The Association Between Inflammatory Markers and the Degree of Psoriasis Vulgaris

Abstract

We read with interest the letter by Aydin regarding our article entitled ‘‘Aortic Arterial Stiffness is a Moderate Predictor of Cardiovascular Disease in Patient With Psoriasis Vulgaris.’’ Arterial stiffness indicates vascular damage and is a measure of the degree of atherosclerosis. Arterial stiffness has received increased attention due to its role as an independent prognostic factor for hypertension, chronic kidney disease, diabetes, and systemic inflammatory diseases such as psoriasis. Increased arterial stiffness is an indicator of coronary artery disease, cerebrovascular disease, or peripheral arterial disease. It can also be affected by risk factors such as smoking, alcohol consumption, hypercholesterolemia, and hypothyroidism. For this reason, we excluded these factors. It can also be affected by medications such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, and statins. We also excluded these factors in our study. We believe that the Psoriasis Area and Severity Index (PASI) and the presence of psoriatic arthritis were associated with higher prevalence of concomitant vascular disease. Severe psoriasis is also associated with increased risk of cardiovascular mortality and morbidity due, in part, to shared immune– inflammatory mechanisms. In our study, the mean PASI was moderate, and psoriatic arthritis was not seen in any patients. We did not analyze the inflammation markers such as homocysteine and gamma-glutamyltransferase (GGT), although their role in inflammation was previously demonstrated. We evaluated C-reactive protein (CRP) together with arterial stiffness parameters, because CRP is a widely available inflammatory marker. In conclusion, not only homocysteine and GGT but also mean platelet volume, red cell distribution width, platelet distribution width, eosinophil, neutrophil–lymphocyte ratio, platelet lymphocyte ratio, total bilirubin, uric acid, and N-terminal pro-B-type natriuretic peptide are potential markers of vascular risk in patients with psoriasis.