At present besides traditional laboratory investigations som

At present, besides traditional laboratory investigations, some new screening tests have been suggested to detect asymptomatic patients at risk of atherosclerosis, such as measurement of carotid artery intima–media thickness (CIMT) and extent of NAFLD by high-resolution B-mode ultrasound. CIMT, an indicator of generalized atherosclerosis, and NAFLD, an indicator of rivastigmine tartrate resistance and metabolic conditions, are accepted important markers for subclinical atherosclerosis and cardiovascular risk prediction in many recent studies.
Methods
Results The main demographic data, clinical features, and laboratory investigations of psoriatic patients and control individuals are shown in Table 1. The mean age and sex distribution for the patient and control groups were similar (p > 0.05). PASI scores of our psoriasis patients ranged from 4.8 to 52.4, with a mean of 12 ± 5. There were no significant differences in BMI, waist circumference, triglycerides, or total, high-density lipoprotein, and low-density lipoprotein cholesterol between patients with psoriasis and controls (p > 0.05). However, patients with psoriasis had significantly higher systolic and diastolic blood pressure, fasting plasma glucose, and HbA1c compared with controls (p < 0.05). Ultrasonographic data of the groups are shown in Table 2. Patients with psoriasis had a greater CIMT value than matched control individuals (0.75 ± 0.1 mm vs. 0.62 ± 0.1 mm; p < 0.001). The frequency of ultrasound-diagnosed NAFLD in psoriatic patients was significantly higher than in matched control individuals (53.3% vs. 35%, p < 0.05). Moreover, the difference between the two groups in terms of moderate–severe NAFLD and the grade of NAFLD distribution was stronger (p < 0.001). The univariate correlation analysis between PASI and related parameters showed that the PASI score was significantly positively correlated with systolic blood pressure (r = 0.368, p < 0.05), diastolic blood pressure (r = 0.414, p < 0.05), BMI (r = 0.443, p < 0.05), waist circumference (r = 0.460, p < 0.05), psoriasis duration (r = 0.510, p < 0.05), HbA1c (r = 0.618, p < 0.001), the presence of NAFLD (r = 0.695, p < 0.001), moderate–severe NAFLD (r = 0.771, p < 0.001), and CIMT (r = 0.802, p < 0.001) (Table 3). Our results also revealed that there is a positive correlation between CIMT and the grade of NAFLD in patients with psoriasis (r = 0.679, p < 0.001; Figure 1). In our study, disease duration showed a positive correlation with CIMT (r = 0.645, p < 0.001) and grade of NAFLD (r = 0.472, p < 0.05) in psoriasis patients. In multivariate linear regression analysis, HbA1c, moderate–severe NAFLD, and CIMT were significantly and independently associated with PASI score, and CIMT showed the most significant association with PASI score (Table 4).
Discussion To date, there have been some studies looking at the prevalence of either increased CIMT or NAFLD in psoriatic patients; however, to the best of our knowledge, this is the first study to evaluate both CIMT and NAFLD in the same group of psoriatic patients. Many previous studies have revealed that psoriasis is a risk factor for increased cardiovascular diseases. However, these studies have focused on selected psoriasis patients, such as those hospitalized for their disease or with multiple comorbidities including obesity, hyperlipidemia, diabetes mellitus, smoking, and hypertension. These studies describe findings of manifest atherosclerosis, but give limited information on early subclinical changes in psoriasis without clinically evident cardiovascular diseases. Therefore, ginkgos is unclear if psoriasis itself, or comorbidities and behaviors associated with psoriasis explain this association. Hence, we excluded all patients with a history of cardiovascular events or traditional cardiovascular risk factors from our study. Our study has shown that patients with psoriasis, who did not have any traditional risk factor or comorbidities for cardiovascular diseases, had greater CIMT and NAFLD values than healthy controls.