Gallstones associated with an increased risk of psoriasis

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This study looked at personal history of gallstones and risk of incident psoriasis and psoriatic arthritis in U.S. women.

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Background:
Metabolic syndrome has been associated with both gallstones and psoriasis, suggesting a potential biological linkage between gallstones and psoriasis. However, the association between gallstones and psoriasis has not yet been studied.

Objective:
To investigate the association between gallstones and psoriasis.

Design:
Prospective cohort study.

Setting:
Nurses’ Health Study II (1991-2005).

Participants:
89,230 women aged 25 to 42 years who were free of psoriasis at baseline and responded to a 2005 follow-up questionnaire regarding their diagnosis of psoriasis.

Main Outcomes and Measures:
Relative risk (RR) of developing psoriasis or psoriatic arthritis (PsA), which were self-reported and validated by supplemental questionnaires.

Results:
In this population of women, 2,206 participants had gallstones confirmed by a history of cholecystectomy at baseline. A total of 642 individuals had a diagnosis of incident psoriasis, of which 157 had concomitant PsA. After adjusting for known risk factors of psoriasis besides body mass index (BMI), a baseline history of cholecystectomy-confirmed gallstones was associated with increased risk of psoriasis (multivariate-adjusted RR = 2.20, 95% CI: 1.56, 3.10) and concomitant PsA (multivariate-adjusted RR = 4.41, 95% CI: 2.70, 7.18). After additionally adjusting for BMI, the fully-adjusted RRs associated with a history of cholecystectomy-confirmed gallstones were 1.70 (95% CI: 1.20,2.41) for psoriasis and 2.96 (95% CI: 1.80, 4.89) for PsA.

Conclusions and Relevance:
Personal history of gallstones was associated with an increased risk of psoriasis and PsA, independent of obesity in a cohort of US women.

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