title: Diabetes incidence in psoriatic arthritis, psoriasis and rheumatoid arthritis: a UK population-based cohort study.
abstract: OBJECTIVE
  The objective of this study was to evaluate the incidence of diabetes among patients with PsA and RA in the general population.
  
  
  METHODS
  We conducted a cohort study using an electronic medical records database representative of the UK general population (1986-2010). We estimated hazard ratios (HRs) for incident diabetes in PsA, psoriasis and RA cohorts compared with age- and sex-matched comparison cohorts without the corresponding conditions, adjusting for BMI, smoking, alcohol use, co-morbidities and glucocorticoids at baseline.
  
  
  RESULTS
  Cohorts included 4196 persons with PsA, 59 281 with psoriasis and 11 158 with RA, with mean follow-up times of 5.9, 5.8 and 5.5 years, respectively. Incidence rates for diabetes were 7.3, 6.4 and 6.3 cases per 1000 person-years among individuals with PsA, psoriasis and RA, respectively. Age- and sex-matched HRs for diabetes were 1.72 (95% CI 1.46, 2.02) in PsA, 1.39 (95% CI 1.32, 1.45) in psoriasis and 1.12 (95% CI 1.01, 1.25) in RA. After adjustment for BMI, smoking and alcohol, the HRs were attenuated substantially (1.43, 1.24 and 1.00, respectively). With further adjustment for baseline glucocorticoid use and co-morbidities, the HRs were 1.33 (1.09, 1.61) in PsA, 1.21 (1.15, 1.27) in psoriasis and 0.94 (0.84, 1.06) in RA.
  
  
  CONCLUSIONS
  This general population study suggests an increased incidence of diabetes in PsA and RA, which is substantially explained by obesity and lifestyle factors. These findings support the importance of managing such factors in PsA and RA patients.
authors.affiliation: Section of Rheumatology and the Clinical Epidemiology Unit, Boston University School of Medicine, 650 Albany Street, Suite 201, Boston, MA 02118, USA. maureen.dubreuil@bmc.org.
authors.forename: Maureen
authors.initials: M
authors.lastname: Dubreuil
authors.forename: Young Hee
authors.initials: YH
authors.lastname: Rho
authors.forename: Ada
authors.initials: A
authors.lastname: Man
authors.forename: Yanyan
authors.initials: Y
authors.lastname: Zhu
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Zhang
authors.forename: Thorvardur Jon
authors.initials: TJ
authors.lastname: Love
authors.forename: Alexis
authors.initials: A
authors.lastname: Ogdie
authors.forename: Joel M
authors.initials: JM
authors.lastname: Gelfand
authors.forename: Hyon K
authors.initials: HK
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000150:complications / Q000453:epidemiology; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D011565:Psoriasis / Q000150:complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology
keywords: diabetes; psoriasis; psoriatic arthritis; rheumatoid arthritis