National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
Department of Internal Medicine, Johns Hopkins University Medical Center, Baltimore, Maryland.
J Am Acad Dermatol. 2021 May;84(5):1329-1338. doi: 10.1016/j.jaad.2020.12.044. Epub 2021 Feb 3.
Psoriasis is associated with a heightened risk of cardiovascular disease and higher prevalence of metabolic syndrome.
Investigate the effect of metabolic syndrome and its factors on early coronary artery disease assessed as noncalcified coronary burden by coronary computed tomography angiography in psoriasis.
This cross-sectional study consisted of 260 participants with psoriasis and coronary computed tomography angiography characterization. Metabolic syndrome was defined according to the harmonized International Diabetes Federation criteria.
Of the 260 participants, 80 had metabolic syndrome (31%). The metabolic syndrome group had a higher burden of cardiometabolic disease, systemic inflammation, noncalcified coronary burden, and high-risk coronary plaque. After adjusting for Framingham risk score, lipid-lowering therapy, and biologic use, metabolic syndrome (β = .31; P < .001) and its individual factors of waist circumference (β = .33; P < .001), triglyceride levels (β = .17; P = .005), blood pressure (β = .18; P = .005), and fasting glucose (β = .17; P = .009) were significantly associated with noncalcified coronary burden. After adjusting for all other metabolic syndrome factors, blood pressure and waist circumference remained significantly associated with noncalcified coronary burden.
Observational nature with limited ability to control for confounders.
In psoriasis, individuals with metabolic syndrome had more cardiovascular disease risk factors, systemic inflammation, and noncalcified coronary burden. Efforts to increase metabolic syndrome awareness in psoriasis should be undertaken to reduce the heightened cardiovascular disease risk.
银屑病与心血管疾病风险增加和代谢综合征患病率升高有关。
通过冠状动脉计算机断层血管造影术评估非钙化冠状动脉负担，探讨代谢综合征及其因素对银屑病患者早期冠状动脉疾病的影响。
本横断面研究纳入 260 名患有银屑病且接受冠状动脉计算机断层血管造影术特征分析的参与者。代谢综合征根据国际糖尿病联合会的协调标准定义。
在 260 名参与者中，有 80 名患有代谢综合征（31%）。代谢综合征组有更高的心血管代谢疾病负担、全身炎症、非钙化冠状动脉负担和高风险冠状动脉斑块。调整 Framingham 风险评分、降脂治疗和生物制剂使用后，代谢综合征（β=0.31；P<0.001）及其个体因素腰围（β=0.33；P<0.001）、三酰甘油水平（β=0.17；P=0.005）、血压（β=0.18；P=0.005）和空腹血糖（β=0.17；P=0.009）与非钙化冠状动脉负担显著相关。在调整所有其他代谢综合征因素后，血压和腰围与非钙化冠状动脉负担仍显著相关。
观察性研究，控制混杂因素的能力有限。
在银屑病中，代谢综合征患者有更多的心血管疾病危险因素、全身炎症和非钙化冠状动脉负担。应努力提高对银屑病患者代谢综合征的认识，以降低心血管疾病的风险。
