title: Characterization of Lipoprotein Composition and Function in Pediatric Psoriasis Reveals a More Atherogenic Profile.
abstract: Psoriasis is associated with increased cardiovascular disease in adults, but the risk profile of children with psoriasis remains to be fully characterized. We measured lipoprotein composition and function in 44 patients with pediatric psoriasis and 44 age- and sex-matched healthy controls, using nuclear magnetic resonance spectroscopy and a validated ex vivo assay of high-density lipoprotein cholesterol efflux capacity. The mean age of the patients was 13 years and the population was ethnically diverse. Children with psoriasis had higher waist-to-hip ratios (0.85 vs. 0.80; P < 0.002) and insulin resistance measures (log-transformed homeostasis model assessment of insulin resistance 0.65 vs. 0.41; P = 0.07). Despite comparable traditional lipid values, having psoriasis was associated with higher apolipoprotein B concentrations (72.4 vs. 64.6; P = 0.02), decreased large high-density lipoprotein particles (5.3 vs. 6.7; P < 0.01), and reduced cholesterol efflux capacity after adjusting for age, sex, fasting glucose, homeostasis model assessment of insulin resistance, systolic blood pressure, body mass index, apolipoprotein A-1, and high-density lipoprotein cholesterol concentration (β -0.22; P = 0.02). Patients with pediatric psoriasis have a more atherogenic cardiometabolic risk profile, with evidence of insulin resistance and lipoprotein dysfunction by particle size, number, and functional assessment. These findings may provide a basis for the observed link later in life between psoriasis and cardiovascular disease, and support the need to screen and educate young patients to minimize later complications.
authors.affiliation: Departments of Pediatrics and Medicine (Dermatology), University of California, San Diego and Rady Children's Hospital, San Diego, California, USA. Electronic address: wtom@rchsd.org.
authors.forename: Wynnis L
authors.initials: WL
authors.lastname: Tom
authors.affiliation: Cardiology Branch, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Martin P
authors.initials: MP
authors.lastname: Playford
authors.affiliation: Departments of Pediatrics and Medicine (Dermatology), University of California, San Diego and Rady Children's Hospital, San Diego, California, USA.
authors.forename: Shehla
authors.initials: S
authors.lastname: Admani
authors.affiliation: Cardiology Branch, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Balaji
authors.initials: B
authors.lastname: Natarajan
authors.affiliation: Cardiology Branch, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Aditya A
authors.initials: AA
authors.lastname: Joshi
authors.affiliation: Departments of Pediatrics and Medicine (Dermatology), University of California, San Diego and Rady Children's Hospital, San Diego, California, USA.
authors.forename: Lawrence F
authors.initials: LF
authors.lastname: Eichenfield
authors.affiliation: Cardiology Branch, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Nehal N
authors.initials: NN
authors.lastname: Mehta
mesh_terms: D000293:Adolescent; D000367:Age Factors; D050197:Atherosclerosis / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000517:prevention & control; D016022:Case-Control Studies; D002648:Child; D002784:Cholesterol / Q000009:adverse effects / Q000378:metabolism; D005260:Female; D006801:Humans; D015994:Incidence; D007333:Insulin Resistance; D016013:Likelihood Functions; D008074:Lipoproteins / Q000097:blood* / Q000378:metabolism; D008297:Male; D010372:Pediatrics; D011379:Prognosis; D011565:Psoriasis / Q000097:blood* / Q000150:complications* / Q000503:physiopathology; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D049629:Waist-Hip Ratio
chemical_list: D008074:Lipoproteins; D002784:Cholesterol