Psoriasis Increases Risk for Metabolic Syndrome and Higher Coronary Plaque Burden

Patients with psoriasis are at an increased risk for metabolic syndrome and often have greater risk factors for cardiovascular disease (CVD), according to study findings published in the Journal of the American Academy Dermatology.

The cross-sectional study included 260 consecutive patients with psoriasis and coronary computed tomography angiography results and data for metabolic syndrome classification (mean age, 50 years). Patients meeting 3 or more harmonized International Diabetes Federation criteria were considered to have metabolic syndrome. Approximately 31% (n=80) of patients with psoriasis met these criteria and were labeled as having metabolic syndrome.

The median BMI in the overall cohort was 28.8. The median PASI score was 6.2, indicative of mostly mild to moderate skin disease severity in the study sample. Patients with metabolic syndrome had greater systemic inflammation as measured by high-sensitivity C-reactive protein (median, 2.4 vs 1.4; P =.02) and GlycA (median, 414 vs 383; P =.005).

Patients with metabolic syndrome had greater insulin resistance (P <.001), lower HDL-C (P <.001), greater triglycerides (P <.001), and higher LDL particle number (P =.001) and VLDL particle number (P =.003).

In an analysis adjusted for Framingham risk score, lipid-lowering therapy, and biologic agent use, the non-calcified coronary burden was associated with the presence of metabolic syndrome (P <.001) and waist circumference (P <.001), triglycerides (P =.005), blood pressure (P =.005), and fasting glucose (P =.009). There were consistent associations between non-calcified coronary burden and blood pressure (P =.03) and waist circumference (P <.001) in an analysis adjusted for all other metabolic syndrome.

Limitations of this study included its observational design as well as the investigators’ limited ability to adjust for potential confounders.

The researchers concluded that “efforts to increase metabolic syndrome awareness in psoriasis should be undertaken to reduce the associated heightened CVD risk.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Teklu M, Zhou W, Kapoor P, et al. Metabolic syndrome and its factors are associated with non-calcified coronary plaque burden in psoriasis: An observational cohort study. Published online December 21, 2020. J Am Acad Dermatol. doi:10.1016/j.jaad.2020.12.044