Evaluation of cardiovascular disease risk factors in patients with mycosis fungoides

Abstract

BACKGROUNDMycosis fungoides, the most common subtype of cutaneous T-cell lymphoma, is more common in patients aged 45-55.OBJECTIVECardiovascular risk factors have been investigated in several skin diseases. However, the relation between cardiovascular diseases and mycosis fungoides remains unclear. Therefore, the aim of this study was to assess cardiovascular risk factors in patients with mycosis fungoides.METHODS32 patients with mycosis fungoides and 26 healthy controls were enrolled in the study. Glucose, total cholesterol, high-density lipoprotein cholesterol, triglyceride, homocystein, high sensitivity C-reactive protein, low-density lipoprotein – cholesterol, were measured in the sera of patients.RESULTSPatients had significantly higher high-sensitivity C-reactive protein, homocysteine, low-density lipoprotein - cholesterol, total cholesterol (p= 0.032) (p< 0.001) (p= 0.001) (p< 0.001). There was a positive correlation between the levels of homo-cysteine and total cholesterol (p= 0.001, r = +0.431). Additionally, a significantly positive correlation was found between the levels of high-sensitivity C-reactive protein and low-density lipoprotein - cholesterol (p= 0.014, r = +0.320) in patient group.CONCLUSIONSPatients with mycosis fungoides had significantly higher levels of total-cholesterol, low-density lipoprotein -cholesterol, homocysteine and high-sensitivity C-reactive protein than healthy subjects. The present study has demonstrated an increased rate of cardiovascular risk in patients with mycosis fungoides. Even though the etiology of these associations is elusive, dermatologists should be sensitized to investigate metabolic derangements in patients with mycosis fungoides, in order to lessen mortality and comorbidity with a multidisciplinary approach.

Morbidity and Causes of Death in Patients with Cutaneous T-cell Lymphoma in Finland

“…Regarding specific causes of death of the patients with CTCL, 1 myocardial infarction and 2 strokes were found. A previous study evaluating cardiovascular risk factors in patients with MF has reported that patients with MF have increased risk of cardiovascular diseases (12). In particular, levels of total cholesterol and low-density lipoprotein were significantly higher in patients with MF.…”

“…These studies have demonstrated an increased risk of secondary cancers in patients with CTCL (8)(9)(10)(11). There are only a few previous studies concerning other comorbidities in CTCL (12)(13)(14). In MF the recently reported increased risk of myocardial infarction may be mediated by chronic inflammation (14).…”

“…In MF the recently reported increased risk of myocardial infarction may be mediated by chronic inflammation (14). Evaluation of cardiovascular risk factors in patients with MF has demonstrated an increased rate of cardiovascular risk related to higher levels of total cholesterol and low-density lipoprotein (LDL) cholesterol than in control patients (12). Interestingly, MF has also been linked to increased risk of anxiety and depression (13).…”

Comorbidities in Mycosis Fungoides and Racial Differences in Co-Existent Lymphomatoid Papulosis: A Cross-Sectional Study of 580 Patients in an Urban Tertiary Care Center

“…A possible explanation for this could be that acquired cardiovascular diseases as well as common coronary artery disease (CAD) risk factors (hypertension and hyperlipidemia) are more frequent beyond middle age which is the most commonly affected age group in MF [32]. However, Cengiz et al recently demonstrated an increased rate of cardiovascular risk factors (hyperlipidemia, high homocysteine and high-sensitivity C-reactive protein) in a cohort of MF patients who did not have pre-existing metabolic disease and were lifetime non-smokers, suggesting a real increase in cardiovascular morbidity by virtue of MF [7]. This begs the chicken or the egg dilemma: are these patients at risk for developing the risk factors for cardiovascular disease (CVD), or do they also have an increased risk of CVD independent of known changes in risk factors or perhaps MF exacerbates risk factors.…”

“…Recent evidence points to a relationship with inflammatory disorders like psoriasis-attributable to similarities in pathogenesis and the possible role of Toll-like receptors in both [5,6]. Patients with MF experience increased rates of cardiovascular risk factors [7], and apart from those experiencing limited plaque/patch stage (T1) MF, lower overall survival when compared to healthy controls matched for race, age and sex [8,9]. Being a chronic relapsing disease, the presence of comorbid conditions can potentially add to patient burden.…”