Psoriasis and Cardiovascular Risk-Do Promising New Biomarkers Have Clinical Impact?

Sirje Kaur,Külli Kingo,Mihkel Zilmer

doi:10.1155/2017/7279818

Sirje Kaur, Külli Kingo + Show 1 more

Open Access

https://doi.org/10.1155/2017/7279818

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Abstract

Epidemiological studies suggest an increased prevalence of cardiovascular disease (CVD) in patients with psoriasis (PS). Therefore, emphasis has lately been laid on the necessity for clinical evaluation of the risk of CVD in these patients. The systemic inflammatory markers C-reactive protein (CRP) and interleukin- (IL-) 6, which have long been used to predict future CVD in the general population, are increased manyfold in patients with PS. Lipid abnormalities characterized by elevated triglycerides, low HDL cholesterol, and higher concentrations of LDL cholesterol and its oxidized form are also prevalent in patients. There is a need for additional laboratory markers for the assessment of cardiovascular status of patients with PS. Due to frequent comorbid overweight and obesity, biologically active compounds produced by adipocytes may have an impact on monitoring the status of the cardiovascular system of patients with PS. For this purpose, two adipokines, adiponectin and leptin, have been most extensively studied. The review focuses on some inflammatory and oxidative stress aspects in patients with PS through the analysis of the impact of prominent adipokines and oxidized low-density lipoprotein (oxLDL) to assess their eligibility for clinical practice as markers of CVD risk in patients with PS.

Highlights

Several lines of evidence indicate that psoriasis (PS) is associated with enhanced atherosclerosis and risk of cardiovascular disease (CVD) [1,2,3] such as coronary artery disease, ischemic heart disease, and myocardial infarction [4]
The principal CVD risk factors are hypertension and dyslipidemia; the latter is characterized by elevated levels of total cholesterol, low-density lipoprotein (LDL) and triglycerides, and lower levels of high-density lipoproteins (HDL) [86]
No laboratory markers have been employed to evaluate psoriasis activity, such a marker would be highly valuable to monitor the effect of therapy and predict recurrences

Summary

Introduction

Several lines of evidence indicate that psoriasis (PS) is associated with enhanced atherosclerosis and risk of cardiovascular disease (CVD) [1,2,3] such as coronary artery disease, ischemic heart disease, and myocardial infarction [4]. The results of epidemiological studies have demonstrated that the risk to develop CVD is higher in patients with severe PS [5,6,7,8,9] and that the risk persists after adjusting for conventional cardiovascular risk factors such as obesity, hypertension, diabetes, and smoking [1, 8]. Several recent studies have emphasized the necessity for additional laboratory markers for earlier diagnosis of cardiovascular complications and their follow-up [14] These markers should correlate with the severity of PS estimated by PASI or body surface area (BSA). This short review focuses on some inflammatory and oxidative stress aspects of PS, considering the potential of prominent adipokines and oxidized lowdensity lipoprotein (oxLDL) as markers of cardiovascular status and skin disease severity in patients with PS

Search Strategy

Inflammatory Background of Psoriasis and Obesity

CRP and Cytokines

Adiponectin and Leptin

Dyslipidemia and OxLDL

Conclusions