Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy.
J Eur Acad Dermatol Venereol. 2015 Sep;29(9):1781-5. doi: 10.1111/jdv.13023. Epub 2015 Mar 23.
People with psoriasis are at higher cardiovascular risk. Plasma levels of homocysteine over the normal range have been recognized as marker of cardiovascular risk. Psoriasis patients express higher levels of plasma homocysteine than healthy people.
Our study aims to investigate the correlation between homocysteinaemia, severity and duration of psoriasis and psoriasis arthritis, and to evaluate the effect of a 12-week administration of a target therapy for psoriasis on homocysteinaemia.
Fifty-two psoriasis patients (study group) submitted to different kind of therapy for psoriasis (biological, systemic not biological and topical) and 24 healthy Italian subject (control group) were evaluated for their plasmatic homocysteine levels, both at baseline (T0) and 12 weeks after they a specific therapy for psoriasis.
A significant difference between the homocysteinaemia of psoriasis patients (mean 19.71 ± 11.16) and control group (13.90 ± 11.18), P < 0.05 (Fig. 1), was found at baseline (T0). The mean plasma levels of homocysteine were directly correlated with disease severity (P = 0.0401), but not with disease duration (P = 0.6018) or presence of arthritis (P = 0.6221) at baseline. None among the treatments administered to psoriasis patients caused a significant reduction in homocysteinaemia after 12 weeks of treatment.
Our results confirm that psoriasis patients with more severe disease, can have hyperhomocysteinaemia, without regard to disease duration or joint involvement. Hyperhomocysteinaemia is not influenced by a target therapy for psoriasis and it is as greater as psoriasis severity. However, limitation of our study is the relatively small number of cases. Homocysteine plasmatic levels should be advisable as a further independent risk factor for cardiovascular disease in psoriasis patients.
患有银屑病的人患心血管疾病的风险较高。血浆同型半胱氨酸水平超过正常范围已被认为是心血管风险的标志物。银屑病患者的血浆同型半胱氨酸水平高于健康人群。
我们的研究旨在探讨同型半胱氨酸血症与银屑病严重程度和发病时间、银屑病关节炎之间的相关性，并评估 12 周靶向银屑病治疗对同型半胱氨酸血症的影响。
52 名银屑病患者（研究组）接受了不同类型的银屑病治疗（生物制剂、非生物系统治疗和局部治疗），24 名意大利健康受试者（对照组）在基线（T0）和接受特定银屑病治疗 12 周后评估其血浆同型半胱氨酸水平。
在基线（T0）时，发现银屑病患者（平均 19.71±11.16）和对照组（平均 13.90±11.18）的同型半胱氨酸水平存在显著差异（P＜0.05，图 1）。同型半胱氨酸的平均血浆水平与疾病严重程度呈直接相关（P=0.0401），但与疾病发病时间（P=0.6018）或关节炎的存在（P=0.6221）无关。在接受银屑病治疗的患者中，没有一种治疗方法能在 12 周的治疗后显著降低同型半胱氨酸血症。
我们的研究结果证实，病情更严重的银屑病患者可能会出现高同型半胱氨酸血症，而与疾病发病时间或关节受累无关。高同型半胱氨酸血症不受银屑病靶向治疗的影响，而且与银屑病严重程度成正比。然而，我们研究的局限性在于病例数量相对较少。血浆同型半胱氨酸水平应作为银屑病患者心血管疾病的另一个独立危险因素。
