Atheroma plaque, metabolic syndrome and inflammation in patients with psoriasis

Abstract

Atheroma plaque, metabolic syndrome and inflammation in patients with psoriasisBackground: Chronic inflammation plays an important role in the development of cardiovascular risk factors. Although the prevalence of comorbidities and cardiovascular events has been described in patients with psoriasis, few studies have examined subclinical atherosclerosis in psoriasis patients. Objective: Our objective was to investigate the prevalence of atheroma plaques in patients with severe psoriasis compared with control subjects and to analyze the association with metabolic syndrome, homocysteine levels and inflammatory parameters. Patients and Methods: This case-control study included 133 patients, 72 with psoriasis and 61 controls consecutively admitted to the outpatient clinic in Dermatology Departments (Granada, Spain.) Results: Carotid atheroma plaques were observed in 34.7% of the psoriatic patients versus 8.2% of the controls (p=0.001) and metabolic syndrome was diagnosed in 40.3% of the psoriatic patients versus 13.1% of the controls (p<0.001). Significantly higher mean values of insulin, aldosterone, homocysteine and acute phase parameters (fibrinogen, D-dimer, C reactive protein and erythrocyte sedimentation rate) were found in psoriatic patients. Binary logistic regression showed a strong association between psoriasis and atheroma plaque and metabolic syndrome after controlling for confounding variables. Limitations: The absence of longitudinal quantification of metabolic syndrome parameters and intima-media thickness in psoriatic patients. Conclusion: The chronic inflammation and hyperhomocysteinemia found in psoriatic patients may explain the association with atheroma plaque and metabolic syndrome. Cardiovascular screening by metabolic syndrome criteria assessment and carotid ultrasound in psoriasis may be useful to detect individuals at risk and start preventive treatment against the development of cardiovascular disease.

Association of 25-hydroxyvitamin D with Metabolic Syndrome in Patients with Psoriasis: A Case-control Study

“…Psoriasis has been associated with a higher prevalence of MeS and an increase in cardiovascular events (5)(6)(7), as also observed for other inflammatory dermatological diseases (8).…”

An update on psoriasis and metabolic syndrome: A meta-analysis of observational studies

“…Out of the 35 articles, ten provided adjusted odds ratios after multivariate adjustment for factors such as age, sex, smoking, alcohol consumption, physical activity, and education [31, 34–42]. Among the remaining articles, 16 provided unadjusted odds ratios [30, 43–58], seven provided percent values for metabolic syndrome prevalence [59–65], and two provided specific numbers of patients affected without percent values or odds ratios. For the nine articles that did not provide any odds ratios, we calculated unadjusted odds that were then included in the meta-analysis (Table 1).…”

Impact of effective tumor necrosis factor-alfa inhibitor treatment on arterial intima-media thickness in psoriasis: Results of a pilot study

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