Association of psoriasis with metabolic disorders and their assessment using epicardial fat thickness, serum lipid profile and homocysteine level
Keywords:Psoriasis, Metabolic disorders, Epicardial fat thickness, Serum lipid profile, Homocysteine level
Background: Psoriasis is a chronic immune-mediated inflammatory disease with worldwide prevalence of 2-4%. It is characterized by sharply demarcated erythematous plaque lesions with silvery white scales. A number of literatures have been published concerning that psoriasis is associated with several cardio-metabolic co-morbidities thus increasing the risk of cardiovascular disease and cardiovascular mortality.
Methods: A prospective observational study was done on patients attending Department of DVL, BRD Medical College, Gorakhpur with psoriasis. A total of 150 patients were enrolled for a study period of 1 year from 15th December 2017 to 31st December 2018. Statistical analysis was done using Statistical package for the social sciences (SPSS version 16.0).
Results: According to our study mean basal metabolic index in psoriatic patients was 27.4±3.9. The mean cholesterol was 198±38 mg/dl, mean low density lipoproteins 129.5±34 mg/dl, mean triglycerides 140±75 mg/dl which is towards higher side, mean homocysteine being 19.5±1.5 µmol/l while the normal range is 4-15 µmol/l. Epicardial fat thickness on ultrasonograpghy was found to be 7.4±0.5 mm in psoriatic patient.
Conclusions: Psoriasis may elevate the risk of atherosclerosis, particularly cardiovascular disorders. Therefore, from the epidemiological point of view screening of psoriatic patients, particularly those with severe psoriasis should be recommended.
Christophers E. Psoriasis- epidemiology and clinical spectrum. Clin Exp Dermatol. 2001;26:314-20.
Nijsten T, Wakkee M. Complexity of the association between psoriasis and comorbidities. J Invest Dermatol. 2009;129:1601-3.
Griffiths CE, Barker JN. Pathogenesis and clinical features of psoriasis. Lancet. 2007;370:263-71.
Singh S, Young P, Armstrong AW. Relationship between psoriasis andmetabolic syndrome: a systematic review. G Ital Dermatol Venereol. 2016;151:663-77.
Balta S, Demirkol S, Kurt O, Sarlak H, Akhan M. Epicardial adipose tissue measurement: inexpensive, easy accessible and rapid practical method. Anadolu Kardiyol Derg. 2013;13:611.
Baker AR, Silva NF, Quinn DW, Harte AL, Pagano D, Bonser RS, et al. Human epicardial adipose tissue expresses a pathogenic profile of adipocytokines in patients with cardiovascular disease. Cardiovasc Diabetol. 2006;5:1.
Iacobellis G, Corradi D, Sharma AM. Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat Clin Pract Cardiovasc Med. 2005;2(10):536-43.
Duell PB, Malinow MR. Homocysteine: an important risk factor for atherosclerotic vascular disease. Curr Opinion Lipidol. 1997;8(1):28-34.
Graham LM, Daly LE, Refsum HM, Robinson K, Brattstrom LE, Ueland PM, et al. Plasma homocysteine as a risk factor for vascular disease: the European Concerted Action Project. J Am Med Assoc. 1997;277(22):1775-81.
Dreiher J, Weitzman D, Shapiro J, Davidovici B, Cohen AD. Psoriasis and chronic obstructive pulmonary disease: a case-control study. Br J Dermatol. 2008;159(4):956-60.
Wysocki J, Skoczynski S, Strozik A, Hochul B, Zygula M. Metabolic or immunometabolic syndrome? Wiadomosci Lekarskie. 2005;58(1-2):124-7.
Sarvtin TM, Hedayati MT, Shokohi T, HajHeydari Z. Serum lipids and lipoproteins in patients with psoriasis. Arch Iran Med. 2014;17:343-6.
Giannoni M, Consales V, Campanati A, Ganzetti G, Giuliodori K, Postacchini V, et al. Homocysteine plasma levels in psoriasis patients: Our experience and review of the literature J Eur Acad Dermatol Venereol. 2015;29(9):1781-5.
Sen B, Atci N, Rifaioglu EN, Ekiz O, Kartal I, Buyukkaya E, et al. Increased epicardial fat tissue is a marker of subclinical atherosclerosis in patients with psoriasis. Br J Dermatol. 2013;169:1081-6.