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. 2024 Jul 23;12(8):1627.
doi: 10.3390/biomedicines12081627.

Early Cerebral Microvasculature Impairment and Increased Body Mass Index in Patients with Psoriasis

Katarzyna Piec  1 , Luiza Marek-Józefowicz  2 , Katarzyna Nadolska  3 , Adam Lemanowicz  3 , Zbigniew Serafin  3   4 , Grzegorz Kozera  5
Affiliations

Early Cerebral Microvasculature Impairment and Increased Body Mass Index in Patients with Psoriasis

Katarzyna Piec et al. Biomedicines. .

Abstract

Psoriasis induces systemic atherosclerosis, but its impact on cerebrovascular function remains unclear. However, stroke prevention must be considered in psoriasis, as it is commonly comorbid with classic cardiovascular risk factors. Thus, the aim of the study is to assess cerebral microvasculature function and its confounders in patients with psoriasis. The study protocol included cerebral autoregulation assessment with measurements of vasomotor reactivity reserve (VMRr) on the middle cerebral arteries with the use of a Transcranial Doppler (TCD) in 50 patients with psoriasis without cerebrovascular events (46; 21-74 years) and 26 healthy controls (41; 29-58 years). Analyses of VMRr relationships with the psoriasis course, comorbidities, inflammatory markers and intima-media thickness (IMT) were performed. The study showed that VMRr was lower (64% vs. 76%, p = 0.001), and the IMT was higher (0.65 vs. 0.52 mm, p = 0.001) in patients compared to controls. The patients were also characterized by a higher body mass index (BMI) and a higher level of Il-6 than the controls (29.14 vs. 25.76 kg/m2, p = 0.004 and 585 vs. 204 pg/mL, p < 0.001, respectively), but only BMI was independently impacting VMRr reduction (p = 0.02). In conclusion, early cerebral microvasculature dysfunction may occur in patients with psoriasis, and its extent is associated with an increase in BMI. Thus, body mass reduction should be strongly recommended for stroke prophylaxis in patients with psoriasis.

Keywords: BMI; Transcranial Doppler; cerebral autoregulation; obesity; psoriasis.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Bone windows typically used in TCD examination.
Figure 2
Figure 2
TCD recording of flow velocity in the MCA during hyperventilation and breath-holding tests. Abbreviations: V mean = mean velocity, MCA L = left middle cerebral artery, MCA R = right middle cerebral artery.
Figure 3
Figure 3
VMRr in patients with psoriasis and controls with an increased BMI. Abbreviations: VMRr = vasomotor reactivity reserve; BMI = body mass index; n = number of patients.
Figure 4
Figure 4
VMRr in patients with psoriasis and controls covariated with BMI (mean of BMI 27.98 kgm2) (A) and covariated with IL-6 (median of IL-G 454.74 pg/mL) (B). Abbreviations: VMRr = vasomotor reactivity reserve; BMI = body mass index; IL-6 = interleukin-6; n = number of patients.
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