Dyslipidemia in psoriasis: as a risk for cardiovascular disease

Abstract

INTRODUCTIONPsoriasis is a common chronic recurrent inflammatory skin disorder characterized by hyperproliferation and reduced differentiation of keratinocytes. It is a life long chronic inflammatory condition affecting approximately 2% of general population.1 The etiology is still unknown, while genetic, metabolic and immunological mechanism has been implicated. Psoriasis has been associated with an increased morbidity and mortality from high frequency of cardiovascular events. This seems to be related to the severity of psoriasis, considering that it occurs much more frequently in patients presenting with large areas of body affected with psoriatic lesions. However, the pathogenesis of atherothrombotic events in psoriasis patients remains to be recognized. Multiple factors including abnormal lipids and lipoprotein profiles and risk factors such as hypertension, obesity, diabetes mellitus have been associated with psoriasis.3 Several reports suggests that psoriatic patients have proatherogenic lipid profile including increased levels of serum triglycerides, LDL-cholesterol, VLDL-cholesterol and low HDL-cholesterol levels. However, studies are ABSTRACT Background: Psoriasis is a common and recurrent proliferative inflammatory skin disease that has been associated with abnormal plasma lipid metabolism and with high frequency of cardiovascular morbidity and mortality. The prevalence seems to be related to the severity of psoriasis, as it occurs more frequently in patients presenting with large areas of the body affected with lesions. The aim of our work was to evaluate the development of dyslipidemia in psoriasis, and to look for a correlation between their levels and severity of diseases in which the risk factors and secondary causes of hyperlipidemia were excluded. Methods: We evaluated the fasting lipid profile in twenty-four patients with mild to moderate psoriasis and twentyfour age and gender matched healthy subjects as the control group. Results: Patients presented risk changes in lipid profile, serum total cholesterol (p<0.001), triglyceride (p<0.01), LDL-cholesterol (p<0.001), VLDL-cholesterol (p<0.01) and TC/HDL ratio (p<0.01) were found to be significantly higher than in control group. No significant statistical difference was observed between HDL levels of the two groups. Significant positive correlation in total cholesterol and LDL-cholesterol was found between mild and moderate psoriasis (PASI score) as compared with controls. Conclusion: Our data suggest that psoriasis patients must be considered as a group at high risk for cardiovascular, since psoriasis per se seems to be associated with risk changes in the lipid profile. We conclude that psoriatic patients should be evaluated and followed up for the risk of hyperlipidemia and cardiovascular diseases.

Role of Oxidative Stress in various stages of Psoriasis

“…Our study also showed a significant reduction in mean HDL-c levels in psoriatic patients when compared to controls (p<0.05). This finding has been supported by Arora et al, (2015) 19 and Augstin et al, (2016) 12 , whereas Dsouza and Kuruville (2013) 20 reported no significant difference in HDL-c levels among psoriatic patients and controls. Mean LDL-c levels in psoriatic patients were found to be significantly elevated in our study when compared to controls (p<0.05).…”

LC-MS/MS analysis of lesional and normally looking psoriatic skin reveals significant changes in protein metabolism and RNA processing

“…These changes might potentially impair the barrier permeability in psoriatic skin, stimulate proliferation and alter the terminal differentiation of the epidermal keratinocytes. To the notice, the previous studies discovered lower levels of esterified cholesterol, and significant changes in the composition of free fatty acids in normally looking and lesional skin of psoriasis patients [ 44 ]. Being the ligands of the nuclear receptors, known as LXRs (liver X receptors), free fatty acids and their derivatives influence a wide range of LXR controlled biological processes including ones that we mentioned above.…”

Frequency of Dyslipidemia in patients with Psoriasis and Association with Disease Severity

“…10 Various international studies have shown lipid profile abnormalities in patients with psoriasis. 11,12 A study reported that dyslipidemia was seen in 29% of psoriaticpatients. 13 Few studies have been conducted in Pakistan but they have their limitations.…”