Department of Biochemistry, University College of Medical Sciences (University of Delhi), Delhi, India.
Department of Dermatology, University College of Medical Sciences (University of Delhi), Delhi, India.
Indian J Med Res. 2017 Dec;146(6):708-713. doi: 10.4103/ijmr.IJMR_717_16.
BACKGROUND & OBJECTIVES: Psoriasis is a recurrent hyper-proliferative skin disease which is often associated with free radical generation, abnormal lipid metabolism and increased inflammatory secretion that induce cardiovascular risk in these patients. The present study was intended to evaluate serum lipids, lipoprotein and oxidants-antioxidants status and to establish their relationship with atherogenic risk markers [oxidized low-density lipoprotein (oxLDL) and high-sensitivity C-reactive protein (hsCRP)] in patients with psoriasis.
The study was conducted on 150 psoriasis patients and 150 age- and sex-matched healthy controls. Overnight fasting blood samples were obtained for lipids, lipoproteins, lipid oxidation and peroxidation products [oxLDL, malondialdehyde (MDA)], antioxidant enzymes [reduced glutathione (GSH) and total antioxidant status] levels and hsCRP estimations.
The mean levels of atherogenic lipids [total cholesterol (P<0.001), triacylglycerol (P<0.01)], lipid peroxidation products (P<0.001) and oxLDL and hsCRP (P<0.001) levels in patients with psoriasis were found to be significantly higher than those of healthy controls. On the other hand, ferric-reducing ability of plasma (FRAP, P<0.001) and antioxidant enzyme activities (reduced GSH, P<0.01) were significantly lower when compared to healthy controls. The plasma oxLDL was positively correlated to LDL cholesterol (P<0.001) and MDA (P<0.001) and negatively associated with antioxidant status in these patients. Serum MDA, FRAP and oxLDL were correlated with risk of atherosclerosis in the patients with psoriasis; however, no significant association was found between reduced GSH and hsCRP.
INTERPRETATION & CONCLUSIONS: The study results suggest that LDL oxidation and reactive oxygen species in addition to inflammatory markers may play a pivotal role in inducing atherosclerosis in patients of psoriasis.
银屑病是一种复发性的过度增殖性皮肤疾病，常伴有自由基生成、脂质代谢异常和炎症分泌增加，这些都会增加患者的心血管风险。本研究旨在评估银屑病患者的血清脂质、脂蛋白和氧化还原状态，并确定它们与动脉粥样硬化风险标志物[氧化型低密度脂蛋白（oxLDL）和高敏 C 反应蛋白（hsCRP）]的关系。
本研究纳入了 150 例银屑病患者和 150 名年龄和性别匹配的健康对照者。采集过夜空腹血样，用于检测脂质、脂蛋白、脂质氧化和过氧化产物[oxLDL、丙二醛（MDA）]、抗氧化酶[还原型谷胱甘肽（GSH）和总抗氧化状态]和 hsCRP 水平。
银屑病患者的致动脉粥样硬化脂质[总胆固醇（P<0.001）、三酰甘油（P<0.01）]、脂质过氧化产物（P<0.001）和 oxLDL 及 hsCRP（P<0.001）水平明显高于健康对照组。另一方面，与健康对照组相比，患者的血浆铁还原能力（FRAP，P<0.001）和抗氧化酶活性（还原型 GSH，P<0.01）明显降低。血浆 oxLDL 与 LDL 胆固醇（P<0.001）和 MDA（P<0.001）呈正相关，与患者的抗氧化状态呈负相关。血清 MDA、FRAP 和 oxLDL 与银屑病患者的动脉粥样硬化风险相关；然而，还原型 GSH 和 hsCRP 之间没有显著相关性。
研究结果表明，LDL 氧化和活性氧物质以及炎症标志物可能在诱导银屑病患者发生动脉粥样硬化中起关键作用。
