Anais brasileiros de dermatologia · 2025
Psoriasis and cardiovascular risk: associated and protective factors.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Agoglia Luciana, Peixoto Helena, Cardoso Ana Carolina, Barbosa Lívia, Victer Cecília S X L, Carneiro Sueli, Salles Gil F, Villela-Nogueira Cristiane A, Chindamo Maria Chiara
Аннотация
BACKGROUND: Psoriasis is an inflammatory skin disease associated with Metabolic Syndrome (MetS), Steatotic Liver Disease (SLD) and cardiovascular risk. However, the effect of anti-inflammatory therapy on cardiovascular risk is uncertain.
OBJECTIVES: To determine the relationship between anti-inflammatory therapy and subclinical atherosclerosis in individuals with psoriasis, using the gold standard carotid-femoral Pulse Wave Velocity (cf-PWV) measurement. Additionally, to evaluate the association between cf-PWV, steatosis and Advanced Fibrosis (AF) using Transient Elastography (TE) by Fibroscan®.
METHODS: Cross-sectional study including psoriasis patients submitted to cf-PWV and TE. Steatosis was defined as a controlled attenuation parameter ≥ 275 dB/m, AF as liver stiffness measurement ≥ 10 kPa, and increased Aortic Stiffness (AoS) as cf-PWV ≥ 10 m/s. Significant cumulative methotrexate dose was ≥ 1500 mg (MTX1500). Logistic regression analysis evaluated the independent variables associated with increased AoS.
RESULTS: Eighty patients were included (mean age 56.2 ± 11.5-years, 57.5% female, BMI 28.6 ± 5.3 kg/m2). Prevalences of MetS, diabetes mellitus, dyslipidemia, systemic arterial hypertension, steatosis and AF were 57.5%, 40.0%, 67.5%, 70.0%, 50.0% and 16.3%, respectively. MTX1500 was present in 45%, immunobiological treatment in 33.8%, and cf-PWV ≥ 10 m/s in 21.2%. On logistic regression analysis, age was independently related to cf-PWV ≥ 10 m/s (OR = 1.21; 95% CI 1.06‒1.38; p = 0.003) and MTX1500 was a protective cardiovascular factor (OR = 0.18; 95% CI 0.038‒0.87; p = 0.033). No association was observed between steatosis, AF or immunobiological therapy and cf-PWV ≥10 m/s.
STUDY LIMITATIONS: Sample size.
CONCLUSION: In patients with psoriasis, increased AoS was associated with age, but not with steatosis or AF. A protective cardiovascular effect of MTX was found in a psoriasis population with a high prevalence of MetS and its components.
OBJECTIVES: To determine the relationship between anti-inflammatory therapy and subclinical atherosclerosis in individuals with psoriasis, using the gold standard carotid-femoral Pulse Wave Velocity (cf-PWV) measurement. Additionally, to evaluate the association between cf-PWV, steatosis and Advanced Fibrosis (AF) using Transient Elastography (TE) by Fibroscan®.
METHODS: Cross-sectional study including psoriasis patients submitted to cf-PWV and TE. Steatosis was defined as a controlled attenuation parameter ≥ 275 dB/m, AF as liver stiffness measurement ≥ 10 kPa, and increased Aortic Stiffness (AoS) as cf-PWV ≥ 10 m/s. Significant cumulative methotrexate dose was ≥ 1500 mg (MTX1500). Logistic regression analysis evaluated the independent variables associated with increased AoS.
RESULTS: Eighty patients were included (mean age 56.2 ± 11.5-years, 57.5% female, BMI 28.6 ± 5.3 kg/m2). Prevalences of MetS, diabetes mellitus, dyslipidemia, systemic arterial hypertension, steatosis and AF were 57.5%, 40.0%, 67.5%, 70.0%, 50.0% and 16.3%, respectively. MTX1500 was present in 45%, immunobiological treatment in 33.8%, and cf-PWV ≥ 10 m/s in 21.2%. On logistic regression analysis, age was independently related to cf-PWV ≥ 10 m/s (OR = 1.21; 95% CI 1.06‒1.38; p = 0.003) and MTX1500 was a protective cardiovascular factor (OR = 0.18; 95% CI 0.038‒0.87; p = 0.033). No association was observed between steatosis, AF or immunobiological therapy and cf-PWV ≥10 m/s.
STUDY LIMITATIONS: Sample size.
CONCLUSION: In patients with psoriasis, increased AoS was associated with age, but not with steatosis or AF. A protective cardiovascular effect of MTX was found in a psoriasis population with a high prevalence of MetS and its components.