Abstract MP046: Visceral Adipose Tissue but Not Subcutaneous Adipose Tissue Associates With Cholesterol Efflux Capacity in Psoriasis

Abstract

Background: Psoriasis (PSO), a chronic inflammatory disease associated with increased cardiovascular (CV) risk, provides an ideal model to study inflammatory atherogenesis in vivo. PSO is associated with impaired cholesterol efflux capacity (CEC) and increased cardiometabolic dysfunction including adipose tissue dysregulation. Recently, visceral adiposity (VAT) was shown to be associated with increased CV events. However, neither VAT nor subcutaneous adiposity (SAT) have been shown to be associated with CEC. Hypothesis: Increased VAT by CT is associated with a decrease in CEC independent of CV risk factors. Methods: Consecutively recruited PSO patients (N=76) underwent CT scans to measure abdominal adiposity. VAT and SAT volume was quantified from the level vertebral level T10 to pubic symphysis. CEC was quantified using a cell-based ex vivo assay measuring the ability of apoB-depleted plasma to mobilize cholesterol from lipid-laden macrophages. The relationship of VAT and SAT with CEC was analyzed using multivariable regression models (STATA 12). Results: The cohort had a low CV risk by FRS [median (IQR): 4.0 (2.0-7.0)], mild to moderate PSO [median (IQR): 5.2 (3.0-8.5)], overweight to obese with a mean BMI of 30, 40% were on statin treatment, and 40% were on systemic/biologic therapy for PSO. In unadjusted models VAT was inversely associated with CEC (beta = -0.41, p <0.001) while SAT was not significantly associated (beta = -0.12, p = 0.32). In fully adjusted models VAT retained inverse association with CEC (beta = -0.35, p = 0.04) while SAT remained insignificant (beta coefficient = 0.15, p-value = 0.43) (Table 1). Conclusions: VAT inversely associated with CEC while SAT showed no significant relationship suggesting that VAT may directly drive inflammatory HDL dysfunction while SAT may not. However, larger studies are needed to confirm these findings.