乾癬與尿路結石在不同膚色族群中特異性相關性的分析：基於全球TriNetX資料庫的研究

盧致誠^1.2 蕭均庭³ 葉志嶸³

¹奇美醫療財團法人柳營奇美醫院 外科部 泌尿外科 ²國立中正大學 資訊管理學系 ³中山醫學大學公共衛生學系

The Association Between Psoriasis and Urinary Stones Across Different Ethnicities: An Analysis Based on the Global TriNetX Database

Chih-Cheng Lu^1,2, Chun-Ting Hsiao³ Chih-Jung Yeh³    

¹Division of Urology, Department of Surgery, Chi Mei Medical Center, Liouying, Tainan

²Department of Information Management, National Chung Cheng University, Chiayi

³Chung Shan Medical University

Purpose:

Previous research has identified a potential association between urinary tract stones and psoriasis, attributing this link to the metabolic abnormalities frequently observed in patients with psoriasis. To investigate this relationship on a global scale, the TriNetX database was utilized, offering a comprehensive platform for large-scale analysis.

Materials and Methods:

A retrospective cohort study was conducted utilizing data from the TriNetX global health database to evaluate the incidence of urinary stones among individuals with psoriasis in comparison to a control group without psoriasis, spanning the period from 2019 to the end of 2023. To account for potential confounding variables, the analysis included adjustments for factors such as age, sex, race, body mass index, healthcare utilization, hypertension, hyperlipidemia, diabetes, and nicotine dependence. Propensity score matching was employed to ensure comparable baseline characteristics between the psoriasis and control groups. Using the matched dataset, statistically adjusted hazard ratios were calculated to provide a precise estimation of the association between psoriasis and the subsequent risk of urinary stone development.

Results:

The hazard ratio for developing urinary stones in individuals with psoriasis was 1.315 [95% CI: 1.245–1.388], with an increased risk specifically for kidney and ureter stones reported at 1.329 [95% CI: 1.257–1.405]. Racial stratification revealed that white individuals with psoriasis had a stone risk ratio of 1.340 [95% CI: 1.26–1.43], with an even greater risk observed among black individuals with psoriasis. When analyzed by sex, women with psoriasis exhibited a higher risk of urinary stones, with a hazard ratio of 1.399 [95% CI: 1.28–1.53], compared to men with psoriasis, who had a risk of 1.290 [95% CI: 1.19–1.40]. Age-based stratification demonstrated that individuals with psoriasis aged 18–64 showed a risk ratio of 1.370 [95% CI: 1.28–1.47], while those aged 65 or older had a similar risk at 1.380 [95% CI: 1.27–1.49].

Conclusion:

Psoriasis is associated with a greater risk of urinary stones when compared to individuals without the condition, a finding consistent across various sex, age, and racial groups. Black psoriasis with higher risk was found, and for those with psoriasis, early intervention in high-risk populations is essential. Further research is needed to explore the biological mechanisms underlying the connection.