title: Atheroma plaque, metabolic syndrome and inflammation in patients with psoriasis.
abstract: BACKGROUND
  Chronic inflammation plays an important role in the development of cardiovascular risk factors. Although the prevalence of comorbidities and cardiovascular events has been described in patients with psoriasis, few studies have examined subclinical atherosclerosis in psoriasis patients.
  
  
  OBJECTIVE
  Our objective was to investigate the prevalence of atheroma plaques in patients with severe psoriasis compared with control subjects and to analyze the association with metabolic syndrome, homocysteine levels and inflammatory parameters.
  
  
  METHODS
  This case-control study included 133 patients, 72 with psoriasis and 61 controls consecutively admitted to the outpatient clinic in Dermatology Departments (Granada, Spain.)
  
  
  RESULTS
  Carotid atheroma plaques were observed in 34.7% of the psoriatic patients versus 8.2% of the controls (p=0.001) and metabolic syndrome was diagnosed in 40.3% of the psoriatic patients versus 13.1% of the controls (p<0.001). Significantly higher mean values of insulin, aldosterone, homocysteine and acute phase parameters (fibrinogen, D-dimer, C reactive protein and erythrocyte sedimentation rate) were found in psoriatic patients. Binary logistic regression showed a strong association between psoriasis and atheroma plaque and metabolic syndrome after controlling for confounding variables.
  
  
  CONCLUSIONS
  The absence of longitudinal quantification of metabolic syndrome parameters and intima-media thickness in psoriatic patients.
  
  
  CONCLUSIONS
  The chronic inflammation and hyperhomocysteinemia found in psoriatic patients may explain the association with atheroma plaque and metabolic syndrome. Cardiovascular screening by metabolic syndrome criteria assessment and carotid ultrasound in psoriasis may be useful to detect individuals at risk and start preventive treatment against the development of cardiovascular disease.
authors.affiliation: Dermatology Department, San Cecilio University Hospital, Granada, Spain. salvadorarias@hotmail.es
authors.forename: Salvador
authors.initials: S
authors.lastname: Arias-Santiago
authors.forename: Jacinto
authors.initials: J
authors.lastname: Orgaz-Molina
authors.forename: Luisa
authors.initials: L
authors.lastname: Castellote-Caballero
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Arrabal-Polo
authors.forename: Sonia
authors.initials: S
authors.lastname: García-Rodriguez
authors.forename: Rubén
authors.initials: R
authors.lastname: Perandrés-López
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Ruiz
authors.forename: Ramón
authors.initials: R
authors.lastname: Naranjo-Sintes
authors.forename: Mercedes
authors.initials: M
authors.lastname: Zubiaur
authors.forename: Jaime
authors.initials: J
authors.lastname: Sancho
authors.forename: Agustín
authors.initials: A
authors.lastname: Buendía-Eisman
mesh_terms: D000209:Acute-Phase Proteins / Q000032:analysis; D000328:Adult; D002340:Carotid Artery Diseases / Q000453:epidemiology; D016022:Case-Control Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D020138:Hyperhomocysteinemia / Q000453:epidemiology; D006946:Hyperinsulinism / Q000453:epidemiology; D007249:Inflammation / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000453:epidemiology*; D015995:Prevalence; D011565:Psoriasis / Q000453:epidemiology*; D018570:Risk Assessment; D018608:Ultrasonography, Doppler
chemical_list: D000209:Acute-Phase Proteins