Epidemiological investigation of dietary risk factors in patients with psoriasis vulgaris

1.Introduction of psoriasis treatment

Psoriasis is a common chronic relapsing inflammatory skin disease, the cause of which is not yet fully understood, nor can it be completely cured, often bringing great economic burden and mental pressure to patients and their families.At present, studies believe that psoriasis is the result of multiple factors such as immune, endocrine, metabolic, environmental, mental and emotional factors under the control of genetic background. Dietary factors are associated with the incidence of psoriasis to some extent, but there are few related literatures.This study investigated the dietary status of 350 patients with primary psoriasis and 350 healthy controls before the investigation, and analyzed the relationship between dietary factors and the incidence of psoriasis.Objective to explore the dietary risk factors related to psoriasis and provide scientific reference for effective prevention of psoriasis.

2.Materials and methods of psoriasis treatment

2.1Research object

The patients in the case group were patients with primary psoriasis who were admitted to the undergraduate outpatient and ward from January 2015 to December 2016.Diagnosed as psoriasis vulgaris, the course of less than 2 years.Exclusion criteria: a history of systemic or allergic disease.The control group was the family members of the patients in several wards of the hospital and the personnel of the physical examination center. There was no history of systemic disease, allergic disease and psoriasis, and the family members had no history of psoriasis.All subjects in this study were informed

Emotional consent process.

2.2Research method

A questionnaire was designed according to the literature and dietary questions frequently consulted by patients with psoriasis in clinical practice.The validity and acceptability of the questionnaire were analyzed by pre-survey before the formal study. The average completion time of the pre-survey was 5 ~ 9min, and the completion rate and recovery rate reached 100%.All researchers received unified training before the study to ensure that case group and control group were screened strictly according to the program requirements.In the process of issuing, guiding and retrieving the questionnaire, the researcher only gives a reasonable and appropriate explanation of the survey questions, and no inductive or focused inquiry is allowed, so as to avoid all kinds of bias.After the survey, the researchers carefully checked the collected data to avoid filling in the wrong information or missing information, and collected the questionnaires on the spot.The main contents of the questionnaire include: (1) general information: age, gender, body mass index, nationality, place of residence, education level, income level, family history, course of psoriasis;(2) risk factors: including drinking, smoking, seafood, red meat, eggs, spicy food, high fat food, high salt food, high sugar food and coffee, respectively, the frequency of intake and single intake;(3) definition of risk factors: the patients in this study were newly diagnosed psoriasis (the onset time was within 2 years), and the risk factors must be exposed to within 12 months before the onset of psoriasis.

2.3Determination of each observation index

Single consumption: very small amount of beer < 250mL/ wine < 100mL/38 liquor < 50g;A small amount is 250 ~ 500mL beer/wine 100 ~ 200mL/38 white spirit 50 ~ 100g/ high white spirit < 50g;The medium amount is 500 ~ 750mL beer/wine 200 ~ 300mL/38 white spirit 100 ~ 150g/ high white spirit 50 ~ 100g;Large quantities of beer > 750mL/ wine > 300mL/38 white wine > 150g/ high white wine > 100g.Frequency of seafood consumption, frequency of beef and mutton, frequency of eggs, frequency of alcohol consumption, frequency of spicy diet, frequency of high-fat diet, frequency of high-salt diet, frequency of high-sugar diet: no consumption, 1-2 times/month, 3-4 times/month, 2-3 times/week, 5 levels per day;Single consumption of seafood, beef and mutton: not edible, < 500g and 500g;Single egg consumption: divided into not edible, each time 1, each time 2, each time 3 or more 4 grades;Smoking: non-smoking, occasional smoking, less than 10 cigarettes a day, 10 ~ 20 cigarettes a day, more than 20 cigarettes a day 5 grades;Coffee: no consumption, 1 to 3 cups/month, 1 to 3 cups/week, 1 to 2 cups/day, 3 cups/day or more.

2.4Statistical treatment

After all the data were collected, the researchers checked again whether the questionnaires were filled in incorrectly or not, to ensure the accuracy of the data. The data were entered into epidata3.1 to establish a database.Counting data were expressed in frequency (%), and the general situation of the case group and the control group was compared by 2 test.Comparison of dietary intake frequency and single intake between the case group and the control group was conducted by mann-whitney U test according to grade data, and values were assigned from low to high according to intake frequency and single intake level.The statistical analysis software was spss19.0, and bilateral tests were used. When P < 0.05, the difference was considered statistically significant.

3.Results of psoriasis treatment

3.1The general comparison between the case group and the control group is shown in table 1.

A total of 350 questionnaires were distributed to the case group, and 350 were recovered. The recovery rate was 100%.A total of 362 questionnaires were issued to the control group, and 362 were recovered. The recovery rate was 100%, 350 valid questionnaires were issued, and the effective rate was 96.69%(the reasons for the invalid questionnaires included: too short time to answer the questionnaires, logic errors in the questions, and consistent answers to all questions).The differences in gender, age, education level and income level between the case group and the control group were not statistically significant (all P < 0.05).

3.2The comparison of dietary intake of high protein between the case group and the control group is shown in table 2.

There was no statistically significant difference between the two groups in the frequency and single consumption of seafood, beef, mutton and eggs (P > 0.05).

