Abstract 12996: Atherogenic Lipoprotein Particle Size and Number Despite Normal Lipid Profiles in Psoriasis
Introduction: Psoriasis is a chronic inflammatory skin disease associated with increased risk of myocardial infarction (MI). Advanced lipoprotein biomarkers measured by nuclear magnetic resonance (NMR) have been shown to associate with adverse cardiometabolic profiles and MI. However, the role of lipid particle size and number in psoriasis is unknown and may provide a link between psoriasis and MI.
Methods: We prospectively enrolled a consecutive sample of patients with psoriasis (n=78) and compared cardiometabolic risk factors with an asymptomatic age and gender matched sample from our practice (n=84). Fasting lipids and lipoprotein concentration and size were measured by NMR (LipoScience, North Carolina). Multivariable linear regression adjusting for cardiometabolic risk factors was performed using STATA 10 software.
Results: As expected, psoriasis was associated with increased hypertension, tobacco use and body mass index (BMI) compared to controls (p<0.001 for all), however, traditional lipids (all in mg/dL) including total cholesterol (188 (±36) vs 208 (±32)), LDL cholesterol (110 (±32) vs 127 (±27)) and HDL cholesterol (47(±14) vs 55(±14)) were lower in psoriasis (p<0.01) with no difference in triglycerides. Advanced lipoprotein testing by NMR showed significant increase in VLDL [72 (±47) vs 53(±33), p=0.008] and LDL [1271 (±413) vs 1139 (±328), p=0.002] total particle concentration. Particle size also showed increase VLDL size [51 (±8) vs 47 (±13), p<0.001], decrease LDL [20 (±0.7) vs 21 (±0.7), p<0.001] and HDL size [8.97 (±0.6) vs 9.04 (±0.3), p=0.01] consistent with a more atherogenic profile. These differences persisted after adjusting for HTN, tobacco use, BMI and traditional lipids in a multivariable model (p<0.001 for VLDL, LDL total particle concentration and LDL size in each model).
Conclusions: We demonstrate that despite normal lipid profiles in psoriasis compared to healthy patients, both particle size and concentration of LDL and VLDL cholesterol by NMR are significantly abnormal in psoriasis. The profile observed is similar to that seen in diabetes and may provide a link between the association of psoriasis and major adverse cardiac events (MACE), however larger studies are needed to validate these findings.
- © 2011 by American Heart Association, Inc.