Subclinical atherosclerosis in psoriatic disease: relation to endocan, TNF-α, age of onset, and body fat

Int J Dermatol. 2019 Apr;58(4):456-464. doi: 10.1111/ijd.14290. Epub 2018 Nov 23.

Abstract

Background: Psoriasis is a common multisystem inflammatory disease with several associated comorbidities. Serological markers to detect associated subclinical atherosclerosis in psoriatic patients are needed. We aimed to study serum endocan levels in psoriasis vulgaris and its relation to severity of psoriasis, systemic inflammation, associated atherosclerosis, obesity, and the possible factors affecting its level in psoriatic patients.

Methods: This study was conducted on 30 moderate-severe psoriasis vulgaris patients and 30 healthy controls. Body mass index, body fat percent, and PASI assessments were done. Serum endocan and tumor necrosis factor-α levels were measured by ELISA. Carotid artery intima-media thickness measurement by high-resolution ultrasound was performed.

Results: Psoriasis patients showed significantly higher serum tumor necrosis factor-α and endocan levels (P1 = 0.008, P2 = 0.003). Additionally, there was a statistically significant difference between mean carotid artery intima-media thickness of both groups (P = 0.005). Serum endocan levels positively correlated with PASI score (P = 0.002), tumor necrosis factor-α levels (P < 0.001), mean carotid artery intima-media thickness (P = 0.001), and body mass index (P < 0.001) in the patients group. Additionally, the age of onset of disease negatively correlated with serum endocan (P = 0.003).

Conclusion: Serum endocan is a promising marker of severity of psoriasis and associated atherosclerosis. Early onset psoriasis is associated with higher serum endocan levels. Body mass index is positively correlated with serum endocan levels. The positive correlation of endocan and tumor necrosis factor-α supports the regulatory effect of the cytokine on endocan production and suggests the role of endocan as an inflammatory marker.

MeSH terms

  • Adiposity
  • Adult
  • Age of Onset
  • Atherosclerosis / blood*
  • Atherosclerosis / complications
  • Atherosclerosis / diagnosis*
  • Biomarkers / blood
  • Body Mass Index
  • Carotid Intima-Media Thickness
  • Case-Control Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Proteins / blood*
  • Obesity / blood*
  • Obesity / complications
  • Predictive Value of Tests
  • Proteoglycans / blood*
  • Psoriasis / blood*
  • Psoriasis / complications
  • ROC Curve
  • Severity of Illness Index
  • Tumor Necrosis Factor-alpha / blood*
  • Young Adult

Substances

  • Biomarkers
  • ESM1 protein, human
  • Neoplasm Proteins
  • Proteoglycans
  • Tumor Necrosis Factor-alpha