Systemic evaluation of the relationship between psoriasis, psoriatic arthritis and osteoporosis: observational and Mendelian randomisation study.

Autor:	Xia J; Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China.; Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China., Xie SY; Binzhou Medical University, Yantai, Shandong, China., Liu KQ; Jiangxi Medical College, Shangrao, Jiangxi, China., Xu L; Binzhou Medical University, Yantai, Shandong, China., Zhao PP; Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China.; Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China., Gai SR; Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China.; Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China., Guan PL; Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China.; Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China., Zhao JQ; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China., Zhu YP; Binzhou Medical University, Yantai, Shandong, China., Tsoi LC; Department of Dermatology, University of Michigan, Ann Arbor, Michigan, United States.; Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan, United States., Stuart PE; Department of Dermatology, University of Michigan, Ann Arbor, Michigan, United States.; Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan, United States., Nair RP; Department of Dermatology, University of Michigan, Ann Arbor, Michigan, United States.; Department of Biostatistics, Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan, United States., Yang HQ; School of Public Health, Boston University, Boston, Massachusetts, United States., Liao YT; School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China., Mao K; School of Cellular and Molecular Medicine, University of Bristol, Bristol, Bristol, United Kingdom., Qiu MC; Jiangxi Medical College, Shangrao, Jiangxi, China., Ying ZM; Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China., Hu B; Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China., Yang ZH; Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.; Department of Orthopedic Surgery, Zhejiang Xiaoshan hospital, Hangzhou, Zhejiang, China., Bai WY; Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China.; Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China., Zhu XW; Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China.; Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China., Cong PK; Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China.; Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China., Elder JT; Department of Dermatology, University of Michigan, Ann Arbor, Michigan, United States.; Ann Arbor Veterans Affairs Hospital, Ann Arbor, Michigan, United States., Ye ZM; Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China., Wang B; Binzhou Medical University, Yantai, Shandong, China., Zheng HF; Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou, Zhejiang, China zhenghoufeng@westlake.edu.cn.; Institute of Basic Medical Sciences, Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China.
Jazyk:	angličtina
Zdroj:	Annals of the rheumatic diseases [Ann Rheum Dis] 2020 Nov; Vol. 79 (11), pp. 1460-1467. Date of Electronic Publication: 2020 Jul 31.
DOI:	10.1136/annrheumdis-2020-217892
Abstrakt:	Objectives and Methods: With 432 513 samples from UK Biobank dataset, multivariable linear/logistic regression were used to estimate the relationship between psoriasis/psoriatic arthritis (PsA) and estimated bone mineral density (eBMD)/osteoporosis, controlling for potential confounders. Here, confounders were set in three ways: model0 (including age, height, weight, smoking and drinking), model1 (model0 +regular physical activity) and model2 (model1 +medication treatments). The eBMD was derived from heel ultrasound measurement. And 4904 patients with psoriasis and 847 patients with PsA were included in final analysis. Mendelian randomisation (MR) approach was used to evaluate the causal effect between them. Results: Lower eBMD were observed in patients with PsA than in controls in both model0 (β-coefficient=-0.014, p=0.0006) and model1 (β-coefficient=-0.013, p=0.002); however, the association disappeared when conditioning on treatment with methotrexate or ciclosporin (model2) (β-coefficient=-0.005, p=0.28), mediation analysis showed that 63% of the intermediary effect on eBMD was mediated by medication treatment (p<2E-16). Patients with psoriasis without arthritis showed no difference of eBMD compared with controls. Similarly, the significance of higher risk of osteopenia in patients with PsA (OR=1.27, p=0.002 in model0) could be eliminated by conditioning on medication treatment (p=0.244 in model2). Psoriasis without arthritis was not related to osteopenia and osteoporosis. The weighted Genetic Risk Score analysis found that genetically determined psoriasis/PsA were not associated with eBMD (p=0.24 and p=0.88). Finally, MR analysis showed that psoriasis/PsA had no causal effect on eBMD, osteoporosis and fracture. Conclusions: The effect of PsA on osteoporosis was secondary (eg, medication) but not causal. Under this hypothesis, psoriasis without arthritis was not a risk factor for osteoporosis. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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