RESEARCH - Cardiovascular risk profile of patients with psoriatic arthritis compared to controls - the role of inflammation

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Rheumatology Advance Access published online on April 9, 2008

Rheumatology, doi:10.1093/rheumatology/ken090

Cardiovascular risk profile of patients with psoriatic arthritis

compared to controls—the role of inflammation

L.-S. Tam1, B. Tomlinson1, T. T.-W. Chu1, M. Li1, Y.-Y. Leung2, L.-W.

Kwok1, T. K. Li1, T. Yu1, Y.-E. Zhu1, K.-C. Wong1, E. W.-L. Kun2 and

E. K. Li1

1Department of Medicine & Therapeutics, The Prince of Wales Hospital,

The Chinese University of Hong Kong and 2Department of Medicine and

Geriatrics. Taipo Hospital, Hong Kong.

Abstract

Objective. To examine the distribution of traditional and novel risk

factors of cardiovascular disease (CVD) in patients with PsA compared

with healthy controls.

Methods. We compared risk factors for CVD between 102 consecutive PsA

patients and 82 controls, adjusting for BMI. We also assessed the role

of inflammation on the CVD risk factor by using a BMI and

high-sensitivity CRP (hsCRP)-adjusted model.

Results. The BMI of PsA patients were significantly higher than

healthy controls. After adjusting for the BMI, PsA patients still have

a higher prevalence of diabetes mellitus (DM) [odds ratio (OR) 9.27,

95% CI 2.09, 41.09) and hypertension (OR 3.37, 95% CI 1.68, 6.72), but

a lower prevalence of low high density lipoprotein (HDL) cholesterol

(OR 0.16, 95% CI 0.07, 0.41). PsA patients have significantly

increased systolic and diastolic blood pressures, insulin resistance

and inflammatory markers (hsCRP and white cell count) compared to

controls. PsA patients have higher HDL cholesterol and apolipoprotein

(Apo) A1 levels; and lower total cholesterol (TC) and low density

lipoprotein cholesterol levels; and a lower TC/HDL ratio. However, the

Apo B level (P < 0.05), and the Apo B/Apo A1 ratio (P = 0.07) were

higher in PsA patients. Further adjustment for hsCRP level rendered

the differences in the prevalence of hypertension and DM; the TC, and

sugar levels; and white cell count non-significant between the two

groups; while the differences in other parameters remained

significant.

Conclusion. These data support the hypothesis that PsA may be

associated with obesity, hypertension, dyslipidaemia and insulin

resistance because of the shared inflammatory pathway.

http://rheumatology.oxfordjournals.org/cgi/content/abstract/ken090v1?papetoc

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