title: Psoriasis is associated with decreased plasma adiponectin levels independently of cardiometabolic risk factors.
abstract: BACKGROUND
  Psoriasis is an inflammatory skin disease that may be associated with an adverse cardiometabolic profile including modulated plasma adiponectin and leptin levels. Whether these levels are independent of cardiometabolic risk factors, which are also prevalent in psoriasis, is not known.
  
  
  METHODS
  A consecutive sample of 122 participants with varying degrees of psoriasis severity, and a random sample of 134 participants without psoriasis, were recruited for this case-control study. Cardiometabolic risk factors including traditional cardiovascular risk factors, waist circumference, insulin resistance, and total plasma adiponectin and leptin were measured. Total plasma adiponectin and leptin levels were compared in unadjusted and adjusted analyses by psoriasis status.
  
  
  RESULTS
  Participants with psoriasis had mostly mild disease and were mainly on topical therapies, but still had a more adverse cardiometabolic profile compared with those without psoriasis. Furthermore, plasma adiponectin levels were significantly lower in participants with psoriasis than those without {7.13 μg/mL [interquartile range (IQR) 4.9-11.3) vs. 14.5 μg/mL (IQR 8.4-24.1); P < 0.001]}. Plasma leptin (ng/mL) levels were higher in the psoriasis group but this did not reach statistical significance [11.3 (IQR 6.4-21.8) vs. 9.8 (IQR 4.9-20.5); P = 0.07]. In multivariable modelling, plasma adiponectin levels were still negatively associated with psoriasis status after adjusting for waist size (% difference = -41.2%, P < 0.001), insulin resistance (% difference = -39.5%, P < 0.001), and both waist size and insulin resistance (% difference = -38.5%, P < 0.001).
  
  
  CONCLUSIONS
  Plasma levels of adiponectin were lower in psoriasis, and this relationship persisted after adjusting for cardiometabolic risk factors known to decrease adiponectin levels. These findings suggest that inflammation present in psoriasis may be associated with adipose tissue dysfunction; however, direct studies of adipose tissue are needed to confirm this.
authors.affiliation: Cardiovascular Institute, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: R C
authors.initials: RC
authors.lastname: Li
authors.forename: P
authors.initials: P
authors.lastname: Krishnamoorthy
authors.forename: S
authors.initials: S
authors.lastname: DerOhannessian
authors.forename: J
authors.initials: J
authors.lastname: Doveikis
authors.forename: M
authors.initials: M
authors.lastname: Wilcox
authors.forename: P
authors.initials: P
authors.lastname: Thomas
authors.forename: D J
authors.initials: DJ
authors.lastname: Rader
authors.forename: M P
authors.initials: MP
authors.lastname: Reilly
authors.forename: A
authors.initials: A
authors.lastname: Van Voorhees
authors.forename: J M
authors.initials: JM
authors.lastname: Gelfand
authors.forename: N N
authors.initials: NN
authors.lastname: Mehta
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D002318:Cardiovascular Diseases / Q000097:blood* / Q000503:physiopathology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011565:Psoriasis / Q000097:blood* / Q000503:physiopathology; D012307:Risk Factors; D055105:Waist Circumference / Q000502:physiology
chemical_list: D052242:Adiponectin; D020738:Leptin