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Carotid intima-media thickness and serum leptin in psoriasis

Karotis-Intima-Media-Dicke und Serumleptin bei Psoriasis

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Abstract

Background

Psoriasis, a chronic inflammatory immune disorder, has been linked to increased cardiovascular mortality and morbidity. Leptin, an obesity-related peptide, has been shown to exert direct effects on the vascular endothelium and on vascular smooth muscle cells. Carotid intima-media thickness (IMT) measurement is a promising tool for detecting atherosclerosis in its pre-occlusive/subclinical phase.

Objective

The objective of the study was to evaluate carotid IMT and serum leptin levels in psoriatic patients as an indicator of subclinical atherosclerosis.

Materials and methods

The study was conducted in 50 psoriatic patients and 10 healthy controls. The clinical severity of skin affection in psoriatic patients was estimated using the psoriatic area and severity index (PASI). Serum leptin levels (ng\ml) and lipid profiles [including serum triglyceride (TG), serum low density lipoproteins (LDL) and serum high density lipoproteins (HDL)] were measured from blood samples. Carotid IMT was measured using carotid duplex ultrasonography.

Results

Psoriatic patients showed significantly higher leptin levels and higher IMT than controls. The mean of the intima-media thickness of the four vessels examined (MIMT) showed a positive correlation with patients’ mean ages, disease duration, body mass index, PASI scores, systolic blood pressure, diastolic blood pressure, leptin levels, LDL levels and triglyceride levels and no correlation with the mean HDL level.

Conclusion

Psoriasis is an independent risk factor for subclinical atherosclerosis. This cardiovascular impairment is influenced mainly by disease severity, serum TG levels and serum leptin levels.

Zusammenfassung

Hintergrund

Psoriasis, eine chronisch-entzündliche Autoimmunkrankheit, wird mit erhöhter kardiovaskulärer Mortalität und Morbidität in Verbindung gebracht. Bei Leptin, einem adipositasbezogenen Peptid, wurde nachgewiesen, dass es eine direkte Wirkung auf Endothel und glatte Muskelzellen der Gefäße hat. Die Messung der Karotis-Intima-Media-Dicke („intima-media thickness“, IMT) ist ein vielversprechendes Instrument zur Erkennung der Arteriosklerose und ihrer präokklusiven/subklinischen Phase.

Ziel

Ziel der Studie war die Bestimmung der Karotis-IMT und des Serumleptinspiegels bei Psoriasispatienten als Indikator einer subklinischen Arteriosklerose.

Material und Methoden

Die Studie wurde mit 50 Psoriasispatienten und 10 gesunden Kontrollen durchgeführt. Bei den Patienten wurde der klinische Schweregrad der Hautaffektion anhand des PASI („psoriatic area and severity index“) erhoben. Anhand von Blutproben wurden Serumleptinspiegel (ng\ml) und Lipidprofile [einschließlich Triglyzeride (TG), LDL („low-density lipoprotein“) und HDL („high-density lipoprotein“) im Serum] gemessen. Die Karotis-IMT wurde mit der Karotisduplexsonographie ermittelt.

Ergebnisse

Bei den Psoriasispatienten waren signifikant höhere Leptinspiegel und eine höhere IMT als bei den Kontrollen nachzuweisen. Das Mittel der IMT für die vier untersuchten Gefäße zeigte eine positive Korrelation mit den Durchschnittswerten für Patientenalter, Krankheitsdauer, Body-Mass-Index, PASI, systolischem und diastolischem Blutdruck, Leptin, LDL und TG, aber keine Korrelation mit dem durchschnittlichen HDL-Wert.

Fazit

Psoriasis ist ein unabhängiger Risikofaktor für subklinische Arteriosklerose. Diese kardiovaskuläre Erkrankung wird hauptsächlich durch die Krankheitsschwere sowie die TG- und Leptinwerte im Serum beeinflusst.

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Authors and Affiliations

  1. Cardiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    B. Enany MD

  2. Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    A.K. El Zohiery, R. Elhilaly & T. Badr

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  1. B. Enany MD
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  2. A.K. El Zohiery
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  3. R. Elhilaly
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  4. T. Badr
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Correspondence to B. Enany MD.

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Enany, B., El Zohiery, A., Elhilaly, R. et al. Carotid intima-media thickness and serum leptin in psoriasis. Herz 37, 527–533 (2012). https://doi.org/10.1007/s00059-011-3547-z

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  • DOI: https://doi.org/10.1007/s00059-011-3547-z

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