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银屑病患者的心血管风险:临床、功能和形态参数。

Cardiovascular Risk in Psoriasis Patients: Clinical, Functional and Morphological Parameters.

机构信息

Faculdade de Ciências Medicas de Minas Gerais - Instituto de Pós-Graduação, Belo Horizonte, MG - Brazil.

出版信息

Arq Bras Cardiol. 2019 Jul 18;113(2):242-249. doi: 10.5935/abc.20190123.

Abstract

BACKGROUND

Psoriasis correlates with metabolic disorders, early atheromatosis and increased cardiovascular risk.

OBJECTIVES

To assess markers of cardiovascular disease in psoriatic patients.

METHODS

Cross-sectional, observational study involving 11 psoriatic participants and 33 controls. Anthropometric, biochemical, hemodynamic and imaging parameters were evaluated. Arterial stiffness was assessed by oscillometric measurement of the brachial artery. Intima-media thickness (IMT) and left ventricular diastolic function were assessed by Doppler echography and echocardiography. Between-group comparisons of numerical variables were performed by the Student's t-test or Wilcoxon Mann-Whitney test for independent samples. Significance level was set at 5%.

RESULTS

Psoriatic patients showed increased pulse wave velocity (PWV) (9.1 ± 1.8 vs 8.0 ± 2 m/s, p = 0.033), IMT of the left common carotid artery (p = 0.018) and a higher percentage of patients above the 75th percentile according to the ELSA table when compared with controls (54.5 vs 18.2%, p = 0.045). Psoriatic patients also showed an increase in peripheral/central systolic blood pressure (137.1 ± 13.2 vs 122.3 ± 11.6 mmHg, p = 0.004)/(127 ± 13 vs 112.5 ± 10.4 mmHg, p = 0.005), peripheral/central diastolic blood pressure (89.9 ± 8.9 vs 82.2 ± 8, p = 0.022)/(91 ± 9.3 vs 82.2 ± 8.3, p = 0.014), total cholesterol (252 ± 43.5 vs 198 ± 39.8 mg/dL, p < 0.001), LDL cholesterol (167 ± 24 vs 118 ± 40.8 mg/dL, p < 0.001) and C-reactive protein (7.6 ± 35.4 vs 1 ± 1.2 mg/L p < 0.001) compared with controls.

CONCLUSION

Psoriasis patients show increased PWV, IMT, peripheral and central blood pressures, and serum cholesterol and C-reactive protein levels, denoting a higher cardiovascular risk.

摘要

背景

银屑病与代谢紊乱、早期动脉粥样硬化和心血管风险增加有关。

目的

评估银屑病患者的心血管疾病标志物。

方法

这是一项涉及 11 名银屑病患者和 33 名对照者的横断面、观察性研究。评估了人体测量学、生化、血液动力学和影像学参数。通过肱动脉振荡测量评估动脉僵硬度。通过多普勒超声心动图和超声心动图评估内-中膜厚度(IMT)和左心室舒张功能。通过学生 t 检验或独立样本 Wilcoxon 曼-惠特尼检验比较两组间数值变量。设定显著性水平为 5%。

结果

与对照组相比,银屑病患者的脉搏波速度(PWV)升高(9.1 ± 1.8 对 8.0 ± 2 m/s,p = 0.033)、左颈总动脉 IMT 增加(p = 0.018)和超过 ELSA 表第 75 百分位数的患者比例更高(54.5%对 18.2%,p = 0.045)。银屑病患者的外周/中心收缩压(137.1 ± 13.2 对 122.3 ± 11.6 mmHg,p = 0.004)/(127 ± 13 对 112.5 ± 10.4 mmHg,p = 0.005)、外周/中心舒张压(89.9 ± 8.9 对 82.2 ± 8,p = 0.022)/(91 ± 9.3 对 82.2 ± 8.3,p = 0.014)、总胆固醇(252 ± 43.5 对 198 ± 39.8 mg/dL,p < 0.001)、LDL 胆固醇(167 ± 24 对 118 ± 40.8 mg/dL,p < 0.001)和 C 反应蛋白(7.6 ± 35.4 对 1 ± 1.2 mg/L,p < 0.001)均高于对照组。

结论

银屑病患者的 PWV、IMT、外周和中心血压以及血清胆固醇和 C 反应蛋白水平升高,提示心血管风险较高。

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