Metabolic syndrome, C-reactive protein and cardiovascular risk in psoriasis patients: a cross-sectional study

An Bras Dermatol. 2018 Mar;93(2):222-228. doi: 10.1590/abd1806-4841.20186397.

Abstract

Background: Psoriasis has been associated with co-morbidities and elevated cardiovascular risk.

Objectives: To analyze the relationships among metabolic syndrome, cardiovascular risk, C-reactive protein, gender, and Psoriasis severity.

Methods: In this cross-sectional study, plaque Psoriasis patients (n=90), distributed equally in gender, were analyzed according to: Psoriasis Area and Severity Index, cardiovascular risk determined by the Framingham risk score and global risk assessment, C-reactive protein and metabolic syndrome criteria (NCEPT-ATP III).

Results: Metabolic syndrome frequency was 43.3% overall, without significance between genders (P=0.14); but women had higher risk for obesity (OR 2.56, 95%CI 1.02-6.41; P=0.04) and systemic arterial hypertension (OR 3.29, 95%CI 1.39-7.81; P=0.006). The increase in the Psoriasis Area and Severity Index also increased the risk for metabolic syndrome (OR 1.060, 95%CI 1.006-1.117; P=0.03). Absolute 10-year cardiovascular risk was higher in males (P=0.002), but after global risk assessment, 51.1% patients, 52.2% women, were re-classified as high-intermediate cardiovascular risk; without significance between genders (P=0.83). C-reactive protein level was elevated nearly six-fold overall, higher in metabolic syndrome (P=0.05), systemic arterial hypertension (P=0.004), and high-intermediate 10-year cardiovascular risk patients (P<0.001); positively correlated to: Framingham risk score (P<0.001; r=0.60), absolute 10-year cardiovascular risk (P<0.001; r=0.58), and age (P=0.001; r=0.35); but not to Psoriasis Area and Severity Index (P=0.14; r=0.16); increased the 10-year cardiovascular risk (R2=33.6; P<0.001), MetS risk (OR 1.17, 95%CI 0.99-1.37; P=0.05) and with age (P=0.001). HDL-cholesterol level was higher in normal C-reactive protein patients (t=1.98; P=0.05).

Study limitations: Restricted sample, hospital-based and representative of a single center and no specification of psoriatic arthritis.

Conclusions: Psoriasis, metabolic syndrome, systemic arterial hypertension and age share the increase in C-reactive protein, which could implicate in additional burden for increasing the cardiovascular risk and be an alert for effective interventions.

MeSH terms

  • Adult
  • Anthropometry
  • Brazil / epidemiology
  • C-Reactive Protein / analysis*
  • Cardiovascular Diseases / etiology*
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension / complications
  • Hypertension / epidemiology
  • Male
  • Metabolic Syndrome / complications*
  • Metabolic Syndrome / epidemiology*
  • Middle Aged
  • Multivariate Analysis
  • Obesity / complications
  • Obesity / epidemiology
  • Prevalence
  • Psoriasis / complications*
  • Psoriasis / epidemiology*
  • Psoriasis / metabolism
  • Reference Values
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Sex Distribution
  • Sex Factors

Substances

  • C-Reactive Protein

Grants and funding

Financial support: This research has received support from the Center for Research in Inflammatory Diseases [CRID] under grant agreement n°11.1.21625.01.0.