3.3The adverse diet and stimulant diet intake of the case group and the control group were compared as shown in table 3.

Patients in the case group had a higher proportion of high frequency and high intake of drinking frequency, single drinking quantity, smoking quantity, high-fat food and high-sugar food diet than those in the control group, and the differences between the two groups were statistically significant (P < 0.05).There was no significant difference in spicy food, salty food and coffee consumption between the two groups (P > 0.05).

4.Discussion of psoriasis treatment

The study results show that the frequency of CPT in drinking, a single drinking, smoking, high fat, high sugar foods high frequency, high intake of proportion are higher than the control group, two groups of comparisons difference was statistically significant (P < 0.05), the above factors associated with the onset of an ordinary psoriasis, is a risk factor for the pathogenesis of psoriasis diet.

In recent years, a number of studies have shown that alcohol consumption is an important risk factor for psoriasis, which is consistent with the results of this study.In this study, the proportion of daily drinking in case group and control group was 5.14% and 1.71%, respectively, and the proportion of single heavy drinking was 9.43% and 3.14%, respectively. The results confirmed that both frequent drinking and single heavy drinking were risk factors for psoriasis.Psoriasis patients are susceptible individuals controlled by genetic background. Under the effect of alcohol vasodilation, the permeability of dermal blood vessels is significantly increased, and the overflow of neutrophils and lymphocytes is increased, and the infiltration to the epidermis is enhanced.Alcohol can inhibit the signal transduction of protein kinase C isomerase family, regulate the ratio of cGMP/cAMP, and lead to excessive proliferation of epidermal cells.Long-term or heavy drinking will have a certain inhibitory effect on the immune system of the body. Alcohol interferes with the function of T cells, thus affecting the cell-mediated immune response. Studies have shown that alcoholics are more prone to multiple infections, and their ability to remove bacteria decreases, which indirectly increases the risk of psoriasis.

More and more evidence that smoking and psoriasis have a clear correlation.A cohort study by Li et al. showed that smoking is a risk factor for psoriasis in both men and women.A cross-sectional study by Fortes et al. found that the risk of psoriasis increased with the amount of smoking, and the trend was more obvious in women.In this study, the proportion of smokers in the case group was significantly higher than that in the control group (P < 0.05), and the proportion of daily smoking was 22.86% and 12.57%, respectively, which further confirmed that smoking was a risk factor for psoriasis.Smoking can induce psoriasis through oxidation, inflammation and genetic mechanisms.Oxidative free radicals produced by smoking stimulate the activation of signaling pathways in psoriasis cells, including mitogen-activated protease (MAPK), nuclear factor-b (nf-b), Janus kinase/signal transducers and transcriptional activators (jak-stat).Nicotine stimulates the release of cytokines by natural immune cells (dendritic cells, macrophages, keratinocytes) related to the pathogenesis of psoriasis to activate T lymphocytes, leading to the persistent inflammatory state of the body.Smoking also increased the expression of hla-cw6, hla-dqa1 *0201 and CYP1A1 genes, which are associated with the risk of psoriasis.

The results of this study showed that the two groups also had significant differences in high-fat and high-sugar diets, among which 49.14% and 34.00% consumed high-fat foods more than three times a month, and 67.71% and 53.71% consumed high-sugar foods more than three times a month, respectively.The reasons may be related to the occurrence of metabolic abnormalities such as abdominal obesity, abnormal lipid metabolism, disregulation of glucose metabolism, and insulin resistance, which are often associated with long-term high-cholesterol, high-saturated fatty acids and high-sugar diets.Recent studies have shown that metabolic abnormalities are closely related to psoriasis, and a variety of inflammatory factors and pro-inflammatory factors play an important role in the occurrence, development and maintenance of psoriasis.

In addition, the results of this study did not suggest that eating spicy, salted vegetables, seafood, beef, lamb, eggs, and coffee habits are associated with the incidence of psoriasis, which is different from the results of previous studies on dietary risk factors of psoriasis.Wei shengcai et al. showed that consumption of fish and shrimp is a risk factor for psoriasis, which may be related to heterogeneous protein allergy or protein metabolism disorder caused by fish and shrimp.And the survey of several common high protein diets include fish and shrimp are not present positive results, analysis of the reason may be related to subjects except the sensitive individuals, groups and survey strictly as incipient ordinary psoriasis (2 years), the investigation of time limit for the 12 months before the onset of psoriasis, except the sick patients with psychological factors and inherent cognitive may investigate the subjective influence of exposure factors;May also with the survey population long-term residence in north China area is given priority to, to the previous investigation in the north-south differences in eating habits and food tolerance, the prompt risk factors in the further research this kind of diet in the future, it is necessary to increase the survey sample size, at the same time in different areas of the national multicenter epidemiological investigation.

In short, psoriasis is under the control of genetic background, susceptible individuals in the environment, metabolism, immunity and other factors, life, diet habits also play an important role.The results of this study showed that smoking, drinking frequency, single consumption, high fat and high sugar diet are risk factors of psoriasis, other dietary habits and psoriasis did not have significant correlation.Psoriasis prevention should try to reduce the exposure of these dietary risk factors, while taking into account the quality of life, healthy eating habits, individualized, avoid blind diet mistakes.

5.Conclusion of psoriasis treatment

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