main Outcome Measure  New diagnosis of diabetes or hypertension, obtained from biennial questionnaires.

Results  Of the 78 061 women, 1813 (2.3%) reported a diagnosis of psoriasis. During the 14 years of follow-up, a total of 1560 incident cases (2%) of diabetes and 15 724 incident cases (20%) of hypertension were documented. The multivariate-adjusted relative risk of diabetes in women with psoriasis compared with women without psoriasis was 1.63 (95% confidence interval, 1.25-2.12). Women with psoriasis were also at an increased risk for the development of hypertension (multivariate relative risk, 1.17; 95% confidence interval, 1.06-1.30). Age, body mass index, and smoking status did not significantly modify the association between psoriasis and risk of diabetes or hypertension (P values for interaction, .07).

Conclusions  In this prospective analysis, psoriasis was independently associated with an increased risk of diabetes and hypertension. Future studies are needed to find out whether psoriasis treatment will reduce the risk of diabetes and hypertension.

Author Affiliations: Channing Laboratory, Department of Medicine (Drs Qureshi, Choi, Setty, and Curhan), and Department of Dermatology (Dr Qureshi), Brigham and Women's Hospital and Harvard Medical School, and Department of Epidemiology, Harvard School of Public Health (Dr Curhan), Boston, Massachusetts.

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