Issue: Vojnosanit Pregl 2016; Vol. 73 (No. 12)
Psoriasis is the independent factor for early atherosclerosis: A prospective study of cardiometabolic risk profile
Authors:
Miroslav Ž. Dinić, Radoš D. Zečević, Zoran Hajduković, Mirjana Mijušković, Predrag Djurić, Zoran Jović, Aleksandra Grdinić, Mirjana Petrović, Brankica Terzić, Janko Pejović, Lidija Kandolf Sekulović
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Background/Aim. Psoriasis as multisystemic inflammatory dis-ease is related with an increased cardiometabolic risk. The aim of the study was to analyze risk biomarkers, peripheral and renal ar-teries ultrasonography and echocardiography for subclinical atherosclerosis and metabolic disease in 106 subjects (66 psoria-sis patients and 40 controls, 20 eczema patients and 20 healthy volunteers). Methods. In all exameenes following parameters were analyzed: body mass index (BMI), C-reactive protein, D-dimer, serum amyloid A (SAA), apolipoprotein (Apo) A1, ApoB, ApoB/Apo A1 index, fasting glucose, C-peptide, fasting insu-linemia, homeostatic model assessment-insulin resistance (HOMA-IR), HOMA-β-cell, lipid profile, serum uric acid con-centration (SUAC), 24-h proteinuria and microalbuminuria. Ca-rotid, brachial, femoral and renal arteries ultrasonography, as well as echocardiography was also performed. Results. Five of 66 (7.6%) psoriasis patients had metabolic syndrome (not present in both control groups). The following variables were increased in patients with psoriasis compared to both control groups: BMI (p = 0.012), insulinemia (p < 0.001), HOMA-IR (p = 0.003), HOMA-β cell (p < 0.001), SUAC (p = 0.006), ApoB/ApoA1 ra-tio (p = 0.006) and microalbuminuria (p < 0.001). Also, increased C-peptide (p = 0.034), D-dimer (p = 0.029), triglycerides (p = 0.044), SAA (p = 0.005) and decreased ApoA1 (p = 0.014) were found in the psoriasis patients compared to healthy con-trols. HDL cholesterol was decreased in the psoriasis patients compared to the control group of eczema patients (p = 0.004). Common carotid (CIMT) and femoral artery intima-media thickness (FIMT) was significantly greater (p < 0.001) and the maximal flow speed (cm/s) in brachial artery significantly de-creased (p = 0.017) in the patients with psoriasis in comparison to both control groups. In multivariate logistic regression analy-sis, after the adjustment for confounding variables, the most im-portant predictor of CIMT and FIMT was the diagnosis of pso-riasis (p < 0.001). Conclusion. Cardiometabolic risk biomarkers and ultrasonographic signs of early atherosclerosis are correlated with the diagnosis of psoriasis, and not to generalized eczema. Psoriasis was found to be an independent risk factor for sub-clinical atherosclerosis.
