Proteinuria and Psoriasis Risk: A Nationwide Population-Based Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Database
2.2. Measurements and Definitions
2.3. Study Outcomes and Follow-Up
2.4. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Effects of Changes in Proteinuria on Psoriasis Development
3.3. Subgroup Analyses
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Group | Total (n = 6,576,851) | Non-Psoriasis Group (n = 6,414,383) | Psoriasis Group (n = 162,468) | p Value |
---|---|---|---|---|
Age (years) | 48.89 ± 13.53 | 48.83 ± 13.52 | 51.53 ± 13.82 | <0.0001 |
Sex, male (%) | 3,747,448 (56.98) | 3,650,244 (56.91) | 97,204 (59.83) | <0.0001 |
Current smoking | ||||
None | 3,848,988 (58.52) | 3,758,772 (58.6) | 90,216 (55.53) | <0.0001 |
Ex | 1,121,581 (17.05) | 1,090,826 (17.01) | 30,755 (18.93) | |
Current | 1,606,282 (24.42) | 1,564,785 (24.39) | 41,497 (25.54) | |
Drinking | ||||
None | 3,337,444 (50.75) | 3,252,694 (50.71) | 84,750 (52.16) | <0.0001 |
Mild | 2,764,312 (42.03) | 2,698,978 (42.08) | 65,334 (40.21) | |
Heavy 1 | 475,095 (7.22) | 462,711 (7.21) | 12,384 (7.62) | |
Physical activity, regular | 1,340,250 (20.38) | 1,306,224 (20.36) | 34,026 (20.94) | <0.0001 |
Income, low 2 | 1,114,375 (16.94) | 1,085,828 (16.93) | 28,547 (17.57) | <0.0001 |
BMI (kg/m2) | 23.83 ± 3.18 | 23.82 ± 3.18 | 24 ± 3.15 | <0.0001 |
Waist circumference (cm) | 80.62 ± 9.00 | 80.6 ± 9.00 | 81.62 ± 8.97 | <0.0001 |
Diabetes mellitus | 401,418 (6.10) | 389,720 (6.08) | 11,698 (7.20) | <0.0001 |
Hypertension | 921,687 (14.01) | 896,970 (13.98) | 24,717 (15.21) | <0.0001 |
Dyslipidemia | 718,083 (10.92) | 699,779 (10.91) | 18,304 (11.27) | <0.0001 |
Fasting blood glucose (mg/dL) | 96.74 ± 22.39 | 96.71 ± 22.36 | 97.84 ± 23.65 | <0.0001 |
Systolic blood pressure (mmHg) | 122.35 ± 14.69 | 122.33 ± 14.69 | 122.92 ± 14.71 | <0.0001 |
Diastolic blood pressure (mmHg) | 76.36 ± 9.88 | 76.35 ± 9.88 | 76.55 ± 9.82 | <0.0001 |
Total cholesterol (mg/dL) | 195.43 ± 40.62 | 195.42 ± 40.62 | 195.96 ± 40.63 | <0.0001 |
Estimated GFR (mL/min/1.73 m2) | 87.21 ± 45.40 | 87.23 ± 45.46 | 86.37 ± 43.09 | <0.0001 |
F/U duration (years) | 7.23 ± 0.93 | 7.32 ± 0.67 | 3.75 ± 2.14 | <0.0001 |
Characteristics | Never Proteinuria (Neg/Neg) (n = 6,323,475) | Past Proteinuria (Pos/Neg) (n = 119,728) | New Proteinuria (Neg/Pos) (n = 101,698) | Persistent Proteinuria (Pos/Pos) (n = 31,950) | p Value |
---|---|---|---|---|---|
Psoriasis event | 155,413 (2.46) | 3186 (2.66) | 2744 (2.7) | 1125 (3.52) | <0.0001 |
Follow-up duration (years) | 7.24 ± 0.91 | 7.14 ± 1.12 | 7.08 ± 1.25 | 6.91 ± 1.48 | <0.0001 |
Age (years) | 48.73 ± 13.49 | 52.43 ± 13.90 | 52.77 ± 14.31 | 55.87 ± 13.15 | <0.0001 |
Sex, male (%) | 3,604,171 (57.00) | 64,272 (53.68) | 57,672 (56.71) | 21,333 (66.77) | <0.0001 |
Income 1 | 1,068,434 (16.9) | 22,119 (18.47) | 18,210 (17.91) | 5612 (17.56) | <0.0001 |
Exercise 2 | 1,287,705 (20.36) | 24,902 (20.80) | 20,912 (20.56) | 6731 (21.07) | <0.0001 |
Smoking | <0.0001 | ||||
