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Psoriasis Vulgaris Hastalarında Subklinik Ateroskleroz Gelişiminin Karotid Arter Ultrasonografi ile Değerlendirilmesi

Year 2013, Volume: 35 Issue: 3 - OSMANGAZİ TIP DERGİSİ / Osmangazi Journal of Medicine, 14 - 22, 18.06.2015

İsil Bulur Turgut Tokmak Hilal Erdoğan Senem Sas Ozge Cevıkalp

Abstract

Psoriasisde kalıcı deri inflamasyonu endotelyal disfonksiyonu ve sonrasında gelişen
ateroskleroz ile kardiyovasküler hastalıkların başlangıcını oluşturmaktadır. Subklinik
aterosklerozun değerlendirilmesinde karotid arter intima media kalınlığının (kİMK) ultrasonografi
ile değerlendirilmesi önem taşımaktadır. Biz de çalışmamızda psoriasis hastalarında
kardiyovasküler hastalıkların erken tanısında karotid arter doppler ultrasonografinin yararlılığını
değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışmamıza bilenen kardiyovasküler risk
faktörleri olmayan, yaş ve cinsiyet açısından homojen, 70 psoriasis vulgaris hastası ve 38 sağlıklı
kontrol dahil edilmiştir. Hasta ve kontrol gruplarında karotid arter intima media kalınlık ölçümleri
yüksek çözünürlüklü renkli doppler ultrasonografi ile yapılmıştır. Sonuçlar gruplar arasında ve
hasta grubunda PASİ, hastalık süresi, serum HDL, LDL, trigliserid, sedimentasyon ve C- reaktif
protein düzeyleri ile istatistiksel olarak karşılaştırılmıştır. Bulgular: Çalışmamızda hasta ve sağlıklı
kontrol grubu arasında yaş, cinsiyet, beden kitle indeksi açısından istatistiksel olarak anlamlı bir
farklılık saptanmamıştır (p=0,259, p=0,108). kİMK değeri psoriasis hasta grubunda 0,70mm
(0,64–0,79), sağlıklı kontrol grubunda 0,57mm (0,50–0,69) olarak değerlendirilmiştir. kİMK
değeri psoriasis hasta grubunda sağlıklı kontrollere göre istatistiksel olarak anlamlı ölçüde artmış
bulunmuştur (p < 0,001). Hasta grubunda kİMK değeri ile PASİ arasında ilişki tespit edilmemiştir
(p= 0,871), diğer taraftan kİMK değeri ile hastalık süresi arasında istatistiksel olarak düşük
düzeyde ilişki gözlenmiştir (p=0,052). Sonuç: Psoriasis hastalarında uzun süreli inflamasyondan
dolayı ateroskleroz riskinin normal popülasyona göre artmış olduğu düşünülmüştür. Bu nedenle
psoriasis tanısı alan hastaların kardiyovasküler hastalıklar açısından takibinde karotid arter
ultrasonografi ile değerlendirmenin önemli olduğu kanaatindeyiz.

