J Korean Med Sci.  2023 Dec;38(49):e377. 10.3346/jkms.2023.38.e377.

Hormone Replacement Therapy and Psoriasis Risk: A Nationwide Population-Based Cohort Study

• Go GM
• Oh HJ
• Han K
• Kim YH
• Lee HJ
• Lee JH

• KMID: 2549174
• DOI: http://doi.org/10.3346/jkms.2023.38.e377

Abstract

Background
Hormone replacement therapy (HRT) is used to relieve menopause symptoms, but has been reported to be associated with coronary heart disease and cancers in women. However, a link between HRT and psoriasis has yet to be established. The aim of this study was to determine the association between HRT and the risk of psoriasis.
Methods
We executed a nationwide population-based study. A total of 1,130,741 postmenopause women were enrolled in the national health care insurance database based on the enrollment criteria. The study population was classified into four groups based on the duration of the HRT, and the risk of psoriasis was analyzed.
Results
The incidence rates of psoriasis per 1,000 person-years were 3.36 and 4.09 in the no history of HRT and ≥ 5 years of HRT, respectively. After adjustment for age, smoking, alcohol intake, regular exercise, body mass index, diabetes mellitus, hypertension, and dyslipidemia, the most prolonged duration of the HRT group (≥ 5 years) exhibited significantly increased risk of developing psoriasis (hazard ratio, 1.22; 95% confidence interval, 1.16–1.29).
Conclusion
We propose that HRT in post-menopausal women is associated with an increased likelihood of psoriasis development.

Keyword

Cohort Study; Epidemiological Study; Hormone Replacement Therapy; Psoriasis; Risk Factor

Figure

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  Fig. 1 Flowchart of the enrollment of the study population in this study.KNHIS = Korean National Health Insurance Service.

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  Fig. 2 Risk of psoriasis according to HRT duration. Model 1: non-adjusted, Model 2: age, Model 3: age, smoking, alcohol intake, regular exercise, and BMI, Model 4: age, smoking, alcohol intake, regular exercise, BMI, diabetes mellitus, hypertension, and dyslipidemia.HRT = hormone replacement therapy, BMI = body mass index.

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