Department of Dermatology, School of Medicine, Sakarya University, Sakarya, Turkey.
Trop Med Int Health. 2024 Nov;29(11):971-978. doi: 10.1111/tmi.14052. Epub 2024 Oct 24.
Psoriasis is a chronic inflammatory disease often associated with serious cardiovascular comorbidities. The aim of this study was to investigate the systemic inflammatory burden in psoriasis by examining various inflammatory markers and to assess the relationship between these markers and the severity of the disease.
This retrospective study was conducted on medical records of patients who visited the dermatology outpatient clinic between 1 January 2016 and 31 December 2022. The study included patients with psoriasis vulgaris and healthy volunteers. Demographic data, Psoriasis Area and Severity Index score, C-reactive protein, monocyte-high-density lipoprotein cholesterol ratio, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, systemic immune-inflammation index, and Systemic Inflammation Response Index were analysed and compared.
A total of 278 psoriasis patients and 90 healthy volunteers were analysed. Compared to the control group, psoriasis patients showed significantly higher systemic immune-inflammation index, Systemic Inflammation Response Index, neutrophil-to-lymphocyte ratio, monocyte-high-density lipoprotein cholesterol ratio, serum C-reactive protein levels, neutrophil count, monocyte count, body mass index, and waist circumference (p < 0.001, p = 0.001, p < 0.001, p = 0.014, p < 0.001, p < 0.001, p = 0.046, p < 0.001, and p = 0.011, respectively). Among patients with severe psoriasis (Psoriasis Area and Severity Index >10), systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and serum C-reactive protein levels were significantly higher compared to patients with mild/moderate psoriasis (Psoriasis Area and Severity Index ≤10). In the ROC curve analysis, the optimal cut-off (AUC, sensitivity, specificity) values for neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, and platelet-to-lymphocyte ratio were found to be 2.11 (0.592, 62%, 57%), 552.9 (0.579, 61%, 58%), and 111.9 (0.578, 64%, 46%), respectively. The inflammatory parameters that showed correlation with Psoriasis Area and Severity Index were systemic immune-inflammation index, Systemic Inflammation Response Index, neutrophil-to-lymphocyte ratio, monocyte-high-density lipoprotein cholesterol ratio, monocyte-to-lymphocyte ratio, and C-reactive protein.
The findings of this study suggest that systemic immune-inflammation index, Systemic Inflammation Response Index, neutrophil-to-lymphocyte ratio, monocyte-high-density lipoprotein cholesterol ratio, and C-reactive protein values have the potential to serve as simple and cost-effective markers for assessing the inflammatory burden in individuals with psoriasis.
银屑病是一种慢性炎症性疾病，常与严重的心血管合并症有关。本研究旨在通过检查各种炎症标志物来研究银屑病的全身炎症负担，并评估这些标志物与疾病严重程度之间的关系。
本回顾性研究对 2016 年 1 月至 2022 年 12 月期间在皮肤科门诊就诊的患者的病历进行了分析。研究包括寻常型银屑病患者和健康志愿者。分析并比较了人口统计学数据、银屑病面积和严重程度指数评分、C 反应蛋白、单核细胞高密度脂蛋白胆固醇比值、中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值、单核细胞与淋巴细胞比值、全身免疫炎症指数和全身炎症反应指数。
共分析了 278 例银屑病患者和 90 名健康志愿者。与对照组相比，银屑病患者的全身免疫炎症指数、全身炎症反应指数、中性粒细胞与淋巴细胞比值、单核细胞高密度脂蛋白胆固醇比值、血清 C 反应蛋白水平、中性粒细胞计数、单核细胞计数、体重指数和腰围均显著升高（p<0.001，p=0.001，p<0.001，p=0.014，p<0.001，p<0.001，p=0.046，p<0.001，p=0.011，分别）。在严重银屑病（银屑病面积和严重程度指数>10）患者中，全身免疫炎症指数、中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值和血清 C 反应蛋白水平明显高于轻度/中度银屑病（银屑病面积和严重程度指数≤10）患者。在 ROC 曲线分析中，发现中性粒细胞与淋巴细胞比值、全身免疫炎症指数和血小板与淋巴细胞比值的最佳截断值（AUC、灵敏度、特异性）分别为 2.11（0.592、62%、57%）、552.9（0.579、61%、58%）和 111.9（0.578、64%、46%）。与银屑病面积和严重程度指数相关的炎症参数为全身免疫炎症指数、全身炎症反应指数、中性粒细胞与淋巴细胞比值、单核细胞高密度脂蛋白胆固醇比值、单核细胞与淋巴细胞比值和 C 反应蛋白。
本研究结果表明，全身免疫炎症指数、全身炎症反应指数、中性粒细胞与淋巴细胞比值、单核细胞高密度脂蛋白胆固醇比值和 C 反应蛋白值有可能成为评估银屑病患者炎症负担的简单、经济有效的标志物。