Keywords

Psöriazis Ateroskleroz Ultrasonografi

References

  • Gudjonsson, J.E. Elder, J.T. (2007). Psoriasis: epidemiology. Clin Dermatol. 25(6), 535-46.
  • Gülekon, A. Adışen, E. (2008). Psoriasis ve Komorbiditeler [Psoriasis and Co-morbidities] Türkderm. 42(2), 23-5.
  • Yiu, K.H. Yeung, C.K. Zhao, C.T. Chan, J.C. Siu, C.W. Tam, S. et al. (2013). Prevalence and extent of subclinical atherosclerosis in patients with psoriasis. J Intern Med. 273(3), 273-82.
  • Naldi, L. Mercuri, S.R. (2010). Epidemiology of comorbidities in psoriasis. Dermatol Ther. 23(2),114–18.
  • Eder, L. Jayakar, J. Shanmugarajah, S. Thavaneswaran, A. Pereira, D. Chandran, V. et al. (2013). The burden of carotid artery plaques is higher in patients with psoriatic arthritis compared with those with psoriasis alone. Ann Rheum Dis. 72(5), 715-20.
  • Christophers, E. (2007). Comorbidities in psoriasis. Clin Dermatol. 25(6), 529-34.
  • Ghazizadeh, R. Shimizu, H. Tosa, M. Ghazizadeh, M. (2010). Pathogenic mechanisms shared between psoriasis and cardiovascular disease. Int J Med Sci. 7(5), 284-89.
  • Gisondi, P. Fantin, F. Del Giglio, M. Valbusa, F. Marino, F. Zamboni, M. et al. (2009). Chronic plaque psoriasis is associated with increased arterial stiffness. Dermatology. 218(2),110-13.
  • Eder, L. Chandran, V. Gladman, D.D. (2013). The Framingham Risk Score underestimates the extent of subclinical atherosclerosis in patients with psoriatic disease. Ann Rheum Dis. 25.
  • Lew, W. Bowcock, A.M. Krueger, J.G. (2004). Psoriasis vulgaris: cutaneous lymphoid tissue supports Tcell activation and "Type 1" inflammatory gene expression. Trends Immunol. 25(6), 295-305.
  • Kim, N. Thrash, B. Menter, A. (2010). Comorbidities in psoriasis patients. Semin Cutan Med Surg. 29(1),10-5.
  • Ghazizadeh, R. Shimizu, H. Tosa, M. (2010). Ghazizadeh, M. Pathogenic mechanisms shared between psoriasis and cardiovascular disease. Int J Med Sci. 7(5), 284-89.
  • Duarte, G.V. Follador, I. Cavalheiro, C.M. Silva, T.S. (2010). Oliveira Mde F: Psoriasis and obezity: literature review and recommendations for management. An Bras Dermatol. 85(3), 355-60.
  • Tobin, A.M. Veale, D.J. Fitzgerald, O. Rogers, S. Collins, P. O'Shea, D. et al. (2010). Cardiovascular disease and risk factors in patients with psoriasis and psoriatic arthritis. J Rheumatol. 37(7), 386-94.
  • Shaharyar, S. Warraich, H. McEvoy, J.W. Oni, E. Ali, S.S. Karim, A. et al. (2014). Subclinical cardiovascular disease in plaque psoriasis: Association or causal link? Atherosclerosis. 232(1), 72-8.
  • Gaeta, M. Castelvecchio, S. Ricci, C. Pigatto, P. Pellissero, G. Cappato, R. (2013). Role of psoriasis as independent predictor of cardiovascular disease: a metaregression analysis. Int J Cardiol. 168(3), 2282-8.
  • Tedgui, A. Mallat, Z. (2006). Cytokines in atherosclerosis. Pathogenic and regulatory pathway.Physiol Rev. 86(2), 515-81.
  • Balta, I.Balta, S. Demir, M. Demirkol, S. Ekiz, O. Unlu, M. (2013). Arterial Stiffness Parameters Should be Evaluated With Different Types of Psoriasis. Angiology. 65(1), 83.
