Thungaturthi Sudhakar, Vadakedath Sabitha, Pavuluri Prathyusha, Rani Jhansi, Gundu Rajkumar, Bheem Jai, Kandi Venkataramana
Biochemistry, Chalmeda Anandrao Institute of Medical Sciences, Karimnagar, IND.
Biochemistry, RVM Institute of Medical Sciences and Research Center, Hyderabad, IND.
Cureus. 2019 Mar 7;11(3):e4203. doi: 10.7759/cureus.4203.
Introduction Psoriasis is a chronic inflammatory skin disorder which commonly affects people aged between 15-25 years with a 2-3 % prevalence rate throughout the world. Psoriasis is a systemic inflammatory disease associated with severe co-morbidities that include cardiovascular risk. Although changes in the atherogenic lipids among psoriasis patients is already documented, very little is known about their role in atherogenesis among the new onset cases of psoriasis. Hence, this study is undertaken to assess the activities of non-high-density lipoprotein cholesterol (non-HDL-C) and other lipids among newly diagnosed psoriasis patients. Methods The study included 25 new onset cases of psoriasis patients aged between 20-60 years (mean age 38.2 years) attending the Dermatology outpatient department (OPD) of the Chalmeda Anandrao Institute of Medical Sciences (CAIMS), Karimnagar, Telangana, India, a tertiary care teaching hospital. An equal number of healthy individuals were included as controls. Blood was collected from all the subjects included in the study and was analyzed for various lipid parameters that included total cholesterol (TC), HDL-C, and triglycerides. The non-HDL-C and low-density lipoprotein cholesterol (LDL-C) were later calculated manually by using the standard formulae. The data were tabulated using Microsoft Excel and was analyzed for their statistical significance using the Student t-test. Results The results demonstrated a statistically significant difference in the lipid parameters between the cases and controls. Among the parameters measured, the pro-atherogenic lipids including the LDL-C and non-HDL-C activities among the cases (LDL-C 171.46±17.13, p=0.0002; non-HDL-C 213.27±20.17, p ≤ 0.0001) and controls (LDL-C 91.04±11.41, p=0.0002; Non-HDL-C 119.0± 12.28, p ≤ 0.0001) were found to be statistically significant. The ratios of non-HDL-C to HDL-C and total cholesterol to HDL-C both among the cases (7.10±0.1, 8.13±1.2) and control groups (3.05±0.30, 4.03±0.42) were also showing a statistically significant difference. Conclusion The results clearly demonstrate the significance of the evaluation of lipids among newly diagnosed cases of psoriasis patients. The activities of different lipoproteins including the non-HDL-C and LDL-C revealed an increase among the psoriasis patients. The ratios of non-HDL-C to HDL-C and TC to HDL-C also showed significant variability. Further, to establish their clinical utility in the development of cardiovascular disease (CVD), and to manage appropriately, a regular follow-up of such parameters both before and after initiation of treatment is required.
引言
银屑病是一种慢性炎症性皮肤病，通常影响15至25岁的人群，全球患病率为2%-3%。银屑病是一种与严重合并症相关的全身性炎症性疾病，其中包括心血管风险。虽然银屑病患者中致动脉粥样硬化脂质的变化已有文献记载，但对于它们在银屑病新发病例的动脉粥样硬化形成中的作用却知之甚少。因此，本研究旨在评估新诊断的银屑病患者中非高密度脂蛋白胆固醇（non-HDL-C）和其他脂质的活性。
方法
该研究纳入了25例年龄在20至60岁之间（平均年龄38.2岁）的银屑病新发病例，这些患者来自印度特伦甘纳邦卡里姆纳加尔市的查尔梅达·阿南德拉奥医学科学研究所（CAIMS）皮肤科门诊，这是一家三级护理教学医院。纳入了同等数量的健康个体作为对照。采集了研究中所有受试者的血液，并对包括总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）和甘油三酯在内的各种脂质参数进行了分析。随后使用标准公式手动计算非高密度脂蛋白胆固醇和低密度脂蛋白胆固醇（LDL-C）。数据使用Microsoft Excel制成表格，并使用学生t检验分析其统计学意义。
结果
结果表明，病例组和对照组之间的脂质参数存在统计学上的显著差异。在所测量的参数中，病例组（LDL-C 171.46±17.13，p=0.0002；non-HDL-C 213.27±20.17，p≤0.0001）和对照组（LDL-C 91.04±11.41，p=0.0002；Non-HDL-C 119.0±12.28，p≤0.0001）中促动脉粥样硬化脂质（包括LDL-C和non-HDL-C活性）的差异具有统计学意义。病例组（7.10±0.1，8.13±1.2）和对照组（3.05±0.30，4.03±0.42）中非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇的比率以及总胆固醇与高密度脂蛋白胆固醇的比率也显示出统计学上的显著差异。
结论
结果清楚地表明了评估新诊断的银屑病患者脂质的重要性。包括非高密度脂蛋白胆固醇和低密度脂蛋白胆固醇在内的不同脂蛋白的活性在银屑病患者中有所增加。非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇的比率以及总胆固醇与高密度脂蛋白胆固醇的比率也显示出显著差异。此外，为了确定它们在心血管疾病（CVD）发展中的临床效用，并进行适当管理，需要在治疗开始前后定期随访这些参数。
