| Objective: 1.To investigate the level of serum adiponectin,leptin and the incidence of atherosclerosis in patients with psoriasis;2.To explore the relationship between psoriasis and atherosclerosis;3.To explore the correlation between clinical indicators and psoriatic atherosclerosis;4.To explore the role and clinical significance of serum adiponectin and leptin levels in patients with psoriatic atherosclerosis.Methods: 1.80 consecutive patients over 18 years old,conforming the diagnostic criteria for psoriasis who were admitted to the department of dermatology,the Affiliated Hospital of Southwest Medical University,within a 6-months period from January to June 2018 were recruited for the study group,including 43 males and 37 females with an average age of 43.54±11.82 years old.40 healthy cases over 18 years old from physical examination center of Affiliated Hospital of Southwest Medical University from May to June 2018 were assigned to the control group,including 21 males and 19 females with an average age of 43.88±11.79 years old.There was no significant difference in gender composition ratio and age between the two groups(?2=0.17,P>0.05,t=-0.148,P>0.05).2.Informed consent was obtained after having provided verbal and written information to all participants.The basic information of two groups were collected through a self-made general condition questionaire,including age,gender,height,weight,body mass index.For The study group,including the course of the disease,the severity of psoriasis were assessed by the PASI.PASI score in study group was evaluated by two dermatologists who had completed the psychological scale rating standard training.3.Blood samples from all the investigators were harvested at 8 o'clock in the morning,the measurement of serum adiponectin and leptin were performed by ELISA,blood lipids(total cholesterol,triglycerides,low density lipoprotein,high density lipoprotein)were performed by automatic blood biochemistry analyzer.4.Color Doppler ultrasonography was performed in all patients with bilateral common carotid arteries,internal and external carotid arteries,and carotid intima-media thickness(IMT)and carotid plaques were recorded.5.Statistical analyses: Results were expressed as frequency(f)or percentages(%)for categorical variables and as mean ± standard deviation(??±s)for the continuous variables.Proportions were compared using the Chi-square test.Continuous data was performed using t-test.Spearman's Rank correlation was used for bivariate correlations.The risk factors for atherosclerosis were investigated with the use of single factor and multivariate logistic regression models.All statistical analysis was performed using SPSS 17.0 software.Results: 1.Defined as IMT?1mm,atherosclerosis was identified in 37(46.25%)cases of psoriasis patients,higher than the control group 5 cases(12.5%).The level of leptin was elevated and the level of serum adiponectin was decreased in the study group compared with the control group(t=6.774,P<0.001,t=-3.511,P<0.05).2.Patients with atherosclerosis showed lower serum adiponectin levels,higher serum leptin levels,when compared with patients without atherosclerosis(t=-2.703,P<0.05,t=3.557,P<0.05).3.According to Spearman analysis,IMT was negatively correlated with level of adiponectin(r=-0.378,P<0.001),positively correlated with level of leptin(r=0.581,P<0.001).There was a positive correlation between PASI score and leptin(r=0.302,P<0.05),which was negatively correlated with adiponectin(r=-0.274,P<0.05).4.By multivariate logistic regression analysis,the occurrence of psoriasis was a independent risk factor for atherosclerosis patients(OR 0.002,95% CI: 0.000-0.054;P<0.001),and other risk factors included age(OR 0.894,95% CI: 0.829-0.964;P<0.05),obesity(OR 0.754,95% CI: 0.590-0.963;P<0.05),high triglyceride levels(OR 0.046,95% CI: 0.011-0.197;P< 0.001),high and low density lipoprotein levels(OR 0.178,95% CI: 0.056-0.566;P<0.001).Conclusion: 1.Psoriasis is an independent pathogenesis of atherosclerosis,and Psoriasis patients should be examined for cardiovascular disease.2.The imbalance of serum leptin and adiponectin levels lead to abnormal lipid metabolism,increased release of inflammatory factors,and involvement in the pathogenesis of atherosclerosis in psoriasis.3.Detection of serum adiponectin and leptin in patients with psoriasis can assess the severity of the disease and early detection of vascular lesions.It is important to control the progression of psoriasis and reduce the development of psoriasis to cardiovascular disease By regulating the balance of leptin and adiponectin. |
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