Abstract
BackgroundAcitretin is a second-generation synthetic retinoid, and is widely used for treating the severe psoriasis vulgaris. However, it should be chosen with caution for its cardiovascular risk, and it is reported that acitretin may increase the serum lipids. The purpose of this study is to investigate the relationship between the Frizzled-related proteins 4 (SFRP4) rs1802073 polymorphism and the changes of serum lipids in Chinese psoriatic patients during the treatment with acitretin.MethodsIn our study, 100 psoriatic patients were recruited systematically treated with acitretin (30 mg/day) for at least eight weeks. Data of the patients’ demographic and clinical characteristics and the results of serum triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were collected pre- and post-treatment.ResultsA total of 84 psoriatic patients were enrolled and divided into three groups by SFRP4 rs1802073 genotypes. The patients who carried with TT genotype had maintained levels of TG and LDL-C after acitretin treatment, while patients with GG/GT genotypes had significantly elevated levels of serum TG and LDL-C compared to the TT genotype (ΔTG%: 27.53 ± 59.13 vs −1.47 ± 37.79, p = 0.026, ΔLDL-C%: 10.62 ± 26.57 vs −1.29 ± 17.07, p = 0.042). The association of rs1802073 with TG and LDL-C profiles remained significant after adjusting for age, gender, and body mass index. Although without significance, the pre-post change in serum level of TC across rs1802073 GG/GT genotypes demonstrated a trend similar to TG and LDL, and the serum level of HDL-C demonstrated a trend opposite to TG, TC and LDL.ConclusionsOur results demonstrated that SFRP4 rs1802073 polymorphism was found to be associated with elevated serum lipid levels after acitretin treatment, and it may serve as a genetic marker of safe and precise treatment for individual psoriatic patients.
Highlights
Psoriasis is an immunologically mediated chronic inflammatory skin disorder that affects 2%–3% of the general population (Boehncke & Schon, 2015; Grayson, 2012; Griffiths & Barker, 2007)
Ten patients carried with rs1802073 GG genotype, 49 patients carried with rs1802073 GT genotype and 25 patients carried with rs1802073 TT genotype
We investigated the association between the secreted frizzled-related proteins 4 (SFRP4) rs1802073 polymorphism and the changes of serum levels of TG, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) for the first time
Summary
Psoriasis is an immunologically mediated chronic inflammatory skin disorder that affects 2%–3% of the general population (Boehncke & Schon, 2015; Grayson, 2012; Griffiths & Barker, 2007). The higher dosage increasing the triglyceride levels occurred in 66% of psoriatic patients and total cholesterol occurred in 33% (Katz, Waalen & Leach, 1999) It should be chosen with caution for its possible elevated risks of serum lipid profile and cardiovascular events (Balta et al, 2013; Orfanos et al, 1997). Acitretin is a second-generation synthetic retinoid, and is widely used for treating the severe psoriasis vulgaris It should be chosen with caution for its cardiovascular risk, and it is reported that acitretin may increase the serum lipids. Our results demonstrated that SFRP4 rs1802073 polymorphism was found to be associated with elevated serum lipid levels after acitretin treatment, and it may serve as a genetic marker of safe and precise treatment for individual psoriatic patients
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