Abdominal Visceral Adiposity Is Associated with Coronary Artery Plaque Lipid-Rich Necrotic Core Partly Mediated by Bone Marrow Uptake of 18F-FDG Positron Emission Tomography/Computed Tomography in Psoriasis

Manyak, Grigory A.; Patel, Nidhi; Dey, Amit; Svirydava, Maryia; Parel, Philip M; Teague, Heather; Sorokin, Alexander V.; Teklu, Meron; Zhou, Wunan; Playford, Martin P.; Mehta, Nehal N.

doi:10.1016/j.jid.2021.10.031

Cited by 3 publications

(6 citation statements)

References 11 publications

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“…IFN-γ levels were also elevated in PsA, as was GlycA, a more comprehensive inflammatory marker. PET maximal standardized uptake values (PET-SUV max ) quantify FDG uptake, which provides a radiographic measure of inflammation within tissues ( 3 , 11 ). Bone marrow, liver, and spleen FDG update are associated with systemic inflammation; bone marrow and liver PET-SUV max were significantly elevated in PsA ( 3 , 11 ).…”

Section: Resultsmentioning

confidence: 99%

“…All patients underwent CCTA using a 320-detector row Aquilion ONE ViSION (Toshiba); acquisition details were previously described ( 11 ). All scans were analyzed in a blinded fashion using QAngio CT (Medis).…”

Section: Methodsmentioning

confidence: 99%

“…Patients with fasting glucose >200 mg/dl were excluded. Analysis was done in a blinded fashion using dedicated PET-CT image analysis software (OsirixTM, Pixmeo SARL) as previously described ( 11 ). Visceral and subcutaneous adipose tissue volumes were analyzed using low-dose CT: 100 transverse slices from the caudal sternum to cranial pubic symphysis were interpreted using automated software with contour model algorithm.…”

Section: Methodsmentioning

confidence: 99%

“…Visceral and subcutaneous adipose tissue volumes were analyzed using low-dose CT: 100 transverse slices from the caudal sternum to cranial pubic symphysis were interpreted using automated software with contour model algorithm. Visceral and subcutaneous adipose tissue volumes were demarcated as previously described ( 11 ).…”

Section: Methodsmentioning

confidence: 99%

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PET/CT-Based Characterization of 18F-FDG Uptake in Various Tissues Reveals Novel Potential Contributions to Coronary Artery Disease in Psoriatic Arthritis

Schwartz

Parel

et al. 2022

Front. Immunol.

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Background and ObjectivesPsoriasis is a heterogeneous inflammatory disease that involves the skin, joints, liver, heart, and other organs. Psoriatic arthritis (PsA) is associated with cardiovascular disease (CVD), but the relative contributions of inflammatory and metabolic dysregulation to CVD are incompletely understood. We set out to discover novel potential contributors to CVD in PsA patients by comprehensively phenotyping a cohort of PsA patients using these advanced technologies.MethodsIn this cross-sectional analysis of a cohort study, we investigated associations of systemic inflammation and metabolic dysregulation with Coronary CT angiography (CCTA)-proven coronary artery disease (CAD) in 39 subjects with PsA. We measured traditional CVD risk factors [blood pressure, Body Mass Index (BMI), diabetes, age, sex, smoking], serum markers of systemic inflammation (hsCRP, GlycA) and metabolic dysfunction (cholesterol efflux capacity), and inflammatory cytokines (IL-1β, IL-6, IL-12/IL-23, IL-17A, TNF-α, IFN-γ). We also incorporated radiographic measures of metabolic dysfunction (visceral and subcutaneous adipose volume) and tissue-specific inflammation (positron emission tomography-computed tomography, PET-CT). To quantify relative contributions of FDG (fluorodeoxyglucose) uptake and adiposity to coronary plaque, we performed multiple linear regression, controlling for Framingham risk score (FRS) and FRS + visceral adiposity.ResultsCompared with non-psoriatic volunteers, subjects with PsA had elevated markers of metabolic and inflammatory disease, which was more pronounced in subjects with moderate-to-severe skin disease. This included visceral (p = 0.005) and subcutaneous (p = 0.004) adiposity, BMI (p = 0.001), hemoglobin A1C (p = 0.037), high sensitivity C-reactive protein (p = 0.005), IL-6 (p = 0.003), IFN-γ (p = 0.006), and liver FDG uptake (p = 0.03). In subjects with PsA, visceral adiposity correlated significantly with subclinical CAD (standardized β = 0.681, p = 0.002), as did FDG uptake in bone marrow (standardized β = 0.488, p = 0.008), liver (standardized β = 0.619, p < 0.001), spleen (standardized β = 0.523, p = 0.004), and subcutaneous adipose (standardized β = 0.524, p = 0.003).InterpretationTogether, these findings reveal inflammatory and metabolic potential contributors to subclinical CAD in PsA, including adipose inflammation, and suggesting novel targets for CVD prevention and treatment in PsA.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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PET/CT-Based Characterization of 18F-FDG Uptake in Various Tissues Reveals Novel Potential Contributions to Coronary Artery Disease in Psoriatic Arthritis

Schwartz

Parel

et al. 2022

Front. Immunol.

