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January 11, 2021
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Psoriasis, metabolic syndrome associated with cardiovascular risk

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Higher systemic inflammation and cardiovascular risk factors were identified in individuals with psoriasis and metabolic syndrome, according to a study published in Journal of the American Academy of Dermatology.

“Those with psoriasis were previously shown to have higher rates of MetSyn, and here, we show that when MetSyn is present, there is higher subclinical rupture-prone heart disease present,” study author Nehal Mehta, MD, MSCE, FAHA, Lasker senior investigator and chief of the Lab of Inflammation and Cardiometabolic Disease at the National Heart, Lung, and Blood Institute, told Healio.

The cross-sectional study included 260 participants from the ongoing prospective longitudinal Psoriasis, Atherosclerosis, and Cardiometabolic Disease Initiative who had psoriasis and coronary computed tomography angiography results.

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Eighty of the participants met metabolic syndrome (MetSyn) criteria. Psoriasis Area Severity Index scores and disease duration were not significantly different in those with and without MetSyn.

Subjects with MetSyn had a higher prevalence of coronary plaque (P = .01) and high-risk plaque (P = .02). After adjusting for 10-year Framingham risk score, biologic use and lipid-lowering therapy, the presence of MetSyn was significantly associated with higher noncalcified coronary burden (NCB) (P < .001).

“The MetSyn group had a higher burden of cardiometabolic disease, systemic inflammation, NCB and high-risk plaque. After adjusting for all other MetSyn factors, blood pressure and waist circumference remained significantly associated with NCB,” Mehta said.

The study’s limitations included its observational and cross-sectional nature, and the authors suggested further study of the role of inflammation and anti-inflammatory treatment on MetSyn’s impact in psoriasis.

“Efforts to increase MetSyn awareness in psoriasis should be undertaken to reduce the heightened CVD risk; providers, patients and payers need to be aware of this association,” Mehta said.

Screening efforts for what he calls “Mehta’s 3 Bs” — BMI, blood pressure and blood measures for glucose and cholesterol — should be increased, he added.