  • Enany, B. El Zohiery, A.K. Elhilaly, R. Badr, T. (2012). Carotid intimamedia thickness and serum leptin in psoriasis. 37(5):527–33.
  • Espeland, M. A. O'leary, D.H.Terry, J.G. Morgan, T. Evans, G. Mudra, H. (2005). Carotid intimal-media thickness as a surrogate for cardiovascular disease events in trials of HMG-CoA reductase inhibitors. Curr Control Trials Cardiovasc Med. 6(1), 3.
  • Pignoli, P. Tremoli, E. Poli, A. Oreste, P. Paoletti, R. (1986). Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging.Circulation.74(6),1399–1406.
  • Blai Coll, M.D. PhD, and Steven, B. Feinstein, M.D. Carotid Intima-Media Thickness Measurements: Techniques and Clinical Relevance. Curr Atheroscler Rep.10(5), 444-50.
  • Lorenz, M. W. Markus, H. S. Bots, M. L. Rosvall, M. Sitzer, M. (2007). Prediction of clinical cardiovascular events with carotid intima–media thickness: a systematic review and meta-analysis. Circulation 115(4), 459 67.
  • Troitzsch, P. Paulista Markus, M.R. Dörr, M. Felix, S.B. Jünger, M. Schminke, U. et al. (2012). Psoriasis is associated with increased intimamedia thickness-The Study of Health in Pomerania (SHIP). Atherosclerosis. 225(2), 486-90.
  • Mazlan, S.A. bin Mohamed Said, M.S. Hussein, H. binti Shamsuddin, K. Shah, S.A. Basri, H. (2009). A study of intima media thickness and their cardiovascular risk factors in patients with psoriatic arthritis. Acta Medica. 52(3), 107-16.
  • El-Mongy, S. Fathy, H. Abdelaziz, A. Omran, E. George, S. Neseem, N. etal. (2010). Subclinical atherosclerosis in patients with chronic psoriasis: a potential association. J Eur Acad Dermatol Venereol. 24(6), 661.
  • Balcı, D.D. Balcı, A. Karazincir, S. Ucar, E. Iyigun, U. Yalcin, F. etal. (2009). Increased carotid artery intima-media thickness and impaired endothelial function in psoriasis. J Eur Acad Dermatol Venereol. 23(1),1-6.
  • Arias-Santiago, S. Orgaz-Molina, J. Castellote-Caballero, L. Arrabal-Polo, MÁ. García-Rodriguez, S. PerandrésLópez, R. et al. (2012). Atheroma plaque, metabolic syndrome and inflammation in patients with psoriasis. Eur J Dermatol. 22(3), 337-44.
  • Prodanovich, S. Ma, F. Taylor, J.R. Pezon, C. Fasihi, T. Kirsner, R.S. (2005).Methotrexate reduces incidence of vascular diseases in veterans with psoriasis or rheumatoid arthritis. J Am Acad Dermatol. 52(2), 262-7.
  • Dixon, W.G. Watson, K.D. Lunt, M. Hyrich, K.L. (2007). Reduction in the incidence of myocardial infarction in patients with rheumatoid arthritis who respond to anti-tumor necrosis factor alpha therapy: results from the British Society for Rheumatology Biologics Register. Arthritis Rheum. 56(9), 2905-12.
  • Jacobsson, L.T. Turesson, C. Nilsson, J.A. Petersson, I.F. Lindqvist, E. Saxne, T. et al. (2007). Treatment with TNF blockers and mortality risk in patients with rheumatoid arthritis. Ann Rheum Dis. 66(5), 670-5.
  • Chen, Y. J. Chang, Y. T. Shen, J. L. Chen, T. T. Wang, C. B. Chen, C. M. etal. (2012). Association between systemic antipsoriatic drugs and cardiovascular risk in patients with psoriasis with or without psoriatic arthritis: a nationwide cohort study. Arthritis Rheum. 64(6), 1879-87.

