Key result
Severe psoriasis linked to ~152% higher subclinical atherosclerosis risk and increased epicardial fat volume.
Why the study?
Is severe psoriasis associated with increased epicardial adipose tissue volume and subclinical atherosclerosis compared to controls?
Case-Control (n=302)
Is severe psoriasis associated with increased epicardial adipose tissue volume and subclinical atherosclerosis compared to controls?
Severe psoriasis is associated with increased epicardial adipose tissue volume and subclinical atherosclerosis, independent of traditional cardiovascular risk factors and abdominal visceral fat.
Answers are grounded in this paper and cite their sources.
May support heightened CV risk assessment in severe psoriasis; hypothesis-generating for EAT mediation in observational data.
BACKGROUND: Psoriasis is a chronic, immune-mediated disease associated with several cardio-metabolic comorbidities, accelerated atherosclerosis and cardiovascular disease (CVD). Other causes beyond systemic inflammation and traditional cardiovascular risk factors (CVRF) may be implicated in the increased risk of CVD observed in these patients. Epicardial adipose tissue (EAT), a type of visceral adipose tissue surrounding the heart and coronary vessels has been implicated in the development of coronary artery disease, by endocrine mechanisms, but particularly by local inflammation. OBJECTIVE: To compare EAT volumes in psoriasis patients and controls using multidetector computed tomography (MDCT) and to analyse if eventual differences were independent from abdominal visceral adiposity; to determine, within psoriasis patients, its relation with subclinical atherosclerosis and other markers of cardiometabolic risk. METHODS: One hundred patients with severe psoriasis, without CVD underwent MDCT, with EAT and abdominal visceral fat (AVF) assessment and coronary artery calcification (CAC) quantification and were compared with 202 control patients. RESULTS: EAT volume was increased in psoriasis patients compared to control subjects, independently from age, sex and AVF, being, on average, 15.2 ± 4.41 mL higher (95% CI: 6.5-26.0, P = 0.001) than in controls. Moreover, psoriasis patients had a statistically significant higher risk of having subclinical atherosclerosis (OR 2.52, 95% CI: 1.23-5.16) than controls, after adjusting for traditional CVRF. Within psoriasis patients EAT volume was associated with subclinical atherosclerosis, independently of age, sex, psoriasis duration, classical CVRF and AVF. CONCLUSION: This study showed that psoriasis was associated with increased EAT volume independently of visceral abdominal fat and with subclinical atherosclerosis. Within psoriasis patients EAT volume was independently associated with CAC. EAT may be another important contributor to the higher cardiovascular risk observed in psoriasis.
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Torres et al. (2014) conducted a case-control in Severe psoriasis (n=302). Severe psoriasis vs. Control patients was evaluated on Epicardial adipose tissue (EAT) volume (Mean difference 15.2 mL, 95% CI 6.5-26.0, p=0.001). Severe psoriasis was associated with a 15.2 mL higher epicardial adipose tissue volume and increased risk of subclinical atherosclerosis compared to controls.
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