Parul Kathuria1, Kenneth B Gordon1, Jonathan I Silverberg2. 1. Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois. 2. Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Electronic address: JonathanISilverberg@gmail.com.
Abstract
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, 1.60-1.78), 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.
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, 1.60-1.78), 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.
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