Year 2013, Volume: 35 Issue: 3 - OSMANGAZİ TIP DERGİSİ / Osmangazi Journal of Medicine, 14 - 22, 18.06.2015

İsil Bulur Turgut Tokmak Hilal Erdoğan Senem Sas Ozge Cevıkalp

Abstract

References

  • Gudjonsson, J.E. Elder, J.T. (2007). Psoriasis: epidemiology. Clin Dermatol. 25(6), 535-46.
  • Gülekon, A. Adışen, E. (2008). Psoriasis ve Komorbiditeler [Psoriasis and Co-morbidities] Türkderm. 42(2), 23-5.
  • Yiu, K.H. Yeung, C.K. Zhao, C.T. Chan, J.C. Siu, C.W. Tam, S. et al. (2013). Prevalence and extent of subclinical atherosclerosis in patients with psoriasis. J Intern Med. 273(3), 273-82.
  • Naldi, L. Mercuri, S.R. (2010). Epidemiology of comorbidities in psoriasis. Dermatol Ther. 23(2),114–18.
  • Eder, L. Jayakar, J. Shanmugarajah, S. Thavaneswaran, A. Pereira, D. Chandran, V. et al. (2013). The burden of carotid artery plaques is higher in patients with psoriatic arthritis compared with those with psoriasis alone. Ann Rheum Dis. 72(5), 715-20.
  • Christophers, E. (2007). Comorbidities in psoriasis. Clin Dermatol. 25(6), 529-34.
  • Ghazizadeh, R. Shimizu, H. Tosa, M. Ghazizadeh, M. (2010). Pathogenic mechanisms shared between psoriasis and cardiovascular disease. Int J Med Sci. 7(5), 284-89.
  • Gisondi, P. Fantin, F. Del Giglio, M. Valbusa, F. Marino, F. Zamboni, M. et al. (2009). Chronic plaque psoriasis is associated with increased arterial stiffness. Dermatology. 218(2),110-13.
  • Eder, L. Chandran, V. Gladman, D.D. (2013). The Framingham Risk Score underestimates the extent of subclinical atherosclerosis in patients with psoriatic disease. Ann Rheum Dis. 25.
  • Lew, W. Bowcock, A.M. Krueger, J.G. (2004). Psoriasis vulgaris: cutaneous lymphoid tissue supports Tcell activation and "Type 1" inflammatory gene expression. Trends Immunol. 25(6), 295-305.
  • Kim, N. Thrash, B. Menter, A. (2010). Comorbidities in psoriasis patients. Semin Cutan Med Surg. 29(1),10-5.
  • Ghazizadeh, R. Shimizu, H. Tosa, M. (2010). Ghazizadeh, M. Pathogenic mechanisms shared between psoriasis and cardiovascular disease. Int J Med Sci. 7(5), 284-89.
  • Duarte, G.V. Follador, I. Cavalheiro, C.M. Silva, T.S. (2010). Oliveira Mde F: Psoriasis and obezity: literature review and recommendations for management. An Bras Dermatol. 85(3), 355-60.
  • Tobin, A.M. Veale, D.J. Fitzgerald, O. Rogers, S. Collins, P. O'Shea, D. et al. (2010). Cardiovascular disease and risk factors in patients with psoriasis and psoriatic arthritis. J Rheumatol. 37(7), 386-94.
  • Shaharyar, S. Warraich, H. McEvoy, J.W. Oni, E. Ali, S.S. Karim, A. et al. (2014). Subclinical cardiovascular disease in plaque psoriasis: Association or causal link? Atherosclerosis. 232(1), 72-8.
  • Gaeta, M. Castelvecchio, S. Ricci, C. Pigatto, P. Pellissero, G. Cappato, R. (2013). Role of psoriasis as independent predictor of cardiovascular disease: a metaregression analysis. Int J Cardiol. 168(3), 2282-8.
  • Tedgui, A. Mallat, Z. (2006). Cytokines in atherosclerosis. Pathogenic and regulatory pathway.Physiol Rev. 86(2), 515-81.
  • Balta, I.Balta, S. Demir, M. Demirkol, S. Ekiz, O. Unlu, M. (2013). Arterial Stiffness Parameters Should be Evaluated With Different Types of Psoriasis. Angiology. 65(1), 83.
  • Enany, B. El Zohiery, A.K. Elhilaly, R. Badr, T. (2012). Carotid intimamedia thickness and serum leptin in psoriasis. 37(5):527–33.
  • Espeland, M. A. O'leary, D.H.Terry, J.G. Morgan, T. Evans, G. Mudra, H. (2005). Carotid intimal-media thickness as a surrogate for cardiovascular disease events in trials of HMG-CoA reductase inhibitors. Curr Control Trials Cardiovasc Med. 6(1), 3.
