牛皮癣和心血管风险：相关和保护因素。

IF 2.6 4区医学 Q2 DERMATOLOGY

Anais brasileiros de dermatologia Pub Date : 2025-05-01 DOI:10.1016/j.abd.2024.07.013

Luciana Agoglia , Helena Peixoto , Ana Carolina Cardoso , Lívia Barbosa , Cecília S.X.L. Victer , Sueli Carneiro , Gil F. Salles , Cristiane A. Villela-Nogueira , Maria Chiara Chindamo

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引用次数: 0

摘要

背景：银屑病（Pso）是一种与代谢综合征（MetS）、脂肪变性肝病（SLD）和心血管风险相关的炎症性皮肤病。然而，抗炎治疗对心血管风险的影响尚不确定。目的：利用金标准颈-股脉波速度（cf-PWV）测量，确定抗炎治疗与Pso患者亚临床动脉粥样硬化之间的关系。此外，使用Fibroscan®的瞬时弹性成像（TE）评估cf-PWV、脂肪变性和晚期纤维化（AF）之间的关系。方法：横断面研究，包括接受cf-PWV和TE治疗的Pso患者。脂肪变性定义为控制衰减参数≥275 dB/m， AF定义为肝刚度测量≥10 kPa，主动脉刚度增加（AoS）定义为cf-PWV ≥ 10 m/s。显著累积甲氨蝶呤剂量≥1500 mg （MTX1500）。Logistic回归分析评估与AoS升高相关的自变量。结果：纳入80例患者（平均年龄56.2 ± 11.5岁，女性57.5%,BMI 28.6 ± 5.3 kg/m2）。met、糖尿病、血脂异常、全身性动脉高血压、脂肪变性和心房颤动的患病率分别为57.5%、40.0%、67.5%、70.0%、50.0%和16.3%。MTX1500占45%，免疫生物学治疗占33.8%，cf-PWV ≥ 10 m/s占21.2%。经logistic回归分析，年龄与cf-PWV ≥ 10 m/s独立相关(OR = 1.21；95% ci 1.06-1.38；p = 0.003)，MTX1500是心血管保护因素(OR = 0.18；95% ci 0.038-0.87； = 0.033页)。脂肪变性、AF或免疫生物学治疗与cf-PWV≥10 m/s无关联。研究局限性：样本量。结论：在Pso患者中，AoS的增加与年龄有关，但与脂肪变性或房颤无关。MTX在MetS及其组成部分高发的Pso人群中发现了保护心血管的作用。

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Psoriasis and cardiovascular risk: associated and protective factors

Background

Psoriasis is an inflammatory skin disease associated with Metabolic Syndrome (MetS), Steatotic Liver Disease (SLD) and cardiovascular risk. However, the effect of anti-inflammatory therapy on cardiovascular risk is uncertain.

Objectives

To determine the relationship between anti-inflammatory therapy and subclinical atherosclerosis in individuals with psoriasis, using the gold standard carotid-femoral Pulse Wave Velocity (cf-PWV) measurement. Additionally, to evaluate the association between cf-PWV, steatosis and Advanced Fibrosis (AF) using Transient Elastography (TE) by Fibroscan®.

Methods

Cross-sectional study including psoriasis patients submitted to cf-PWV and TE. Steatosis was defined as a controlled attenuation parameter ≥ 275 dB/m, AF as liver stiffness measurement ≥ 10 kPa, and increased Aortic Stiffness (AoS) as cf-PWV ≥ 10 m/s. Significant cumulative methotrexate dose was ≥ 1500 mg (MTX1500). Logistic regression analysis evaluated the independent variables associated with increased AoS.

Results

Eighty patients were included (mean age 56.2 ± 11.5-years, 57.5% female, BMI 28.6 ± 5.3 kg/m²). Prevalences of MetS, diabetes mellitus, dyslipidemia, systemic arterial hypertension, steatosis and AF were 57.5%, 40.0%, 67.5%, 70.0%, 50.0% and 16.3%, respectively. MTX1500 was present in 45%, immunobiological treatment in 33.8%, and cf-PWV ≥ 10 m/s in 21.2%. On logistic regression analysis, age was independently related to cf-PWV ≥ 10 m/s (OR = 1.21; 95% CI 1.06‒1.38; p = 0.003) and MTX1500 was a protective cardiovascular factor (OR = 0.18; 95% CI 0.038‒0.87; p = 0.033). No association was observed between steatosis, AF or immunobiological therapy and cf-PWV ≥10 m/s.

Study limitations

Sample size.

Conclusion

In patients with psoriasis, increased AoS was associated with age, but not with steatosis or AF. A protective cardiovascular effect of MTX was found in a psoriasis population with a high prevalence of MetS and its components.

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来源期刊

Anais brasileiros de dermatologia DERMATOLOGY-

CiteScore

2.40

自引率

0.00%

发文量

184

审稿时长

32 days

期刊介绍： The journal is published bimonthly and is devoted to the dissemination of original, unpublished technical-scientific study, resulting from research or reviews of dermatological topics and related matters. Exchanges with other publications may be accepted.