Carotid intima–media thickness, nonalcoholic fatty liver disease, and hemoglobin A1c are independently associated with the severity of psoriasis

Abstract

Keywords: atherosclerosis cardiovascular risk carotid artery intimaemedia thickness nonalcoholic fatty liver disease psoriasis a b s t r a c t Background: Systemic inflammation plays an important role in the pathogenesis of atherosclerosis in psoriasis patients. Carotid artery intimaemedia thickness (CIMT) and nonalcoholic fatty liver disease (NAFLD) are accepted important markers for subclinical atherosclerosis and cardiovascular risk prediction.Objectives: The aim of this study was to evaluate the potential association between subclinical atherosclerosis and chronic plaque psoriasis without traditional cardiovascular risk factors. Methods: Sixty consecutive patients with chronic plaque psoriasis (patient group) attending our dermatology outpatient clinic and 60 age-and sex-matched healthy controls (control group) were included in this study. Demographic and biochemical data, and Psoriasis Area and Severity Index (PASI) score of the psoriasis group were recorded. CIMT and NAFLD values were compared. Results: Patients with psoriasis had significantly higher systolic and diastolic blood pressure, fasting levels of glucose, and hemoglobin A1c (HbA1c) compared with controls. Patients with psoriasis had greater CIMT and NAFLD values than matched controls. PASI score was significantly positively correlated with systolic and diastolic blood pressure, body mass index, waist circumference, psoriasis duration, HbA1c, the presence of NAFLD, moderateesevere NAFLD, and CIMT in psoriatic patients. In multivariate linear regression analysis, HbA1c, moderateesevere NAFLD, and CIMT were significantly and independently associated with PASI score, and CIMT showed the most significant association with PASI score. Conclusion: Our data suggest a need for aggressive treatment of the inflammatory process in psoriatic patients as well as better monitoring of nontraditional atherosclerotic risk factors to reduce cardiovascular mortality/morbidity and liver diseases. Abdominal and carotid ultrasonography appear to be useful, simple, and noninvasive examinations to investigate the presence of subclinical atherosclerosis even in psoriatic patients who seem to be otherwise healthy.

Prevalence and risk of nonalcoholic fatty liver disease among adult psoriatic patients: A systematic review, meta-analysis, and trial sequential analysis

“…Forty-one studies [12–14,18,33–69] were included in the meta-analysis that 19 studies were case–control studies and 22 studies had no control groups (Table 1).…”

“…TSA showed that the analysis of OR included sufficient cases and there was a publication bias across the studies for the calculation of pooled ER and OR. [34] Turkey Caucasian 20/250 -44 MSP US, liver test, exclusion of other liver diseases Fahim, 2023 [35] Pakistan Asian 30/80 16/80 38 CPP US, liver test, exclusion of other liver diseases Ruan, 2022 [39] China Asian 96/148 4018/5524 38.8 NR US, liver test, exclusion of other liver diseases Ghafoor, 2021 [12] Pakistan Asian 53/101 29/101 46.4 NR US, liver test, exclusion of other liver diseases Gau, 2022 [36] China Asian 1191/5591 295,749/1,479,360 50.4 NR US, liver test, exclusion of other liver diseases Inci, 2016 [37] Turkey Caucasian 32/60 21/60 44.5 CPP US, liver test, exclusion of other liver diseases Lee, 2019 [38] China Asian 34/307 ->18 NR Not described Valenzuela, 2022 [40] Chile Mixed 28/598 -49.2 Mixed Not described Gandha, 2020 [41] Indonesia Asian 28/36 -40.1 Vulgaris US, liver test, exclusion of other liver diseases Shibata, 2022 [46] Japan Asian 13/46 14/138 50.6 Mixed US, liver test, exclusion of other liver diseases Li, 2022 [44] China Asian 46/127 -46.5 PsA US, liver test, exclusion of other liver diseases Yadav, 2023 [47] India Asian 17/50 2/50 38.9 CPP US, liver test, exclusion of other liver diseases Ho, 2019 [43] China Asian 58/223 -58 PsA US, liver test, exclusion of other liver diseases Ortolan, 2019 [45] Italy Caucasian 40/76 -57.7 PsA US, liver test, exclusion of other liver diseases Gisondi, 2016 [42] Italy Caucasian 55/124 21/79 55 CPP US, liver test, exclusion of other liver diseases Gisondi, 2009 [13] Italy [51] China Asian 34/307 ->18 NR Not described Magdaleno-Tapial, 2020 [52] Spain [58] India Asian 17/61 5/24 46 CPP US, liver test, exclus8ion of other liver diseases…”