Vascular endothelial function assessed by a noninvasive ultrasound method and serum asymmetric dimethylarginine concentrations in mild-to-moderate plaque-type psoriatic patients

Usta, Murat; Yurdakul, Selen; Aral, Hale; Turan, Enver; Oner, Ender; İnal, Berrin Berçik; Öner, Fatma Alıbaz; Gürel, Mehmet Salih; Güvenen, Güvenç

doi:10.1016/j.clinbiochem.2011.06.007

Cited by 16 publications

(14 citation statements)

References 41 publications

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“… 38 , 39 One study 40 was further excluded because the reported FMD value was particularly high in both psoriatic patients and controls than other studies. Finally, only 20 studies 10 – 28 , 30 were included in the quantitative synthesis. The flowchart of the studies’ selection process is outlined in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

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Association Between Psoriasis and Subclinical Atherosclerosis

2016

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The association between psoriasis and carotid intima-media thickness (CIMT) or impaired flow-mediated dilation (FMD) remains controversial. We aimed to evaluate the extent of subclinical atherosclerosis as measured by CIMT and FMD in patients with psoriasis by conducting a meta-analysis.A systematic literature search was performed using PubMed, Embase, Cochrane databases, China National Knowledge Infrastructure, and VIP databases up to February 2015. Observational studies investigating CIMT or FMD in patients with psoriasis and controls were eligible. Psoriatic patients and controls were at least age- and sex-matched. Random-effects analysis was used to estimate the weighted mean difference (WMD) and 95% confidence interval (CI) between psoriatic patients and controls.A total of 20 studies were identified and analyzed. Meta-analysis showed that psoriatic patients had a significantly thicker CIMT (WMD 0.11 mm; 95% CI 0.08–0.15) and lower FMD (WMD −2.79%; −4.14% to −1.43%) than those in controls. Subgroup analysis indicated that psoriatic arthritis appeared to have less impaired FMD (WMD −2.45%) and thinner CIMT (WMD 0.10 mm). Psoriatic patients with mean age >45 years had much thicker CIMT (WMD 0.13 mm). The impaired FMD (WMD −3.99%) seemed more pronounced in psoriatic patients with mean age <45 years.This meta-analysis suggests that patients with psoriasis are associated with excessive risk of subclinical atherosclerosis. Screening and monitoring CIMT and brachial artery FMD may be recommended to identify a subgroup of psoriatic patients at higher risk for cardiovascular events.

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Section: Resultsmentioning

confidence: 99%

“…Twenty studies 10 – 28 , 30 comprising 1066 psoriatic patients and 962 controls were included in the meta-analysis. The sample size of individual study ranged from 54 to 196.…”

Section: Resultsmentioning

confidence: 99%

Association Between Psoriasis and Subclinical Atherosclerosis

2016

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“…Although results have been mixed, a 2014 systematic review of 20 studies of endothelial function in psoriasis patients found that FMD was significantly impaired in the majority of studies in which FMD was used [72]. Some data suggest that the likelihood of endothelial dysfunction is correlated with disease severity or disease duration [73]; however, a number of studies of patients with disease classified as “severe” have demonstrated no impairment in FMD [74,75]. Interestingly, increased carotid intima-media thickness, a measure of subclinical atherosclerosis, has been demonstrated repeatedly in patients with psoriasis and has been shown to correlate with FMD [72,73].…”

Section: Clinical Findings Of Major Chronic Inflammatory Diseases mentioning

confidence: 99%

Endothelial Dysfunction in Chronic Inflammatory Diseases

Steyers

Miller

2014

IJMS

381

299

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Chronic inflammatory diseases are associated with accelerated atherosclerosis and increased risk of cardiovascular diseases (CVD). As the pathogenesis of atherosclerosis is increasingly recognized as an inflammatory process, similarities between atherosclerosis and systemic inflammatory diseases such as rheumatoid arthritis, inflammatory bowel diseases, lupus, psoriasis, spondyloarthritis and others have become a topic of interest. Endothelial dysfunction represents a key step in the initiation and maintenance of atherosclerosis and may serve as a marker for future risk of cardiovascular events. Patients with chronic inflammatory diseases manifest endothelial dysfunction, often early in the course of the disease. Therefore, mechanisms linking systemic inflammatory diseases and atherosclerosis may be best understood at the level of the endothelium. Multiple factors, including circulating inflammatory cytokines, TNF-α (tumor necrosis factor-α), reactive oxygen species, oxidized LDL (low density lipoprotein), autoantibodies and traditional risk factors directly and indirectly activate endothelial cells, leading to impaired vascular relaxation, increased leukocyte adhesion, increased endothelial permeability and generation of a pro-thrombotic state. Pharmacologic agents directed against TNF-α-mediated inflammation may decrease the risk of endothelial dysfunction and cardiovascular disease in these patients. Understanding the precise mechanisms driving endothelial dysfunction in patients with systemic inflammatory diseases may help elucidate the pathogenesis of atherosclerosis in the general population.

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“…A series of recent reports have investigated endothelial function in patients with psoriasis. The majority of the data indicate a significant decrease in endothelial cell‐dependent vasodilation measured by FMD and no alteration in endothelial cell‐independent vasodilation measured by nitroglycerine‐induced vasodilation, suggesting that the production of nitric oxygen from endothelial cells is impaired, while the dilation of vascular smooth muscle cells in response to nitric oxygen is intact in patients with psoriasis. The involvement of TNF‐α‐dependent vascular inflammation in this phenomenon has been suggested by the decreased risk of cardiovascular events in patients with psoriasis administered TNF inhibitors .…”

Section: Discussionmentioning

confidence: 99%