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“… 74 The distinction between visceral and subcutaneous adiposity is crucial, with visceral adiposity linked to subclinical cardiovascular disease and vascular inflammation in PsA and psoriasis. 75 , 76 The unique subset of adipose tissue macrophages in psoriasis lean towards pro-inflammatory cytokine expression and adipose tissue dysfunction. 77 Additionally, perivascular adipose tissue surrounding blood vessels may contribute to cardiometabolic disease, promoting atherosclerosis through adipokine and chemokine production.…”

Section: Pathophysiological Connectionsmentioning

confidence: 99%

Cardiovascular Considerations and Implications for Treatment in Psoriasis: An Updated Review

Mehta,

Narang,

Dogra

et al. 2024

VHRM

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Psoriasis, a prevalent chronic inflammatory skin disorder affecting 2–3% of the global population, has transcended its dermatological confines, revealing a profound association with cardiovascular diseases (CVD). This comprehensive review explores the intricate interplay between psoriasis and cardiovascular system, delving into genetic links, immune pathways, and adipose tissue dysfunction beyond conventional CVD risk factors. The pathophysiological connections unveil unique signatures, distinct from other inflammatory skin conditions, in particular psoriasis-specific genetic polymorphisms in IL-23 and TNF-α have consistently been linked to CVD. The review navigates the complex landscape of psoriasis treatments, addressing challenges and future directions in particular relevance to CVDs in psoriasis. Therapeutic interventions, including TNF inhibitors (TNFi), present promise in reducing cardiovascular risks, and methotrexate could constitute a favourable choice. Conversely, the relationship between IL-12/23 inhibitors and cardiovascular risk remains uncertain, while recent evidence indicates that Janus kinase inhibitors may not carry CVD risks. Emerging evidence supports the safety and efficacy of IL-17 and IL-23 inhibitors in patients with CVDs, hinting at evolving therapeutic paradigms. Lifestyle modifications, statins, and emerging therapies offer preventive strategies. Dedicated screening guidelines for CVD risk assessment in psoriasis are however lacking. Further, the impact of different disease phenotypes and treatment hierarchies in cardiovascular outcomes remains elusive, demanding ongoing research at the intersection of dermatology, rheumatology, and cardiology. In conclusion, unraveling the intricate connections between psoriasis and CVD provides a foundation for a holistic approach to patient care. Collaboration between specialties, advancements in screening methodologies, and a nuanced understanding of treatment impacts are essential for comprehensive cardiovascular risk management in individuals with psoriasis.

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Impact of GLP-1 Receptor Agonists on Psoriasis and Cardiovascular Comorbidities: A Narrative Review

Haran,

Johnson,

Smith

et al. 2024

PTT

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Psoriasis is an immune-mediated skin disease known to be associated with a higher risk of cardiometabolic comorbidities such as hypertension, myocardial infarction, and stroke. GLP-1 receptor agonists (GLP-1RAs) are medications approved to treat type 2 diabetes mellitus and obesity and have been reported to improve psoriasis. As more psoriasis patients start GLP-1RAs for approved indications, it is of interest to understand the impact of GLP-1RAs on both psoriasis and associated cardiovascular risk. In this review, we examine the effect of GLP-1RAs on psoriasis and cardiovascular comorbidities—defined as hypertension, stroke, and myocardial infarction. The majority of case reports and prospective cohort studies found GLP-1RAs improved psoriasis, while two randomized controlled trials showed conflicting results. For cardiovascular disease, most studies found GLP-1RAs reduced systolic blood pressure, total stroke, and myocardial mortality. These results suggest that GLP-1RAs may be a particularly promising treatment for psoriasis patients with diabetes or obesity comorbidities, offering both cardioprotective benefits and potential improvement in psoriatic symptoms.

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Abdominal Visceral Adiposity Is Associated with Coronary Artery Plaque Lipid-Rich Necrotic Core Partly Mediated by Bone Marrow Uptake of 18F-FDG Positron Emission Tomography/Computed Tomography in Psoriasis

Cited by 3 publications

References 11 publications

PET/CT-Based Characterization of 18F-FDG Uptake in Various Tissues Reveals Novel Potential Contributions to Coronary Artery Disease in Psoriatic Arthritis

PET/CT-Based Characterization of 18F-FDG Uptake in Various Tissues Reveals Novel Potential Contributions to Coronary Artery Disease in Psoriatic Arthritis

Cardiovascular Considerations and Implications for Treatment in Psoriasis: An Updated Review

Impact of GLP-1 Receptor Agonists on Psoriasis and Cardiovascular Comorbidities: A Narrative Review

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