脂质蓄积产物指数作为银屑病内脏肥胖指标的病例对照研究
Lipid Accumulation Product Index as Visceral Obesity Indicator in Psoriasis: A Case-control Study.
作者信息
Ganguly Satyaki, Ray Lopamudra, Kuruvila Sheela, Nanda Sunil Kumar, Ravichandran Kandasamy
机构信息
Department of Dermatology, Venereology and Leprosy, Pondicherry Institute of Medical Sciences, Puducherry, India.
Department of Biochemistry, Pondicherry Institute of Medical Sciences, Puducherry, India.
出版信息
Indian J Dermatol. 2018 Mar-Apr;63(2):136-140. doi: 10.4103/ijd.IJD_315_16.
BACKGROUND
Psoriasis has well-known associations with individual components of metabolic syndrome such as hypertension, dyslipidemia, insulin resistance, and obesity. Traditional anthropometric measurements of obesity such as waist circumference (WC) and body mass index (BMI) do not differentiate between subcutaneous fat and visceral fat, the latter being associated with cardiovascular risk factors. Lipid accumulation product (LAP) index is a measure of visceral fat and has been found to be a better predictor of cardiovascular risk. However, LAP index has not been well-studied in psoriasis patients.
AIMS AND OBJECTIVES
Our objective was to find out if LAP index differs significantly between psoriasis patients and controls and whether LAP index shows a correlation with duration and severity of psoriasis.
MATERIALS AND METHODS
A case-control study was undertaken with 40 chronic plaque psoriasis patients and 42 controls. BMI and LAP index were calculated for all the patients and controls. Psoriasis area severity index (PASI) was calculated for all the psoriasis patients. Mann-Whitney U-test was done for comparing the age, BMI, WC, serum triglyceride, and LAP index between the cases and controls and to compare the LAP index between mild psoriasis and moderate-to-severe psoriasis groups. Spearman's correlation coefficient was used to assess the correlation of LAP index with duration of psoriasis and with PASI. Logistic regression models were done to assess the risk factors in psoriasis.
RESULTS
A statistically significant difference was observed between the LAP index of controls (23.79 ± 13.02) and that of psoriasis patients (46.42 ± 27.2). LAP index was significantly higher in the moderate-to-severe psoriasis group as compared to the mild psoriasis group. LAP index was a significant risk factor associated with psoriasis (OR = 1.07; 95% CI: 1.03 - 1.11).
CONCLUSION
Calculation of LAP index in psoriasis patients helps in identification of more individuals at high risk of cardiovascular morbidity than traditional anthropometric measurements of obesity.
背景
银屑病与代谢综合征的各个组成部分如高血压、血脂异常、胰岛素抵抗和肥胖有着众所周知的关联。传统的肥胖人体测量指标如腰围（WC）和体重指数（BMI）无法区分皮下脂肪和内脏脂肪，而后者与心血管危险因素相关。脂质蓄积产物（LAP）指数是一种衡量内脏脂肪的指标，已被发现是心血管风险的更好预测指标。然而，LAP指数在银屑病患者中尚未得到充分研究。
目的
我们的目的是确定银屑病患者和对照组之间的LAP指数是否存在显著差异，以及LAP指数是否与银屑病的病程和严重程度相关。
材料与方法
进行了一项病例对照研究，纳入40例慢性斑块状银屑病患者和42例对照。计算所有患者和对照的BMI和LAP指数。为所有银屑病患者计算银屑病面积严重程度指数（PASI）。采用曼-惠特尼U检验比较病例组和对照组之间的年龄、BMI、WC、血清甘油三酯和LAP指数，并比较轻度银屑病组和中度至重度银屑病组之间的LAP指数。采用Spearman相关系数评估LAP指数与银屑病病程和PASI的相关性。采用逻辑回归模型评估银屑病的危险因素。
结果
观察到对照组的LAP指数（23.79±13.02）与银屑病患者的LAP指数（46.42±27.2）之间存在统计学显著差异。与轻度银屑病组相比，中度至重度银屑病组的LAP指数显著更高。LAP指数是与银屑病相关的显著危险因素（OR = 1.07；95%CI：1.03 - 1.11）。
结论
与传统的肥胖人体测量指标相比，计算银屑病患者的LAP指数有助于识别更多有心血管发病高风险的个体。
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