Health Boards
Wed-23-05-2012, 13:38 PM
Objective: To examine the association between total physical activity, walking, and vigorous exercise and the incidence of psoriasis in women.
Design: Cohort study.
Setting: The Nurses' Health Study II, a cohort of 116 430 women aged 27 to 44 years in 1991.
Participants: The study population included 86 655 US female nurses who reported whether they had ever been diagnosed as having psoriasis and who completed detailed physical activity questionnaires in 1991, 1997, and 2001. We excluded participants with a history of psoriasis prior to 1991.
Main Outcome Measures: Risk of psoriasis by quintile of physical activity as measured by a metabolic equivalent task score.
Results: We documented 1026 incident psoriasis cases during 1 195 703 person-years of follow-up (14 years, 1991-2005). After adjusting for age, smoking, and alcohol use, increasing physical activity was inversely associated with the risk of psoriasis. The most physically active quintile of women had a lower multivariate relative risk (RR) of psoriasis (0.72 [95% CI, 0.59-0.89; P < .001 for trend]) compared with the least active quintile. Vigorous physical activity (≥6 metabolic equivalents) was associated with a reduced risk of psoriasis (multivariate RR for the highest quintile, 0.66 [95% CI, 0.54-0.81; P < .001 for trend]); this association remained significant after adjusting for body mass index (RR, 0.73 [95% CI, 0.60-0.90; P = .009 for trend]). Walking was not associated with psoriasis risk. In a subset of 550 confirmed psoriasis cases, we observed a similarly reduced risk of psoriasis associated with vigorous physical activity (multivariate RR for the highest quintile, 0.64 [95% CI, 0.48-0.86; P = .03 for trend]).
Conclusion: In this study of US women, vigorous physical activity is independently associated with a reduced risk of incident psoriasis.
Psoriasis is an immunologic disorder characterized by systemic inflammation and cutaneous plaques.1 Prospective studies have demonstrated that higher body mass index (BMI),2 weight gain, alcohol intake,3 and smoking4 are associated with an increased risk of psoriasis. However, the role of physical activity in psoriasis prevention remains undetermined. Results from cross-sectional studies have been inconsistent; an association between psoriasis and physical inactivity was observed in some studies5 - 6 but not in others.7 The Iowa Women's Health Study found that women who engaged in regular physical activity were less likely to have psoriasis than women who denied exercising regularly (age-adjusted odds ratio, 0.8 [95% CI, 0.7-0.9]).5 Another study found no difference in mean physical activity between women with and without psoriasis.7 These cross-sectional analyses did not adjust for other lifestyle factors, such as BMI, that may vary across groups of differing physical activity levels and do not permit a determination of cause and effect. No prospective studies have evaluated the association between physical activity and incident psoriasis.
Physical activity has been associated with a decreased risk of disorders characterized by systemic inflammation, including type 2 diabetes mellitus,8 colon cancer,9 coronary artery disease,10 and breast cancer.11 Walking and vigorous exercise appear to have an equal role in reducing the risk of developing coronary artery disease, type 2 diabetes, and breast cancer. A dose-response relationship has also been demonstrated, with higher amounts of physical activity associated with a lower risk of disease. The relative effects of walking and vigorous activity on psoriasis risk and the dose-response relationship between physical activity and psoriasis remain unknown. It is biologically plausible that physical activity may affect psoriasis risk through effects on systemic inflammatory mediators.
In this study, we prospectively evaluated the association between physical activity and incident psoriasis in a large cohort of women in the United States. We also assessed the association between type of physical activity (eg, walking vs vigorous exercise) and the risk of psoriasis, using detailed, repeated assessments of physical activity, and validated our findings in a subset of confirmed psoriasis cases.
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Design: Cohort study.
Setting: The Nurses' Health Study II, a cohort of 116 430 women aged 27 to 44 years in 1991.
Participants: The study population included 86 655 US female nurses who reported whether they had ever been diagnosed as having psoriasis and who completed detailed physical activity questionnaires in 1991, 1997, and 2001. We excluded participants with a history of psoriasis prior to 1991.
Main Outcome Measures: Risk of psoriasis by quintile of physical activity as measured by a metabolic equivalent task score.
Results: We documented 1026 incident psoriasis cases during 1 195 703 person-years of follow-up (14 years, 1991-2005). After adjusting for age, smoking, and alcohol use, increasing physical activity was inversely associated with the risk of psoriasis. The most physically active quintile of women had a lower multivariate relative risk (RR) of psoriasis (0.72 [95% CI, 0.59-0.89; P < .001 for trend]) compared with the least active quintile. Vigorous physical activity (≥6 metabolic equivalents) was associated with a reduced risk of psoriasis (multivariate RR for the highest quintile, 0.66 [95% CI, 0.54-0.81; P < .001 for trend]); this association remained significant after adjusting for body mass index (RR, 0.73 [95% CI, 0.60-0.90; P = .009 for trend]). Walking was not associated with psoriasis risk. In a subset of 550 confirmed psoriasis cases, we observed a similarly reduced risk of psoriasis associated with vigorous physical activity (multivariate RR for the highest quintile, 0.64 [95% CI, 0.48-0.86; P = .03 for trend]).
Conclusion: In this study of US women, vigorous physical activity is independently associated with a reduced risk of incident psoriasis.
Psoriasis is an immunologic disorder characterized by systemic inflammation and cutaneous plaques.1 Prospective studies have demonstrated that higher body mass index (BMI),2 weight gain, alcohol intake,3 and smoking4 are associated with an increased risk of psoriasis. However, the role of physical activity in psoriasis prevention remains undetermined. Results from cross-sectional studies have been inconsistent; an association between psoriasis and physical inactivity was observed in some studies5 - 6 but not in others.7 The Iowa Women's Health Study found that women who engaged in regular physical activity were less likely to have psoriasis than women who denied exercising regularly (age-adjusted odds ratio, 0.8 [95% CI, 0.7-0.9]).5 Another study found no difference in mean physical activity between women with and without psoriasis.7 These cross-sectional analyses did not adjust for other lifestyle factors, such as BMI, that may vary across groups of differing physical activity levels and do not permit a determination of cause and effect. No prospective studies have evaluated the association between physical activity and incident psoriasis.
Physical activity has been associated with a decreased risk of disorders characterized by systemic inflammation, including type 2 diabetes mellitus,8 colon cancer,9 coronary artery disease,10 and breast cancer.11 Walking and vigorous exercise appear to have an equal role in reducing the risk of developing coronary artery disease, type 2 diabetes, and breast cancer. A dose-response relationship has also been demonstrated, with higher amounts of physical activity associated with a lower risk of disease. The relative effects of walking and vigorous activity on psoriasis risk and the dose-response relationship between physical activity and psoriasis remain unknown. It is biologically plausible that physical activity may affect psoriasis risk through effects on systemic inflammatory mediators.
In this study, we prospectively evaluated the association between physical activity and incident psoriasis in a large cohort of women in the United States. We also assessed the association between type of physical activity (eg, walking vs vigorous exercise) and the risk of psoriasis, using detailed, repeated assessments of physical activity, and validated our findings in a subset of confirmed psoriasis cases.
Source: NO LINKS ALLOWED