A cross-sectional study will be conducted, which will include 80 young patients with psoriasis, aged 30-45 years, treated with five different types of antipsoriatic treatment, and 20 healthy patients. All 100 subjects will be subjected to anthropometric measurements, blood will be collected for laboratory tests, and an imaging test will be performed to determine the function of the endothelium and arterial stiffness. The results will then be statistically analyzed.
Research design: A cross-sectional study will be conducted, which will include 80 young patients with psoriasis, aged 30-45 years, without other chronic diseases, treated with five different types of treatment (local therapy, methotrexate, inhibitor of tumor necrosis factor α, inhibitor of interleukin 17 and inhibitor of interleukin 23), and 20 healthy patients aged 30-45 years. All 100 subjects will be subjected to anthropometric measurements (measurement of weight, height, systolic and diastolic blood pressure, heart rate, waist circumference), blood will be collected for laboratory tests (full blood count with differential, CRP, serum electrolytes, lipid panel, fasting glucose, HbA1c, alanine aminotransferase, aspartate aminotransferase, creatinine, urea, TNF-alpha, IL-6, IL-12, IL-17, IL-23, hsCRP, IFN-gamma, TRANCE, TRAIL, GDF-15, D-dimer, fibrinogen, overall haemostasis potential, overall coagulation potential, VCAM-1, ECAMs), and an imaging test (flow-mediated dilation and measurement of pulse wave velocity) will be performed to determine the function of the endothelium and arterial stiffness. The results will then be statistically analyzed. Aim of the study: The impact of chronic systemic inflammation in psoriasis on subclinical defects in the cardiovascular system (endothelial dysfunction, arterial stiffness, insulin resistance, platelet activation, and coagulation activation) and their effects on each other will be studied. In addition, the effect of the five main types of psoriasis treatment on all listed subclinical defects of the cardiovascular system will be investigated. Moreover, it will be investigated whether the type of treatment affects systemic inflammation in psoriasis in the same manner. Expected results: It is expected that all five groups of patients will differ from each other in terms of the degree of subclinical impairment of the cardiovascular system, depending on the expression of psoriasis and the type of treatment they receive. This will form the basis for establishing preventive measures against cardiovascular diseases in patients with psoriasis.
Study Type
OBSERVATIONAL
Enrollment
100
University Medical Centre Ljubljana
Ljubljana, Slovenia
Arterial function - endothelial function
Endothelial function (flow-mediated dilation)
Time frame: through study completion, an average of 6 months
Arterial function - arterial stiffness
Arterial stiffness (pulse wave velocity)
Time frame: through study completion, an average of 6 months
Endothelial activation
Circulating markers of endothelial activation (E-selectin, vascular cell adhesion molecule-1 (VCAM-1), Endothelial cell adhesion molecules (ECAMs))
Time frame: through study completion, an average of 6 months
Inflammation
Circulating markers of inflammation (tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-6, IL-12, IL-17, IL-23, high sensitivity C-reactive protein (hs-CRP), interferon-gamma, TNF-related activation-inducing ligand (TRANCE), TNF-related apoptosis-inducing ligand (TRAIL), Growth/differentiation factor-15 (GDF-15), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR))
Time frame: through study completion, an average of 6 months
Insulin resistance
Circulating markers of insulin resistance (fasting glucose, insulin), HOMA-IR equation (Homeostatic Model Assessment for Insulin Resistance)
Time frame: through study completion, an average of 6 months
Metabolic disturbances - dyslipidemia
Parameters of (pre)metabolic syndrome (lipid panel)
Time frame: through study completion, an average of 6 months
Metabolic disturbances
Parameters of (pre)metabolic syndrome (TyG (triglyceride-glucose index))
Time frame: through study completion, an average of 6 months
Liver steatosis
Laboratory markers (aspartate aminotransferase (AST), Alanine Aminotransferase (ALT), Fib4 score (Fibrosis-4))
Time frame: through study completion, an average of 6 months
Coagulation
Circulating markers of coagulation activation (D-dimer, fibrinogen)
Time frame: through study completion, an average of 6 months
Activation of hemostasis
Hemostatic assay (overall hemostasis potential (OHP) assay)
Time frame: through study completion, an average of 6 months
Activation of coagulation
Coagulation assay (overall coagulation potential (OCP) assay)
Time frame: through study completion, an average of 6 months
Platelet activation (1)
Circulating markers of platelet activation (mean platelet volume (MPV)
Time frame: through study completion, an average of 6 months
Platelet activation (2)
Circulating markers of platelet activation (P-selectin)
Time frame: through study completion, an average of 6 months
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