Visceral Adiposity in Psoriasis is Associated With Vascular Inflammation by 18 F-Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography Beyond Cardiometabolic Disease Risk Factors in an Observational Cohort Study

JACC Cardiovasc Imaging. 2018 Feb;11(2 Pt 2):349-357. doi: 10.1016/j.jcmg.2017.08.014. Epub 2017 Oct 18.

Abstract

Objectives: The authors sought to examine the relationship between visceral adipose tissue (VAT) and vascular inflammation (VI) by 18F-Fluorodeoxyglucose (18F-FDG) positron-emission tomography (PET)/computed tomography (CT) in psoriasis (PSO). Furthermore, we evaluated whether treatment of PSO modulated VAT and VI.

Background: PSO, a chronic inflammatory skin disease, is associated with VI by 18F-FDG PET/CT and increased cardiometabolic risk including adipose tissue dysregulation. Recently, VI was associated with future cardiovascular events; however, the relationship of visceral and subcutaneous adiposity with VI in PSO has yet to be evaluated.

Methods: Consecutive PSO patients (N = 77) underwent 18F-FDG PET/CT scans to measure VI and abdominal adiposity. A subset of PSO patients with severe skin disease was scanned at 1 year following PSO treatment (N = 13).

Results: The cohort was middle aged (51.8 ± 12.6 years), predominantly male (n = 44, 57%), had low cardiovascular risk by Framingham 10-year risk (median 4 years [interquartile range (IQR): 2 to 7 years]), and mild-to-moderate skin disease (5.2 [IQR: 3.0 to 8.5]). PSO disease severity associated with VAT (β = 0.33; p = 0.004) beyond SAT (β = 0.30; p = 0.005). VAT (β = 0.55; p < 0.001), but not SAT (β = 0.15; p = 0.11), associated with VI beyond cardiovascular risk factors. We followed a subset of severe PSO patients treated aggressively for PSO and observed improvement in PSO severity and VAT, which was associated with an improvement in VI at 1 year beyond cardiovascular risk factors (β = 0.53; p = 0.049).

Conclusions: Volume-based CT measurement of VAT may capture metabolic risk associated with VI compared to subcutaneous adipose tissue in PSO. PSO treatment associated with a decrease in VAT as well as decrease in VI suggesting VAT as a relevant biomarker related to VI in PSO.

Keywords: (18)F-FDG PET/CT; cardiometabolic disease; cardiovascular disease; psoriasis; vascular inflammation; visceral adiposity.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiposity*
  • Adult
  • Female
  • Fluorodeoxyglucose F18 / administration & dosage*
  • Humans
  • Intra-Abdominal Fat / diagnostic imaging*
  • Intra-Abdominal Fat / physiopathology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Positron Emission Tomography Computed Tomography*
  • Predictive Value of Tests
  • Prognosis
  • Psoriasis / diagnostic imaging*
  • Psoriasis / physiopathology
  • Psoriasis / therapy
  • Radiopharmaceuticals / administration & dosage*
  • Risk Factors
  • Subcutaneous Fat / diagnostic imaging*
  • Subcutaneous Fat / physiopathology
  • Time Factors
  • Vasculitis / diagnostic imaging*
  • Vasculitis / physiopathology
  • Vasculitis / therapy
  • Whole Body Imaging

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18