Seçkin D, Tokgözoğlu L, Akkaya S
Faculty of Medicine, Hacettepe University, Ankara, Turkey.
J Am Acad Dermatol. 1994 Sep;31(3 Pt 1):445-9. doi: 10.1016/s0190-9622(94)70208-x.
Previous studies have demonstrated that patients with psoriasis may have an increased risk of a variety of noncutaneous diseases, including arterial and venous occlusive diseases. Changes in plasma lipid and lipoprotein composition in patients with psoriasis may be the reason for the increased risk of atherosclerosis in these patients. Lipoprotein (a) (Lp(a)) is a genetically determined lipoprotein associated with an increased prevalence of atherosclerotic and thrombotic cardiovascular diseases.
The aim of this prospective study was to determine the lipid profile and to define the significance of Lp(a) levels in men with psoriasis. The other purpose was to learn whether a correlation exists between psoriasis area and severity index score and serum Lp(a) or other lipids.
Serum Lp(a) levels were measured with a commercially available noncompetitive enzyme-linked immunosorbent assay in 32 men with psoriasis and in 13 healthy men. Total serum cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, apolipoprotein A-I and apolipoprotein B levels, and atherosclerotic risk factors other than hyperlipidemia were determined. Secondary hyperlipidemia from various diseases and drugs was ruled out in both groups.
Serum Lp(a) levels were higher in men with psoriasis than in healthy male subjects, but the difference was not significant (p = 0.063). Serum fasting glucose levels were also found to be higher in the psoriasis group (p < 0.05). Higher serum Lp(a) and fasting glucose levels tended to occur in patients with extensive and severe skin involvement. No statistical differences were observed in the total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, apolipoprotein A-I, and apolipoprotein B levels between the two groups (p > 0.05).
Our results suggest that the increased Lp(a) level might be a factor involved in occlusive vascular disorders in patients with psoriasis and that patients with extensive and severe skin involvement are more predisposed to relatively high Lp(a) levels.
既往研究表明，银屑病患者患包括动脉和静脉闭塞性疾病在内的多种非皮肤疾病的风险可能增加。银屑病患者血浆脂质和脂蛋白组成的变化可能是这些患者动脉粥样硬化风险增加的原因。脂蛋白(a)[Lp(a)]是一种由基因决定的脂蛋白，与动脉粥样硬化和血栓形成性心血管疾病的患病率增加相关。
这项前瞻性研究的目的是确定银屑病男性患者的血脂谱，并明确Lp(a)水平的意义。另一个目的是了解银屑病面积和严重程度指数评分与血清Lp(a)或其他脂质之间是否存在相关性。
采用市售的非竞争性酶联免疫吸附测定法，对32例银屑病男性患者和13例健康男性测定血清Lp(a)水平。测定总血清胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、载脂蛋白A-I和载脂蛋白B水平，以及除高脂血症外的动脉粥样硬化危险因素。两组均排除各种疾病和药物引起的继发性高脂血症。
银屑病男性患者的血清Lp(a)水平高于健康男性受试者，但差异无统计学意义(p = 0.063)。银屑病组的空腹血糖水平也较高(p < 0.05)。皮肤广泛且严重受累的患者血清Lp(a)和空腹血糖水平往往较高。两组的总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、载脂蛋白A-I和载脂蛋白B水平无统计学差异(p > 0.05)。
我们的结果表明，Lp(a)水平升高可能是银屑病患者发生闭塞性血管疾病的一个因素，皮肤广泛且严重受累的患者更容易出现相对较高的Lp(a)水平。