None | 3,699,938 (58.51) | 72,828 (60.83) | 59,386 (58.39) | 16,836 (52.69) | |
Ex- | 1,075,202 (17.00) | 20,709 (17.30) | 18,423 (18.12) | 7247 (22.68) | |
Current | 1,548,335 (24.49) | 26,191 (21.88) | 23,889 (23.49) | 7867 (24.62) | |
Drinking | <0.0001 | ||||
None | 3,199,180 (50.59) | 66,013 (55.14) | 54,373 (53.47) | 17,878 (55.96) | |
Mild | 2,669,906 (42.22) | 44,552 (37.21) | 38,523 (37.88) | 11,331 (35.46) | |
Heavy | 454,389 (7.19) | 9163 (7.65) | 8802 (8.66) | 2741 (8.58) | |
DM | 359,676 (5.69) | 15,426 (12.88) | 17,737 (17.44) | 8579 (26.85) | <0.0001 |
HTN | 861,774 (13.63) | 24,016 (20.06) | 24,827 (24.41) | 11,070 (34.65) | <0.0001 |
Dyslipidemia | 684,227 (10.82) | 14,033 (11.72) | 14,490 (14.25) | 5333 (16.69) | <0.0001 |
BMI (kg/m2) | 23.8 ± 3.16 | 24.34 ± 3.47 | 24.39 ± 3.57 | 25.05 ± 3.65 | <0.0001 |
WC (cm) | 80.54 ± 8.96 | 82.1 ± 9.59 | 82.55 ± 9.79 | 85.1 ± 9.70 | <0.0001 |
Glucose (mg/dL) | 97.07 ± 21.44 | 104.1 ± 32.44 | 109.01 ± 37.87 | 118.63 ± 46.63 | <0.0001 |
SBP (mmHg) | 122.36 ± 14.48 | 125.21 ± 15.75 | 126.91 ± 17.01 | 132.09 ± 17.29 | <0.0001 |
DBP (mmHg) | 76.28 ± 9.75 | 77.49 ± 10.41 | 78.57 ± 11.01 | 80.71 ± 11.24 | <0.0001 |
TC (mg/dL) | 195.04 ± 36.48 | 194.55 ± 38.66 | 197.67 ± 40.82 | 198.9 ± 45.20 | <0.0001 |
HDL | 55.22 ± 21.92 | 54.2 ± 19.28 | 54.43 ± 34.85 | 51.61 ± 17.17 | <0.0001 |
LDL | 114.58 ± 44.17 | 112.92 ± 44.37 | 115.89 ± 56.72 | 114.64 ± 77.38 | <0.0001 |
GFR (mL/min/1.73 m2) | 89.6 ± 37.71 | 86.18 ± 39.33 | 83.98 ± 36.21 | 72.26 ± 42.26 | <0.0001 |
TG | 111.63 (111.58–111.68) | 119.23 (118.84–119.62) | 121.87 (121.43–122.32) | 144.46 (143.54–145.38) | <0.0001 |
Proteinuria | Total (n) | Psoriasis (n) | IR (per 1000) | HR (95% Confidence Interval) | ||
---|---|---|---|---|---|---|
Model 1 | Model 2 | Model 3 | ||||
Never (Neg/Neg) | 6,323,475 | 155,413 | 3.40 | 1 (ref.) | 1 (ref.) | 1 (ref.) |
Past (Pos/Neg) | 101,698 | 2744 | 3.81 | 1.12 (1.08–1.17) | 1.06 (1.02–1.10) | 1.05 (1.01–1.09) |
New (Neg/Pos) | 119,728 | 3186 | 3.73 | 1.10 (1.06–1.14) | 1.04 (1.01–1.08) | 1.03 (1.00–1.07) |
Persistent (Pos/Pos) | 31,950 | 1125 | 5.10 | 1.51 (1.42–1.60) | 1.33 (1.26–1.41) | 1.32 (1.24–1.40) |
p value | <0.0001 | <0.0001 | <0.0001 |
Proteinuria Significance | Total (n) | Psoriasis (n) | IR (per 1000) | HR (95% Confidence Interval) | ||
---|---|---|---|---|---|---|
Model 1 | Model 2 | Model 3 | ||||
2011 | ||||||
Negative | 6,313,688 | 155,308 | 3.40 | 1 (ref.) | 1 (ref.) | 1 (ref.) |
trace | 129,515 | 3291 | 3.54 | 1.04 (1.01–1.08) | 1.01 (0.98–1.05) | 1.01 (0.98–1.05) |
1+ | 88,245 | 2426 | 3.88 | 1.14 (1.10–1.19) | 1.07 (1.03–1.11) | 1.06 (1.02–1.11) |
2+ | 34,340 | 1068 | 4.46 | 1.31 (1.24–1.40) | 1.20 (1.13–1.27) | 1.19 (1.12–1.26) |
3+ | 9353 | 307 | 4.81 | 1.42 (1.27–1.59) | 1.26 (1.13–1.41) | 1.25 (1.12–1.40) |
4+ | 1710 | 68 | 5.93 | 1.78 (1.40–2.25) | 1.60 (1.27–2.03) | 1.58 (1.25–2.00) |
p trend | < 0.0001 | < 0.0001 | < 0.0001 | |||
2009 | ||||||
Negative | 6,279,838 | 154,350 | 3.40 | 1 (ref.) | 1 (ref.) | 1 (ref.) |
