Risk of Psoriasis in Patients with Polycystic Ovary Syndrome: A National Population-Based Cohort Study.

Tsung-Hsien Lee,Maw-Sheng Lee,Hei-Tung Yip,Cheng-Hsuan Wu,Chun-I Lee,James Cheng-Chung Wei,Ming-Li Chen

doi:10.3390/jcm9061947

Abstract

Both polycystic ovary syndrome (PCOS) and psoriasis are associated with insulin resistance and metabolic syndrome. Nonetheless, the incidence of psoriasis in patients with PCOS is unclear. We used the Longitudinal Health Insurance Research Database (LHID) in Taiwan from 2000 to 2012 to perform a retrospective population-based cohort study to elucidate the occurrence of psoriasis in PCOS patients. Patients with PCOS without psoriasis in the index year (the year of PCOS diagnosis) were recruited as the PCOS group. Those without PCOS nor psoriasis (control group) were selected using propensity score matching at a ratio of 4:1. Hazard ratios (HRs) were obtained using the Cox proportional hazards regression model. In total, 4707 and 18,828 patients were included in the PCOS and control groups, respectively. The incidence rates of psoriasis in the control and PCOS groups were 0.34 and 0.70 per 1000 person-years, respectively. The risk of psoriasis was higher in the PCOS group by an HR of 2.07 (95% confidence interval [CI] = 1.25–3.43) compared with the control group. In conclusion, the incidence of psoriasis in the PCOS group was higher than that in the control group. Further studies should be conducted to investigate the mechanism underlying the association, and to benefit the long-term management of patients with PCOS.

Highlights

Polycystic ovary syndrome (PCOS) is a chronic anovulation disorder, and it is diagnosed if two of three diagnostic criteria are met: oligomenorrhea, hyperandrogenism, and polycystic ovarian morphology [1]
The cumulative incidence curve of psoriasis was higher in the PCOS group than in the control group (p = 0.004, log-rank test, Figure 1)
The PCOS group showed a higher risk of psoriasis by an Hazard ratios (HRs) of 2.07 (95% confidence interval [CI] = 1.25–3.43, p < 0.01) compared with the control group

Summary

Introduction

Polycystic ovary syndrome (PCOS) is a chronic anovulation disorder, and it is diagnosed if two of three diagnostic criteria are met: oligomenorrhea, hyperandrogenism, and polycystic ovarian morphology [1]. Elevated androgen and insulin resistance are key pathologic features of PCOS [2]. Hyperinsulinemia, dyslipidemia and dysglycemia (fasting glucose > 100 mg/dL) resulted from insulin resistance in PCOS patients [3]. Such metabolic effects composed metabolic syndrome in adults. Psoriasis is a chronic skin inflammatory disease, featuring scaly and erythematous plaques. Patients with psoriasis were reported to be at risk of PCOS in a cross-sectional study in Italy [7], as both PCOS and psoriasis are correlated with hyperandrogenism and metabolic syndrome. Since insulin resistance and metabolic syndrome are common features to PCOS and psoriasis, we propose that patients with PCOS might have a high incidence of psoriasis.

Data Source

Study Participants

Main Outcome and Comorbidities

Statistical Analysis

Results