The Level of FGF 21 as a New Risk Factor for the Occurrence of Cardiometabolic Disorders amongst the Psoriatic Patients

Abstract

Fibroblast growth factors 21 and 23 are used as markers of cardiometabolic disorders which are common comorbidities in psoriasis. The study aimed to evaluate the serum level of these factors in psoriatic patients and elucidate the possible interplay between disease activity, metabolic or inflammatory parameters, and systemic treatment. A total of 33 patients with active plaque-type psoriasis and 11 healthy controls were enrolled in the study. Patients were divided into subgroups based on their BMI, disease severity, and treatment. Blood samples were collected at the beginning of the study and after 3 months of systemic treatment with acitretin or methotrexate. Serum FGF21 levels in psoriatic patients were higher versus control group (p < 0.05). FGF21 levels regarding psoriasis activity were significantly increased in all three subgroups compared to the controls (p < 0.05). Regarding FGF23, no significant changes were found beside positive correlation with aspartate transferase (p < 0.05). No significant effect of systemic treatment on FGF21 and FGF23 levels was found. Interestingly, a nearly threefold decrease in FGF21 concentration after acitretin-based treatment was observed (p < 0.05). After methotrexate therapy, FGF21 levels remained unchanged. FGF21 levels might be helpful in prediction of the risk of cardiometabolic comorbidities development especially in patients with severe psoriasis and obesity.

Potential Predictive Value of Serum Pentraxin 3 and Paraoxonase 1 for Cardiometabolic Disorders Development in Patients with Psoriasis—Preliminary Data

“…The available data on PON1 in psoriasis are conflicting. In the previous studies, its activity was reported to be lower than in the controls [12,18]. Therefore, patients with psoriasis were suggested to be considered at higher risk for atherosclerosis development [12].…”

Higher Serum Selenoprotein P Level as a Novel Inductor of Metabolic Complications in Psoriasis

“…We were the first to evaluate the potential value of fibroblast growth factor 21 (FGF21) as one of the hepatokines in psoriasis. In a recently published paper, we concluded that FGF21 might be a novel predicting factor of CMD development in patients with psoriasis, especially with severe form or concomitant obesity [ 29 ]. These outcomes, together with significant roles in pathophysiological conditions, especially metabolic ones, prompt us to further explore the links with other hepatokines, particularly selenoprotein P. The biological function of SeP is characterized by the selenium transport, but it definitely has wider, unsuspected and still to be elucidated roles.…”

Non-Alcoholic Fatty Liver Disease (NAFLD) in Patients with Psoriasis: A Review of the Hepatic Effects of Systemic Therapies

“…Interestingly, ACI decreased FGF-21 more than MTX. Finally, there was a positive link between FGF-23 and AST levels which suggests a possible link with liver activity [ 90 ] MTX Review of the evidence for the potential pro-atherosclerotic effects of MTX MTX improves endothelial function and vascular homeostasis, and is associated with a significant reduction in CV morbidity. These effects appear to be mediated via inhibition of pro-atherosclerotic cytokines such as TNF-α, IL-1 and IL-6 [ 91 , 92 ] CYC TGFβs plays a key role in cell growth and differentiation, modulation of immune activity and regulation of the cell cycle.…”

“…In one small trial, acitretin was reported to decrease FGF-21 by three-fold which was significantly greater than the reduction observed with methotrexate. 90 In an earlier small clinical trial, it was shown that patients with chronic psoriasis treated with acitretin had reduced retinol-binding protein-4 levels and decreased insulin resistance. 111 Given the link between psoriasis and increased insulin resistance/diabetes these changes could be clinically meaningful if confirmed in a larger study.…”

“…Assessment of hepatoprotection can be derived from several different research pathways including in vitro experiments, animal models and monitoring of potential biomarkers (Table 3). [89][90][91][92][93][94][95][96][97][98][99][100][101][102][103][104][105][106][107][108] Given the common etiology of inflammation between psoriasis and NAFLD, it might be postulated that systemic therapies for psoriasis that attenuate systemic inflammation may also have beneficial effects on NAFLD by targeting pro-inflammatory cytokines. 109 However, to date, clinical data are scarce for any direct hepatoprotective effects of systemic psoriasis treatments.…”