Systemic inflammation and imbalance between endothelial injury and repair in patients with psoriasis are associated with preclinical atherosclerosis

• Published in: European journal of preventive cardiology 2015-08, Vol.22 (8), p.1027-1035
• Main Authors: Pirro, Matteo, Stingeni, Luca, Vaudo, Gaetano, Mannarino, Massimo R, Ministrini, Stefano, Vonella, Marilisa, Hansel, Katharina, Bagaglia, Francesco, Alaeddin, Abdalkader, Lisi, Paolo, Mannarino, Elmo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Asymptomatic Diseases; C-Reactive Protein - analysis; Carotid Artery Diseases - blood; Carotid Artery Diseases - diagnosis; Carotid Artery Diseases - epidemiology; Carotid Artery Diseases - immunology; Carotid Intima-Media Thickness; Case-Control Studies; Cell-Derived Microparticles - pathology; Endothelial Progenitor Cells - pathology; Endothelium, Vascular - immunology; Endothelium, Vascular - metabolism; Endothelium, Vascular - pathology; Female; Humans; Inflammation - blood; Inflammation - diagnosis; Inflammation - epidemiology; Inflammation - immunology; Inflammation Mediators - blood; Italy - epidemiology; Male; Metabolic Syndrome - diagnosis; Metabolic Syndrome - epidemiology; Middle Aged; Predictive Value of Tests; Prevalence; Psoriasis - blood; Psoriasis - diagnosis; Psoriasis - epidemiology; Psoriasis - immunology; Risk Assessment; Risk Factors
• ISSN: 2047-4873; 2047-4881
• DOI: 10.1177/2047487314538858

Background Systemic inflammation and imbalance between endothelial injury and repair, the latter referred to as vascular incompetence, are associated with atherosclerosis and cardiovascular risk. Psoriasis, an inflammatory disease of the skin, has been associated with atherosclerosis. We investigated whether, in psoriasis, inflammation and vascular incompetence are associated with carotid intima-media thickness (cIMT) irrespective of metabolic syndrome and other established cardiovascular risk factors. Methods High sensitivity C-reactive protein (hsCRP), the ratio between endothelial microparticles (EMPs) and progenitors (EPCs), a marker of vascular incompetence, and cIMT were measured in 84 patients with psoriasis and 90 healthy controls, balanced for age, gender and the prevalence of metabolic syndrome. Results Patients with psoriasis had higher hsCRP, EMP/EPC ratio and cIMT than controls. Patients with both psoriasis and metabolic syndrome had the highest hsCRP levels, psoriasis and metabolic syndrome being associated with a 3.1- and 2.6-fold increased risk of having high hsCRP levels, respectively. Logarithm transformed hsCRP and EMP/EPC ratio were predictors of high cIMT (odds ratio 3.8; 95% confidence interval 1.3–11.4; p = 0.02 and odds ratio 8.7; 95% confidence interval 2.7–27.5; p