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Psoriasis is a common autoimmune disease, the most serious complication of which is psoriasis arthritis.
although extensive previous studies have focused on the relationship between psoriasis and osteoporosis, the results are inconsistent, leading to a current debate about whether psoriasis causes osteoporosis.
study, published in Ann Rheum Dis, used 432,513 samples from biobanks in the UK to assess the relationship between psoriasis/psoriasis arthritis (PsA) and estimated bone density (eBMD)/osteoporosis using multifaceted linear/logistic regression.
mixing factors are set to three ways: model 0 (including age, height, weight, smoking and alcohol consumption), model 1 (model 0 plus regular physical activity), and model 2 (model 1 plus medication).
eBMD is measured with heel ultrasound.
final analysis included 4,904 psoriasis patients and 847 PSA patients.
used the Mendel Random (MR) method to assess the causal relationship between them.
found that PSA patients with models 0 and 1 had lower eBMD than the control group.
However, when treated with methotrexate or cyclosporine (model 2), the association disappeared, and intermediary analysis showed that 63 per cent of the mediated effects of eBMD were mediated by drug therapy (p.lt;2E-16).
eBMD was no different from that of the control group in patients without arthritis.
, medication can eliminate the risk of osteoporosis in PSA patients (Model 0, OR= 1.27, p=0.002) (Model 2 p=0.244).
psoriasis, which is free of arthritis, is not associated with bone reduction or osteoporosis.
weighted genetic risk scoring analysis found that genetically-related psoriasis/PsA was not associated with eBMD (p=0.24 and p=0.88).
, MR analysis showed no causal relationship between psoriasis/PsA and eBMD, osteoporosis and fractures.
, PsA's effect on osteoporosis is secondary (e.g. medication) and there is no causal relationship.
, psoriasis without arthritis is not a risk factor for osteoporosis.
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