Shu-Hui Wang1, Jui Wang2, Yu-Sheng Lin3, Tao-Hsin Tung4, Ching-Chi Chi5. 1. Department of Dermatology, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate Institute of Applied Science and Engineering, College of Science and Engineering, Fu Jen Catholic University, New Taipei City, Taiwan. 2. Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. 3. Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan. 4. Department of Medical Research and Education, Cheng Hsin General Hospital, Taipei, Taiwan. Electronic address: ch2876@chgh.org.tw. 5. Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: chingchi@cgmh.org.tw.
Abstract
BACKGROUND: The association between psoriasis and thyroid diseases is unclear. OBJECTIVE: To examine the risk for thyroid diseases among psoriasis patients. METHODS: We used Taiwan's National Health Insurance Research Database to conduct a nationwide cohort study. We examined the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for incident thyroid diseases in relation to psoriasis and psoriatic arthritis. RESULTS: We identified 13,266 patients with psoriatic arthritis (psoriatic arthritis group), 149,576 with psoriasis alone (psoriasis group), and 162,842 nonpsoriasis controls. Compared with the nonpsoriasis controls, the psoriatic arthritis and psoriasis groups had increased risk for incident hyperthyroidism (aHR 1.32, 95% CI 1.07-1.65 [psoriatic arthritis]; aHR 1.22, 95% CI 1.11-1.33 [psoriasis]) and Graves disease (aHR 1.38, 95% CI 1.07-1.79 [psoriatic arthritis]; aHR 1.26, 95% CI 1.13-1.41 [psoriasis]). Both groups also had increased risk for incident hypothyroidism (aHR 1.74, 95% CI 1.34-2.27 [psoriatic arthritis]; aHR 1.38, 95% CI 1.23-1.56 [psoriasis]) and Hashimoto thyroiditis (aHR 2.09, 95% CI 1.34-3.24 [psoriatic arthritis]; aHR 1.47, 95% CI 1.18-1.82 [psoriasis]). LIMITATIONS: Lack of data on psoriasis severity. CONCLUSION: People with psoriatic disease are associated with an increased incident thyroid diseases, including hyperthyroidism, hypothyroidism, thyroiditis, Graves disease, and Hashimoto thyroiditis. Endocrinology consultation may be considered when psoriasis patients present with thyroid symptoms.
BACKGROUND: The association between psoriasis and thyroid diseases is unclear. OBJECTIVE: To examine the risk for thyroid diseases among psoriasispatients. METHODS: We used Taiwan's National Health Insurance Research Database to conduct a nationwide cohort study. We examined the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for incident thyroid diseases in relation to psoriasis and psoriatic arthritis. RESULTS: We identified 13,266 patients with psoriatic arthritis (psoriatic arthritis group), 149,576 with psoriasis alone (psoriasis group), and 162,842 nonpsoriasis controls. Compared with the nonpsoriasis controls, the psoriatic arthritis and psoriasis groups had increased risk for incident hyperthyroidism (aHR 1.32, 95% CI 1.07-1.65 [psoriatic arthritis]; aHR 1.22, 95% CI 1.11-1.33 [psoriasis]) and Graves disease (aHR 1.38, 95% CI 1.07-1.79 [psoriatic arthritis]; aHR 1.26, 95% CI 1.13-1.41 [psoriasis]). Both groups also had increased risk for incident hypothyroidism (aHR 1.74, 95% CI 1.34-2.27 [psoriatic arthritis]; aHR 1.38, 95% CI 1.23-1.56 [psoriasis]) and Hashimoto thyroiditis (aHR 2.09, 95% CI 1.34-3.24 [psoriatic arthritis]; aHR 1.47, 95% CI 1.18-1.82 [psoriasis]). LIMITATIONS: Lack of data on psoriasis severity. CONCLUSION:People with psoriatic disease are associated with an increased incident thyroid diseases, including hyperthyroidism, hypothyroidism, thyroiditis, Graves disease, and Hashimoto thyroiditis. Endocrinology consultation may be considered when psoriasispatients present with thyroid symptoms.