Dyslipidemia in psoriasis patients: a case-control study

Surinder Gupta; Preeti Garg; Nakul Gupta

doi:10.18203/issn.2455-4529.IntJResDermatol20190039

Authors

Surinder Gupta Department of Dermatology, Venereology and Leprology, Maharaja Agrasen Medical College, Agroha, Haryana, India
Preeti Garg Gupta Skin Clinic, Hisar, Haryana, India
Nakul Gupta Department of Medicine, Ganga Ram Institute of Postgraduate Medical Education and Research (Sir Ganga Ram Hospital), New Delhi, India

DOI:

https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20190039

Keywords:

Dyslipidemia, Psoriasis, Cardiovascular risk

Abstract

Background: Psoriasis is a chronic inflammatory disorder with defective proliferation and differentiation of keratinocytes. It is associated with metabolic syndrome i.e. dyslipidemia, hypertension, obesity, cardiovascular diseases and insulin resistance. The high incidence of cardiovascular events in psoriasis is highly associated with abnormal lipid metabolism. This case-control study was done in North Indian medical institute to investigate the levels of serum lipids in psoriasis patients taking in account various parameters like weight, height, body mass index, blood pressure and diabetes.

Methods: We assessed the fasting lipid profile in 48 psoriasis patients and 48 healthy, age and sex matched controls.

Results: The study found significant elevation (p<0.05) of serum total cholesterol, triglycerides, low density lipoproteins (LDL) and very low density lipoproteins (VLDL) in psoriasis patients compared to controls. The levels of high density lipoproteins (HDL) were also significantly lower (p<0.05) in psoriasis patients.

Conclusions: This study suggests that psoriasis is a high risk disorder for cardiovascular mortality and morbidity because of its association with dyslipidemia.

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References

Reich K. The concept of psoriasis as a systemic inflammation: implications of disease management. J Eur Acad Dermatol Venereol. 2012;2:3-11.

Icen M, Crowson CS, McEvoy TM, Dann FJ, Gabrie Sl, Kreme HM. Trends in incidence of adult-onset psoriasis over three decades: a population-based study. J Am Acad Dermatol. 2009;60:394-401.

Napolitano M, Megna M, Monfrecola G. Insulin resistance and skin diseases. Sci World J. 2015;2015:479354.

Lønnberg AS, Skov L. Co-morbidity in psoriasis: mechanisms and implications for treatment. Expert Rev Clin Immunol. 2016;28:1–8.

Napolitano M, Caso F, Scarpa R, Megna M, Patrì A, Balato N, et al. Psoriatic arthritis and psoriasis: differential diagnosis. Clin Rheumatol. 2016;35(8):1893–901.

Lowes MA, Suárez-Fariñas M, Krueger JG. Immunology of psoriasis. Annu Rev Immunol. 2014;32:227–55.

Javidi Z, Meibodi NT, Nahidi Y. Serum lipids abnormalities and psoriasis. Indian J Dermatol. 2007;52:89-92.

Bajaj DR, Mahesar SM, Devrajani BR, Iqbal MP. Lipid profile in patients with psoriasis presenting at Liaquat University Hospital, Hyderabad. J Pak Med. Assoc 2009;59:512-5.

Mallbris L, Granath F, Hamsten A, Stahle M. Psoriasis is associated with lipid abnormalities at the onset of skin disease. J Am Acad Dermatol. 2006;54:614-21.

Griffiths CEM, Barker JNWN. Pathogenesis and clinical features of psoriasis. The Lancet. 2007;370(9583):263–71.

Kaplan NM. The deadly quartet: upper body obesity, glucose intolerance, hypertriglyceridemia and hypertension. Arch Intern Med. 1989;149:1514–20.

DeFronzo RA, Ferrannini E. Insulin resistance. A multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia, and atherosclerotic cardiovascular disease. Diabetes. Care. 1992;14:173–94.

Boehncke WH, Boehncke S, Tobin M, Kirby B. The “psoriatic march”: a concept of how severe psoriasis may drive cardiovascular comorbidity. Exp Dermatol. 2011;20:303-7.

