Abstract
Introduction: Psoriasis (PSO), a chronic inflammatory disease associates with increased metabolic and cardiovascular (CV) risk. Dysglycemia may contribute to the increased risk of CV disease observed in psoriasis. Therefore, the aim of this study was to characterize whether dysglycemia assessed by hemoglobin A1c (HbA1c) is associated with subclinical coronary artery disease in psoriasis. Hypothesis: We hypothesized that total burden (TB) of coronary artery plaque and non-calcified burden (NCB) would be associated with HbA1c values in psoriasis independent of cardiovascular risk factors. Methods: Consecutive psoriasis patients (n=103) and age and sex matched controls (n=42) underwent CCTA (Toshiba, 320-detector row) for coronary plaque characterization. TB and NCB were quantified using QAngio (Medis, The Netherlands). Fasting blood samples were collected on the same day to get HbA1c values. The relationship of HbA1c with TB and NCB was analyzed using multivariable regression models (STATA 12). Results: PSO patients were middle-aged, predominantly male, had a low CV risk by FRS and had mild to moderate skin disease (Table 1). HbA1c levels were elevated in psoriasis compared to controls (P=0.007). Furthermore, total (P=0.02) and non-calcified (P=0.04) burden were elevated in psoriasis as compared to controls. HbA1c directly associated with TB ( β =0.21; P=0.001) and NCB ( β =0.18; P=0.004); a relationship which persisted beyond CV risk factors (TB and NCB: β =0.22; P=0.01). Conclusions: HbA1c was associated with total and non-calcified burden in psoriasis population independent of CV risk factors. These findings underscore the importance of screening for glycemic abnormalities to mitigate CV disease risk in patients with psoriasis.
Published Version
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