  • Pignoli, P. Tremoli, E. Poli, A. Oreste, P. Paoletti, R. (1986). Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging.Circulation.74(6),1399–1406.
  • Blai Coll, M.D. PhD, and Steven, B. Feinstein, M.D. Carotid Intima-Media Thickness Measurements: Techniques and Clinical Relevance. Curr Atheroscler Rep.10(5), 444-50.
  • Lorenz, M. W. Markus, H. S. Bots, M. L. Rosvall, M. Sitzer, M. (2007). Prediction of clinical cardiovascular events with carotid intima–media thickness: a systematic review and meta-analysis. Circulation 115(4), 459 67.
  • Troitzsch, P. Paulista Markus, M.R. Dörr, M. Felix, S.B. Jünger, M. Schminke, U. et al. (2012). Psoriasis is associated with increased intimamedia thickness-The Study of Health in Pomerania (SHIP). Atherosclerosis. 225(2), 486-90.
  • Mazlan, S.A. bin Mohamed Said, M.S. Hussein, H. binti Shamsuddin, K. Shah, S.A. Basri, H. (2009). A study of intima media thickness and their cardiovascular risk factors in patients with psoriatic arthritis. Acta Medica. 52(3), 107-16.
  • El-Mongy, S. Fathy, H. Abdelaziz, A. Omran, E. George, S. Neseem, N. etal. (2010). Subclinical atherosclerosis in patients with chronic psoriasis: a potential association. J Eur Acad Dermatol Venereol. 24(6), 661.
  • Balcı, D.D. Balcı, A. Karazincir, S. Ucar, E. Iyigun, U. Yalcin, F. etal. (2009). Increased carotid artery intima-media thickness and impaired endothelial function in psoriasis. J Eur Acad Dermatol Venereol. 23(1),1-6.
  • Arias-Santiago, S. Orgaz-Molina, J. Castellote-Caballero, L. Arrabal-Polo, MÁ. García-Rodriguez, S. PerandrésLópez, R. et al. (2012). Atheroma plaque, metabolic syndrome and inflammation in patients with psoriasis. Eur J Dermatol. 22(3), 337-44.
  • Prodanovich, S. Ma, F. Taylor, J.R. Pezon, C. Fasihi, T. Kirsner, R.S. (2005).Methotrexate reduces incidence of vascular diseases in veterans with psoriasis or rheumatoid arthritis. J Am Acad Dermatol. 52(2), 262-7.
  • Dixon, W.G. Watson, K.D. Lunt, M. Hyrich, K.L. (2007). Reduction in the incidence of myocardial infarction in patients with rheumatoid arthritis who respond to anti-tumor necrosis factor alpha therapy: results from the British Society for Rheumatology Biologics Register. Arthritis Rheum. 56(9), 2905-12.
  • Jacobsson, L.T. Turesson, C. Nilsson, J.A. Petersson, I.F. Lindqvist, E. Saxne, T. et al. (2007). Treatment with TNF blockers and mortality risk in patients with rheumatoid arthritis. Ann Rheum Dis. 66(5), 670-5.
  • Chen, Y. J. Chang, Y. T. Shen, J. L. Chen, T. T. Wang, C. B. Chen, C. M. etal. (2012). Association between systemic antipsoriatic drugs and cardiovascular risk in patients with psoriasis with or without psoriatic arthritis: a nationwide cohort study. Arthritis Rheum. 64(6), 1879-87.
There are 32 citations in total.

Details

Primary Language Turkish
Journal Section ORİJİNAL MAKALE
Authors

İsil Bulur

Turgut Tokmak This is me

Hilal Erdoğan This is me

Senem Sas This is me

Ozge Cevıkalp This is me

Publication Date June 18, 2015
Published in Issue Year 2013 Volume: 35 Issue: 3 - OSMANGAZİ TIP DERGİSİ / Osmangazi Journal of Medicine

Cite

Vancouver Bulur İ, Tokmak T, Erdoğan H, Sas S, Cevıkalp O. Psoriasis Vulgaris Hastalarında Subklinik Ateroskleroz Gelişiminin Karotid Arter Ultrasonografi ile Değerlendirilmesi. Osmangazi Tıp Dergisi. 2015;35(3):14-22.


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