Department of Rheumatology, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto Psoriatic Arthritis Program, Toronto, Ontario, Canada.
Ann Rheum Dis. 2013 May;72(5):715-20. doi: 10.1136/annrheumdis-2012-201497. Epub 2012 Jun 26.
To compare the extent of atherosclerosis in patients with psoriatic arthritis (PsA) and patients with cutaneous psoriasis without arthritis (PsC).
In this cross-sectional study the authors compared patients with PsA with PsC patients. Psoriasis patients underwent a rheumatological assessment to exclude inflammatory arthritis. Ultrasonographic measurements of carotid total plaque area (TPA) and carotid intima-media thickness (cIMT) were performed. t Test was used to compare the imaging findings between the two groups. Multivariate linear regression analysis was used to assess the association between disease status and imaging findings after adjusting for potential confounders.
Overall, 125 PsA and 114 PsC patients were compared. There were no significant differences in age, gender or cardiovascular risk factors between the two groups. Patients with PsA exhibited greater TPA than did PsC patients (TPA (square root of area in mm(2)) 3.33±3.34 vs 2.43±2.72, p=0.03). This difference remained statistically significant in the multivariate regression analysis after adjusting for potential confounders (p=0.03). The difference in cIMT between the groups did not achieve statistical significance (p=0.09). The following disease-related variables were associated with increase in TPA in multivariate regression analysis among PsA patients: duration of PsA (p=0.04), highest Psoriasis Area and Severity Index recorded in the first 3 years of follow-up (p=0.02) and erythrocyte sedimentation rate (p=0.005).
PsA patients suffer from more severe subclinical atherosclerosis compared with patients with PsC. This difference is independent of traditional cardiovascular risk factors and correlates with PsA disease duration, more severe skin disease and increased inflammatory markers.
比较银屑病关节炎（PsA）患者与无关节炎的皮肤银屑病（PsC）患者的动脉粥样硬化程度。
在这项横断面研究中，作者比较了 PsA 患者和 PsC 患者。对银屑病患者进行了风湿病学评估，以排除炎症性关节炎。对颈动脉总斑块面积（TPA）和颈动脉内膜中层厚度（cIMT）进行超声测量。采用 t 检验比较两组影像学结果。采用多元线性回归分析，在调整潜在混杂因素后，评估疾病状态与影像学结果之间的关系。
共比较了 125 例 PsA 和 114 例 PsC 患者。两组患者的年龄、性别或心血管危险因素无显著差异。与 PsC 患者相比，PsA 患者的 TPA 更大（TPA（面积平方根，mm²）3.33±3.34 比 2.43±2.72，p=0.03）。在调整潜在混杂因素后，多元回归分析仍显示差异具有统计学意义（p=0.03）。两组间 cIMT 差异无统计学意义（p=0.09）。多元回归分析显示，在 PsA 患者中，以下疾病相关变量与 TPA 增加相关：PsA 病程（p=0.04）、随访前 3 年记录的最高银屑病面积和严重程度指数（p=0.02）和红细胞沉降率（p=0.005）。
与 PsC 患者相比，PsA 患者患有更严重的亚临床动脉粥样硬化。这种差异独立于传统心血管危险因素，与 PsA 病程、更严重的皮肤疾病和炎症标志物增加相关。
