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Psoriasis is associated with lipid abnormalities at the onset of skin disease

https://doi.org/10.1016/j.jaad.2005.11.1079Get rights and content

Background

Psoriasis appears to have increased cardiovascular morbidity. The underlying pathogenetic mechanisms remain unclear. Multiple factors, including systemic inflammation, oxidative stress, aberrant lipid profile, and concomitant established risk factors, have been discussed. However, previous studies consist of heterogeneous patient materials, including persons with highly varying disease duration and treatment.

Methods

Two-hundred patients were investigated at the onset of psoriasis, comparing plasma concentrations of lipids, lipoproteins, and apolipoproteins with those of matched controls (N = 285).

Results

Psoriasis patients manifest significant lipid abnormalities. Specifically, patients had significantly higher cholesterol concentrations in the very-low-density lipoprotein and high-density-lipoprotein fractions. Adjustment for established environmental risk factors did not affect the results.

Limitation

The response rate among control subjects was low. However, an additional analysis of a random subset of nonresponders demonstrated no substantial differences in the main results.

Conclusion

The study supports the notion that lipid abnormalities in psoriasis may be genetically determined rather than acquired.

Section snippets

Cases

The recruitment process has been described.18 In brief, the cases comprised consecutive patients older than 15 years of age with onset of psoriasis lesions on nonhairy skin within the past 12 months before consultation. A total of 200 patients living in the county of Stockholm were enrolled. All patients were examined by one dermatologist (L. M.) at the Department of Dermatology, Karolinska University Hospital, Stockholm, Sweden between 2001 and 2002. Measurement of skin disease severity was

Results

Demographic data were similar for patients and control subjects except for smoking, where patients with psoriasis more often were current or previous cigarette smokers than control subjects (Table I). There was no difference between patients and control subjects with regard to body mass index (BMI), systolic and diastolic blood pressure, physical activity, and alcohol consumption.

Discussion

Almost half a century ago, Lea, Cornish, and Block21 reported increased serum lipid concentrations in patients with psoriasis. Since then, much research has been performed in this area, most of which consistently points to a raised prevalence of lipid abnormalities in individuals diagnosed with psoriasis. However, to date all accumulated knowledge derives from studying psoriasis patients without considering disease duration. To our knowledge, the present study provides the first evaluation of

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      Citation Excerpt :

      In a recent study, liraglutide reduced psoriasiform inflammation in mice that were obese and had diabetes, with improvements in PASI, insulin resistance, and glucose metabolism positively correlating with IL-23, IL-17, IL-22, and TNF-α levels (Chen et al., 2020). In addition to metabolic dysfunction, patients with PsV and PsA have a higher prevalence of CV risk factors such as dyslipidemia (Dreiher et al., 2008; Holzer et al., 2012; Ma et al., 2014; Mallbris et al., 2006), lipoprotein dysfunction (Ahlehoff et al., 2011; Cerman et al., 2008; Hjuler et al., 2017; Mehta et al., 2013, 2012; Rivers et al., 2018; Sorokin et al., 2018), and adiposity (Sajja et al., 2018; Snekvik et al., 2017) and are at increased risk for CV events, including myocardial infarction (MI), stroke, and CV death (Ahlehoff et al., 2011; Brauchli et al., 2009; Gelfand et al., 2011, 2010, 2007, 2006; Hu and Lan, 2017; Kimball et al., 2010; Kurd and Gelfand, 2009; Mehta et al., 2013, 2011a, 2010; Neimann et al., 2006; Noe et al., 2018; Ogdie et al., 2015). Furthermore, psoriasis is associated with a greater presence and extent of vascular inflammation as assessed by 18F-fluorodeoxyglucose positron emission tomography with computed tomography (CT) (Dey et al., 2017; Mehta et al., 2011b; Naik et al., 2015; Youn et al., 2015), lipid-rich noncalcified coronary disease, coronary artery calcium as assessed by CT (Elnabawi et al., 2019, Joshi et al., 2018, Lerman et al., 2017, Mansouri et al., 2016, Staniak et al., 2014), and carotid as well as femoral atherosclerotic plaques as assessed by ultrasound (Di Minno et al., 2011; Eder et al., 2018, 2013).

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    Funding sources: Supported by funds from Swedish Heart-Lung Foundation, Swedish Psoriasis Association, Swedish Medical Research Council, Welander-Finsen Foundation, and Karolinska Institutet.

    Conflicts of interest: None identified.

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