Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2019 Feb 8;14(2):e0211808.
doi: 10.1371/journal.pone.0211808. eCollection 2019.

Subclinical atherosclerosis in psoriasis. Usefulness of femoral artery ultrasound for the diagnosis, and analysis of its relationship with insulin resistance

Alvaro Gonzalez-Cantero  1 , Jorge Gonzalez-Cantero  2 , Ana Isabel Sanchez-Moya  1 , Cristina Perez-Hortet  1 , Salvador Arias-Santiago  3 , Cristina Schoendorff-Ortega  1 , Jorge Luis Gonzalez-Calvin  4
Affiliations
Clinical Trial

Subclinical atherosclerosis in psoriasis. Usefulness of femoral artery ultrasound for the diagnosis, and analysis of its relationship with insulin resistance

Alvaro Gonzalez-Cantero et al. PLoS One. .

Abstract

Background: Psoriasis is associated with an increased risk of cardiovascular disease (CVD) at younger ages that is not identifiable by traditional risk factors. Screening for subclinical atherosclerosis with ultrasound has only been investigated in carotid arteries. Femoral artery ultrasound has never been considered for this purpose. The link between psoriasis and accelerated atherosclerosis has not yet been established.

Objective: To study the usefulness of femoral artery ultrasound for the detection of subclinical atherosclerosis in psoriasis. We also investigated its possible relationship with changes in insulin resistance.

Methods: We conducted a cross-sectional study in 140 participants, 70 patients with moderate-to-severe psoriasis and 70 healthy controls, matched 1:1 for age, sex, and BMI. Femoral and carotid atherosclerotic plaques were evaluated by ultrasonography. Insulin resistance was assessed by the homeostasis model assessment method (HOMA-IR).

Results: Femoral atherosclerotic plaque prevalence was significantly higher in patients with psoriasis (44.64%) than in controls (19.07%) (p<0.005), but no significant difference was found in carotid plaque prevalence (p<0.3). Femoral plaques were significantly more prevalent than carotid plaques (21.42%) among patients with psoriasis (p<0.001). In the regression analysis, insulin resistance was the most influential determinant of atherosclerosis in psoriasis and C-reactive protein the most significant predictor of insulin resistance.

Conclusions: Ultrasound screening for femoral atherosclerotic plaques improves the detection of subclinical atherosclerosis in patients with psoriasis, whereas the study of carotid arteries is not sufficiently accurate. Insulin resistance appears to play a greater role in the development of atherosclerosis in these patients in comparison to other classical CVD risk factors.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Percentage of participants with subclinical atherosclerosis among patients with psoriasis and controls.
*: p< 0.05.
Fig 2
Fig 2. Percentage of participants with atherosclerotic plaque in femoral and carotid arteries among patients with psoriasis and controls.
*: p< 0.05.
See this image and copyright information in PMC

References

    1. Griffiths CE, Barker JN. Pathogenesis and clinical features of psoriasis. Lancet. 2007;370: 263–271. 10.1016/S0140-6736(07)61128-3 - DOI - PubMed
    1. Neimann AL, Shin DB, Wang X, Margolis DJ, Troxel AB, Gelfand JM. Prevalence of cardiovascular risk factors in patients with psoriasis. J Am Acad Dermatol. 2006;55: 829–835. 10.1016/j.jaad.2006.08.040 - DOI - PubMed
    1. Gelfand JM, Neimann AL, Shin DB, Wang X, Margolis DJ, Troxel AB. Risk of myocardial infarction in patients with psoriasis. JAMA. 2006;296: 1735–41. 10.1001/jama.296.14.1735 - DOI - PubMed
    1. Lerman JB, Joshi AA, Chaturvedi A, Aberra TM, Dey AK, Rodante JA, et al. Coronary plaque characterization in psoriasis reveals high-risk features that improve after treatment in a prospective observational study. Circulation. 2017;136: 263–276. 10.1161/CIRCULATIONAHA.116.026859 - DOI - PMC - PubMed
    1. Mehta NN, Krishnamoorthy P, Yu Y, Khan O, Raper A, Van Voorhees A, et al. The impact of psoriasis on 10-year Framingham risk. J Am Acad Dermatol. 2012;67: 796–798. 10.1016/j.jaad.2012.05.016 - DOI - PMC - PubMed

Publication types

MeSH terms