Association of psoriasis and psoriatic arthritis with osteoporosis and pathological fractures

作者：Kathuria Parul; Gordon Kenneth B; Silverberg Jonathan I

来源：Journal of the American Academy of Dermatology, 2017, 76(6): 1045-+.

DOI：10.1016/j.jaad.2016.11.046

• ankylosing spondylitis
• burden
• comorbidities
• cost of care
• emergency care
• hospitalization
• length of stay
• osteomalacia
• osteopenia
• osteoporosis
• psoriasis
• psoriatic arthritis
• urgent care

Background: Previous studies examining the relationship between psoriasis (Pso), osteoporosis, and pathological fractures found conflicting results.
Objective: To determine whether Pso and psoriatic arthritis (PsA) are associated with osteoporosis and fractures in US adults.
Methods: Cross-sectional study of 198,102,435 children and adults, including 183,725 with Pso and 28,765 with PsA from the 2006-2012 National Emergency Department Sample, including 20% of the emergency care visits throughout the United States.
Results: In a pooled analysis across all 7 years, patients with Pso had significantly higher odds (multivariate logistic regression; odds ratio, 95% confidence intervals) of diagnosis with osteopenia (2.86, 2.70-3.02), osteoporosis (2.97, 2.89-3.06), osteomalacia (4.40, 2.50-7.74), ankylosing spondylitis (13.34, 12.02-14.81), and pathological fractures (2.35, 2.19-2.53). Similar associations were observed for PsA. Pso was also associated with vertebral (1.17, 1.09-1.25), pelvic (1.18, 1.06-1.31), femoral (1.68, 1.601.78), and tibial/fibular fractures (1.28, 1.16-1.41). Whereas, PsA was associated with stress (2.87, 1.08-7.64) and vertebral (1.45, 1.24-1.70), pelvic (1.75, 1.41-2.18), femoral (2.07, 1.85-2.32), and tibial/fibular (1.60, 1.28-2.01) fractures.
Limitations: Data on severity and treatments of Pso were not available.
Conclusion: Pso and PsA were associated with osteopenia, osteoporosis, ankylosing spondylitis, and pathologic fractures.

• 出版日期2017-6
• 单位西北大学