Ann Dermatol.  2016 Jun;28(3):360-363. 10.5021/ad.2016.28.3.360.

The Association between Psoriasis Area and Severity Index and Cardiovascular Risk Factor in Korean Psoriasis Patients

• Ku SH
• Kwon WJ
• Cho EB
• Park EJ
• Kim KH
• Kim KJ

• KMID: 2164644
• DOI: http://doi.org/10.5021/ad.2016.28.3.360

Abstract

BACKGROUND
Psoriasis is associated with increased risk of cardiovascular morbidities, especially in severe cases. Severity of the disease has been known to be associated with higher prevalence of these risk factors. However, in the absence of robust measurements, studies to date relied mostly on treatment spectrum as a proxy for the severity.
OBJECTIVE
To evaluate the relationship between psoriasis area and severity index (PASI) and cardiovascular risk factors in Korean patients.
METHODS
Presence of diabetes mellitus (DM), hypertension, smoking history was surveyed through questionnaires and serum lipid profile analysis were done after fasting overnight. The severity of psoriasis was assessed using PASI scores: mild, <10; moderate to severe, ≥10. Cardiovascular risk factors such as smoking, hypertension, diabetes and dyslipidemia were compared between the mild group and moderate to severe group. The prevalence of diabetes and hypertension was compared among these two groups of psoriasis patients and the general population based control; age and gender were matched among three groups accordingly prior to analysis.
RESULTS
A total of 256 patients with plaque type psoriasis were included. Between mild group and moderate to severe group, significant differences of cardiovascular risk factors including lipid profile were not discovered except in triglyceride level. Comparing to general population, prevalence of diabetes was found significantly higher in psoriasis patients while that of hypertension was similar.
CONCLUSION
Our results suggest that among cardiovascular risks, presence of DM and triglyceride level seem to be associated with the presence of psoriasis in Korean psoriasis patients, while other factors may not contribute meaningfully.

Keyword

Psoriasis; Psoriasis area and severity index; Cardiovascular risk factor

MeSH Terms

Diabetes Mellitus
Dyslipidemias
Fasting
Humans
Hypertension
Prevalence
Proxy
Psoriasis*
Risk Factors*
Smoke
Smoking
Triglycerides
Smoke

Reference

1. Hugh J, Van Voorhees AS, Nijhawan RI, Bagel J, Lebwohl M, Blauvelt A, et al. From the Medical Board of the National Psoriasis Foundation: the risk of cardiovascular disease in individuals with psoriasis and the potential impact of current therapies. J Am Acad Dermatol. 2014; 70:168–177.

2. Churton S, Brown L, Shin TM, Korman NJ. Does treatment of psoriasis reduce the risk of cardiovascular disease? Drugs. 2014; 74:169–182.

3. Korea Centers for Disease Control and Prevention. The Sixth Korea National Health and Nutrition Examination Survey (KNHANES VI-1), 2013. Cheongju: Korea Centers for Disease Control and Prevention;2013.

4. Shlyankevich J, Mehta NN, Krueger JG, Strober B, Gudjonsson JE, Qureshi AA, et al. Accumulating evidence for the association and shared pathogenic mechanisms between psoriasis and cardiovascular-related comorbidities. Am J Med. 2014; 127:1148–1153.

5. Armstrong AW, Harskamp CT, Armstrong EJ. Psoriasis and the risk of diabetes mellitus: a systematic review and meta-analysis. JAMA Dermatol. 2013; 149:84–91.

6. Miller IM, Ellervik C, Yazdanyar S, Jemec GB. Meta-analysis of psoriasis, cardiovascular disease, and associated risk factors. J Am Acad Dermatol. 2013; 69:1014–1024.

7. Armstrong AW, Harskamp CT, Armstrong EJ. Psoriasis and metabolic syndrome: a systematic review and meta-analysis of observational studies. J Am Acad Dermatol. 2013; 68:654–662.

8. Kim GW, Park HJ, Kim HS, Kim SH, Ko HC, Kim BS, et al. Analysis of cardiovascular risk factors and metabolic syndrome in Korean patients with psoriasis. Ann Dermatol. 2012; 24:11–15.

9. Choi WJ, Park EJ, Kwon IH, Kim KH, Kim KJ. Association between psoriasis and cardiovascular risk factors in Korean patients. Ann Dermatol. 2010; 22:300–306.

10. Gladman DD, Ang M, Su L, Tom BD, Schentag CT, Farewell VT. Cardiovascular morbidity in psoriatic arthritis. Ann Rheum Dis. 2009; 68:1131–1135.

11. Fernández-Torres R, Pita-Fernández S, Fonseca E. Psoriasis and cardiovascular risk. Assessment by different cardiovascular risk scores. J Eur Acad Dermatol Venereol. 2013; 27:1566–1570.

12. Gisondi P, Tessari G, Conti A, Piaserico S, Schianchi S, Peserico A, et al. Prevalence of metabolic syndrome in patients with psoriasis: a hospital-based case-control study. Br J Dermatol. 2007; 157:68–73.

13. Gyldenløve M, Storgaard H, Holst JJ, Vilsbøll T, Knop FK, Skov L. Patients with psoriasis are insulin resistant. J Am Acad Dermatol. 2015; 72:599–605.

14. Deshmukh M, Lee HW, McFarlane SI, Whaley-Connell A. Antihypertensive medications and their effects on lipid metabolism. Curr Diab Rep. 2008; 8:214–220.

15. Keidan B, Hsia J, Katz R. Plasma lipids and antidiabetic agents: a brief overview. Br J Diabetes Vasc Dis. 2002; 2:40–43.