Endocrine and Metabolic Comorbidities in Hospitalized Psoriasis Patients in the United States

Introduction: Psoriasis is a chronic immune-mediated, genetic disease manifesting in the skin or joints or both. Studies have shown an association between psoriasis and metabolic syndrome [1]. However, there is a scarcity of studies on metabolic and endocrine co-morbidities of hospitalized psoriasis patients. This study aims to compare the prevalence of metabolic and endocrine co-morbidities in hospitalized psoriasis patients to hospitalized non-psoriasis patients. Methods: Data were abstracted from the National Inpatient Sample (NIS) 2016 and 2017 Database. NIS is the largest inpatient hospitalization database in the United States. The NIS was searched for hospitalizations for adult patients aged 18 years or above with a principal or secondary diagnosis of psoriasis and those without any diagnosis of psoriasis. Chi-square test was used to compare the prevalence of common metabolic and endocrine comorbidities between psoriasis and non-psoriasis hospitalized patients. Co-morbidities were obtained from secondary diagnoses. We used ICD-10 codes to obtain psoriasis hospitalizations and co-morbidities. STATA, version 16 was used for analysis. Results: There were over 71 million discharges in the combined 2016 and 2017 NIS database. Out of this, 323,405 hospitalizations had a diagnosis of psoriasis. Psoriasis hospitalizations had a higher prevalence of dyslipidemia (41.8% vs 31.8%, p<0.0001), hypothyroidism (15.6% vs 12.0%, p<0.0001), hyperthyroidism (0.6% vs 0.5%, p=0.0133), type 2 diabetes mellitus (31.1% vs 24.5%, p<0.0001), obesity (24.4% vs 14.3%, p<0.0001), Non-alcoholic fatty liver disease (0.9% vs 0.3%, p<0.0001) and similar prevalence of type 1 diabetes mellitus (0.9% vs 0.9%, p=0.1567) compared to non-psoriasis hospitalizations. Conclusion: Hospitalized psoriasis patients have a higher prevalence of dyslipidemia, hypothyroidism, hyperthyroidism, type 2 diabetes mellitus, obesity and non-alcoholic fatty liver disease compared to non-psoriasis hospitalized patients. Endocrinology consultation during hospitalization will be helpful in managing these comorbidities in psoriasis patients. References 1. Gisondi P, Fostini AC, Fossà I, Girolomoni G, Targher G. Psoriasis and the metabolic syndrome. Clin Dermatol. 2018;36(1):21–28. doi:10.1016/j.clindermatol.2017.09.005