Journal of the Egyptian Women’s Dermatologic Society (Jan 2019)
YKL-40, fetuin-A plasma levels, and carotid intima-media thickness: do they have relations with subclinical atherosclerosis associated with psoriasis and the disease severity?
Abstract
Background Despite the risk of cardiovascular incidents being high among patients with psoriasis, the mechanism of such association has not been established yet. YKL-40 is an active biological compound that could be related to subclinical atherosclerosis. Fetuin-A is a glycoprotein that inhibits vascular calcification, and its serum level is low in patients with atherosclerosis. Objective To find out if there is a relation between fetuin-A, YKL-40, and carotid intima-media thickness (CIMT) and subclinical atherosclerosis associated with psoriasis. Patients and methods The current study was carried out on 30 patients admitted to Alexandria Main University Hospital with chronic generalized psoriasis. Enzyme-linked immunosorbent assay was used to evaluate serum YKL-40 and fetuin-A. Carotid artery intima-media thickness was evaluated by B-mode ultrasonography. Psoriasis area and severity index was calculated in all psoriatic patients. Patients with BMI more than 30, waist circumference, fasting blood sugar, and lipid profile levels were excluded. Results Patients with psoriasis demonstrated a significantly higher YKL-40 serum levels, significantly lower fetuin-A, and significantly higher carotid artery intima-media thickness than controls. Psoriasis area and severity index score showed a significant positive correlation with YKL-40 and CIMT and no correlation with fetuin-A levels. YKL-40 is significantly correlated with abnormal CIMT. Fetuin-A is significantly correlated with normal and abnormal CIMT. Conclusion The increased plasma YKL-40 and the decreased plasma fetuin-A levels reported in patients with psoriasis might play a role in the increased risk of cardiovascular risk disorders in these patients. Carotid ultrasonography is a noninvasive, simple tool that detects subclinical atherosclerosis in patients with psoriasis.
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