Rocha-Pereira P, Santos-Silva A, Rebelo I, Figueiredo A, Quintanilha A, Teixeira F. Dislipidemia and oxidative stress in mild and in severe psoriasis as a risk for cardiovascular disease. Clinica Chimica Acta. 2001;303(1-2):33–9.

Uyanik BS, Ari Z, Onur E, G¨und¨uz K, Tan¨ulk¨u S, Durkan K. Serum lipids and apolipoproteins in patients with psoriasis. Clin Chem Lab Med. 2002;40(1):65-68.

Mallbris L, Akre O, Granath F, Yin L, Lindelof B, Ekbom A, et al. Increased risk for cardiovascular mortality in psoriasis inpatients but not in outpatients. Eur J Epidemiol. 2004;19:225-30.

Shaharyar S, Warraich H, McEvoy JW, Oni E, Ali SS, Karim A, et al. Subclinical cardiovascular disease in plaque psoriasis: association or causal link? Atherosclerosis. 2014;232:72-8.

Asokan N, Prathap P, Rejani P. Severity of psoriasis among adult males is associated with smoking, not with alcohol use. Indian J Dermatol. 2014;59:237-40.

Lakshmi S, Nath AK, Udayashankar C. Metabolic syndrome in patients with psoriasis: A comparative study. Indian Dermatol Online J. 2014;5:132-7.

Ni C, Chiu MW. Psoriasis and comorbidities: links and risks. Clin Cosmet Investig Dermatol. 2014;7:119-32.

Dommasch ED, Troxel AB, Gelfand JM. Major cardiovascular events associated with anti-IL 12/23 agents: a tale of two meta-analyses. J Am Acad Dermatol. 2013;68:863-5.

Grozdev I, Korman N, Tsankov N. Psoriasis as a systemic disease. Clin Dermatol. 2014;32:343-50.

Wang Y, Gao H, Loyd CM, Fu W, Diaconu D, Liu S, et al. Chronic skin-specific inflammation promotes vascular inflammation and thrombosis. J Invest Dermatol. 2012;132:2067-75.

Cohen AD, Dreiher J, Shapiro Y, Vidavsky L, Vardy DA, Davidovici B, et al. Psoriasis and diabetes: a population-based cross-sectional study. J Eur Acad Dermatol Venereol. 2008;22: 585-9.

Mehta NN, Li K, Szapary P, Krueger J, Brodmerkel C. Modulation of cardiometabolic pathways in skin and serum from patients with psoriasis. J Transl Med. 2013;11:194.

Langan SM, Seminara NM, Shin DB, Troxel AB, Kimmel SE, Mehta NN, et al. Prevalence of metabolic syndrome in patients with psoriasis: a population based study in the United Kingdom. J Invest Dermatol. 2012;132:556-62.

Balta I, Balta S, Demirkol S, Celik T, Ekiz O, Cakar M, et al. Aortic arterial stiffness is a moderate predictor of cardiovascular disease in patients with psoriasis vulgaris. Angiology. 2014;65:74–78.

Ghafoor R, Rashid A, Anwar MI. Dyslipidemia and Psoriasis: A Case Control Study. J Coll Physicians Surg Pak. 2015;25:324-7.

Irimie M, Oanţă A, Irimie CA, Fekete LG, Minea DL Pascu A. Cardiovascular Risk Factors in Patients with Chronic Plaque Psoriasis: A Case-control Study on the Brasov County Population. Acta Dermatovenerol Croat. 2015;23(1):28-35.

Nakhwa YC, Rashmi R, Basavaraj KH. Dyslipidemia in Psoriasis: A Case Controlled Study. Int Sch Res Notices. 2014;2014:729157.

Takahashi H, Iizuka H. Psoriasis and metabolic syndrome. J Dermatol. 2012;39:212-8.

Taheri Sarvtin M, Hedayati MT, Shokohi T, HajHeydari Z. Study on serum lipids and lipoproteins in patients with psoriasis. Arch Iran Med. 2014;17(5):343-6.

Javidi Z, Meibodi NT, Nahidi Y. Serum lipids abnormalities and psoriasis. Indian J Dermatol. 2007;52:89-92.

Abidoye O, Lediju O, Zahid Z, Naseeruddin R, Patel P, Lal M, et al. Development of Dyslipidemia In Psoriasis Patients. EJBPS. 2017;4:746-8.