Diabetes Increases Cardiovascular Risk in Patients With Psoriasis, Coronary Artery Disease

Patients living with both psoriasis and coronary artery disease face a significantly higher risk of major cardiovascular complications if they also have diabetes, according to a new study.¹ Researchers found that diabetes independently predicted major adverse cardiovascular events (MACE), especially among male patients and those without chronic kidney disease, underscoring the need for targeted risk assessment and management in this high-risk population.

This single-center, retrospective cohort study is published in BMC Endocrine Disorders.

New research identifies diabetes as an independent predictor of major adverse cardiovascular events in patients with both psoriasis and coronary artery disease. | Image credit: hirakun - stock.adobe.com

“These findings highlight the potential for biologic therapies to improve both dermatologic and systemic inflammatory profiles in this population,” wrote the researchers of the study. “This is a large study on the prognostic value of diabetes on adverse cardiovascular events in patients with psoriasis and coronary artery disease.”

Previously, a study published in Cureus confirmed significant associations between psoriasis and key metabolic disorders—including type 2 diabetes, hypertension, hyperlipidemia, and obesity—across a combined cohort of 6.6 million individuals, underscoring the importance of routine metabolic screening, risk management, and careful selection of psoriasis therapies that may impact metabolic health.²

The current study analyzed clinical data from adult patients diagnosed with both psoriasis and coronary artery disease who were admitted to the hospital between January 2017 and May 2022.¹ Patients were grouped based on the presence or absence of diabetes, and their medical records were reviewed to compare baseline characteristics, comorbidities, and laboratory values.

Among the 305 patients with psoriasis and coronary artery disease, 147 (48.2%) had diabetes. Compared with those without diabetes, those with diabetes were more likely to have hypertension (80.3% vs 71.2%; P = .045), peripheral vascular disease (18.4% vs 10.6%; P = .043), and a history of stroke (14.3% vs 7.2%; P = .041).

Additionally, patients with diabetes also had higher mean levels of low-density lipoprotein cholesterol (3.12 mmol/L vs. 2.88 mmol/L; P = .039) and homocysteine (14.9 μmol/L vs. 12.6 μmol/L; P = 0.006). After a median follow-up of 36 months, the incidence of MACE was significantly higher in the diabetic group (28.6% vs. 17.8%; P = .032). Regression analysis confirmed diabetes as an independent predictor of MACE (HR, 1.67; 95% CI, 1.02-2.75; P = .039). Furthermore, subgroup analysis showed that the association between diabetes and MACE was particularly significant in male patients (P = .008) and those without chronic kidney disease (P = .021).

However, the researchers acknowledged several limitations of the study, including being conducted at a single study center and being retrospective in design. Additionally, the accuracy of diagnoses and clinical data relied on existing medical records, which may have had documentation errors. Moreover, the relationship between the onset of psoriasis and diabetes could not be clearly established, restricting insight into how disease sequence may affect cardiovascular risk. Lastly, the use of anonymized data limited the ability to conduct more detailed analyses of individual risk factors.

Despite these limitations, the researchers believe the study suggests an association between diabetes and risk of MACE in this patient population.

“Diabetes in patients with psoriasis and coronary artery disease is linked with cardiovascular adverse events,” wrote the researchers. “These findings have important implications for the risk assessment for patients with psoriasis and coronary artery disease. Considering the prevalence of diabetes and psoriasis in the world, our findings have public health implications.”

References

1. Zhao L, Sun L, Yang K, et al. Diabetes is associated with a poor prognosis in patients with psoriasis and coronary artery disease. BMC Endocr Disord. 2025;25(1):174. doi:10.1186/s12902-025-01996-z

2. Steinzor P. Psoriasis linked to metabolic disorders in adult patients, study finds. AJMC^®. January 27, 2024. Accessed July 16, 2025. https://www.ajmc.com/view/psoriasis-linked-to-metabolic-disorders-in-adult-patients-study-finds