Abstract P210: Lipoprotein Profiles in Patients With and Without Psoriasis
Introduction: Psoriasis is associated with chronically heightened systemic inflammatory tone and increased risk for cardiovascular disease. It remains to be established if the psoriatic state itself associates with dyslipidemia. Hypothesis: The lipid profile of patients with psoriasis is more atherogenic compared to disease-free control patients. Methods: The concentration and size of lipoprotein particles were measured using nuclear magnetic resonance spectroscopy in 221 patients with a diagnosis of psoriasis (53.6% men; mean age=56.6 years; mild cases=31%; moderate/severe only skin=27%; arthritis=27%)) and 689 disease-free persons matched by sex and age. We compared means of lipoprotein particle concentration and size using a univariate general linear model and adjusting for body-mass index, waist circumference, diabetes, use of lipid lowering-drugs, as well as duration/severity of psoriasis. Results: Patients with psoriasis were more overweight, had larger waist circumference, and a higher frequency of diabetes and use of lipid-lowering drugs. Total LDL particle means (nmol/L) for the psoriasis and control groups were 1436 (1378-1494) vs. 1420 (1388-1452) (P=0.4), respectively. The mean concentration of IDL was higher in patients with psoriasis compared to controls: 143.6 (130.7-156.5) vs. 106.1 (99.1-113.2), P<0.01. Large and small LDL particle concentrations were similar between groups. Large VLDL/chylomicron particle concentrations (nmol/L) were higher in psoriasis patients compared to controls 6.1 (5.2-7.0) vs. 4.0 (3.6-4.5) (P<0.01). Total HDL particle and subfractions were not statistically different between groups. The mean size (nm) of VLDL was higher in psoriasis patients: 50.2 (49.2-51.2) vs. 46.2 (45.6-46.7) (P<0.001) for psoriasis and controls, respectively. In contrast, mean sizes of LDL and HDL particles were similar (P=0.3). Adjustment for covariates above mentioned did not change these findings. The absence/presence of arthritis did not change the results. Conclusion: Patients with psoriasis have a more atherogenic lipid profile compared to controls with higher levels of IDL and VLDL of large and small size. In addition, the greater mean size of VLDL particles in psoriasis compared to controls suggests enhanced secretion of triglyceride loaded VLDL, impaired lipolysis and impaired clearance of remnant IDL.