trace | 145,335 | 3807 | 3.64 | 1.07 (1.04–1.11) | 1.04 (1.01–1.08) | 1.04 (1.01–1.08) |
1+ | 103,394 | 2802 | 3.80 | 1.12 (1.08–1.16) | 1.06 (1.02–1.10) | 1.05 (1.01–1.09) |
2+ | 37,429 | 1115 | 4.23 | 1.25 (1.18–1.32) | 1.15 (1.08–1.22) | 1.14 (1.08–1.21) |
3+ | 9107 | 333 | 5.29 | 1.57 (1.41–1.75) | 1.42 (1.27–1.58) | 1.40 (1.26–1.56) |
4+ | 1748 | 61 | 5.08 | 1.50 (1.17–1.93) | 1.34 (1.04–1.72) | 1.33 (1.03–1.70) |
p trend | < 0.0001 | < 0.0001 | < 0.0001 |
Proteinuria | Total (n) | Psoriasis (n) | IR (per 1000) | HR (95% CI) Model 3 | Proteinuria | Total (n) | Psoriasis (n) | IR (per 1000) | HR (95% CI) Model 3 |
---|---|---|---|---|---|---|---|---|---|
eGFR < 60 mL/min/1.73 m2 | eGFR ≥ 60 mL/min/1.73 m2 | ||||||||
Never | 312,727 | 8848 | 3.96 | 1 (ref.) | Never | 6,010,748 | 146,565 | 3.37 | 1 (ref.) |
Past | 12,695 | 427 | 4.88 | 1.13 (1.02–1.24) | Past | 107,033 | 2759 | 3.59 | 1.02 (0.98–1.06) |
New | 13,018 | 474 | 5.40 | 1.24 (1.13–1.36) | New | 88,680 | 2270 | 3.59 | 1.01 (0.97–1.05) |
Persistent | 10,075 | 454 | 6.86 | 1.52 (1.38–1.67) | Persistent | 21,875 | 671 | 4.35 | 1.16 (1.07–1.25) |
p value | < 0.0001 | p value | 0.0023 | ||||||
eGFR < 60 mL/min/1.73 m2 | eGFR ≥ 60 mL/min/1.73 m2 | ||||||||
Negative | 314,640 | 8906 | 3.96 | 1 (ref.) | Negative | 5,999,048 | 146,402 | 3.37 | 1 (ref.) |
trace | 10,782 | 369 | 4.90 | 1.16 (1.05–1.29) | Trace | 118,733 | 2922 | 3.42 | 0.99 (0.95–1.03) |
1+ | 11,831 | 432 | 5.37 | 1.22 (1.11–1.35) | 1+ | 76,414 | 1994 | 3.66 | 1.02 (0.98–1.07) |
2+ | 7750 | 318 | 6.21 | 1.40 (1.25–1.57) | 2+ | 26,590 | 750 | 3.98 | 1.09 (1.01–1.17) |
3+ | 2923 | 148 | 7.95 | 1.76 (1.50–2.08) | 3+ | 6430 | 159 | 3.52 | 0.94 (0.81–1.10) |
4+ | 589 | 30 | 8.11 | 1.79 (1.25–2.56) | 4+ | 1121 | 38 | 4.89 | 1.34 (0.98–1.84) |
p trend | <0.0001 | p trend | 0.0817 |
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Bae, E.H.; Kim, B.; Song, S.H.; Oh, T.R.; Suh, S.H.; Choi, H.S.; Kim, C.S.; Ma, S.K.; Han, K.-D.; Kim, S.W. Proteinuria and Psoriasis Risk: A Nationwide Population-Based Study. J. Clin. Med. 2021, 10, 2356. https://doi.org/10.3390/jcm10112356
Bae EH, Kim B, Song SH, Oh TR, Suh SH, Choi HS, Kim CS, Ma SK, Han K-D, Kim SW. Proteinuria and Psoriasis Risk: A Nationwide Population-Based Study. Journal of Clinical Medicine. 2021; 10(11):2356. https://doi.org/10.3390/jcm10112356
Chicago/Turabian StyleBae, Eun Hui, Bongseong Kim, Su Hyun Song, Tae Ryom Oh, Sang Heon Suh, Hong Sang Choi, Chang Seong Kim, Seong Kwon Ma, Kyung-Do Han, and Soo Wan Kim. 2021. "Proteinuria and Psoriasis Risk: A Nationwide Population-Based Study" Journal of Clinical Medicine 10, no. 11: 2356. https://doi.org/10.3390/jcm10112356
APA StyleBae, E. H., Kim, B., Song, S. H., Oh, T. R., Suh, S. H., Choi, H. S., Kim, C. S., Ma, S. K., Han, K.-D., & Kim, S. W. (2021). Proteinuria and Psoriasis Risk: A Nationwide Population-Based Study. Journal of Clinical Medicine, 10(11), 2356. https://doi.org/10.3390/jcm10112356