Characterization of Lipoprotein Composition and Function in Pediatric Psoriasis Reveals a More Atherogenic Profile.
Characterization of Lipoprotein Composition and Function in Pediatric Psoriasis Reveals a More Atherogenic Profile.
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DOI：
10.1038/jid.2015.385
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发表时间：
2016-01
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影响因子：
--
通讯作者：
Mehta NN
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作者：
Tom WL;Playford MP;Admani S;Natarajan B;Joshi AA;Eichenfield LF;Mehta NN
银屑病与成人心血管疾病（CVD）的增加有关，但儿童银屑病的风险特征仍有待充分表征。我们使用核磁共振光谱法和经验证的高密度脂蛋白（HDL）胆固醇外排能力（CEC）离体测定法测量了44名儿科银屑病患者和44名年龄和性别匹配的健康对照者的脂蛋白组成和功能。平均年龄为13.0岁，人群种族多样。银屑病儿童的腰臀比（0.85 vs. 0.80; p<0.002）和胰岛素抵抗指标（对数转换HOMA-IR 0.65 vs. 0.41; p=0.07）较高。尽管与传统的血脂值相似，银屑病患者的载脂蛋白B浓度较高（72.4 vs. 64.6; p=0.02），大HDL颗粒减少（5.3 vs. 6.7; p<0.01），并且在校正年龄、性别、空腹血糖、HOMA-IR、收缩压、体重指数、载脂蛋白A-1、和HDL胆固醇浓度（β-0.22，p=0.02）。儿童银屑病患者具有更高的致动脉粥样硬化性心脏代谢风险特征，通过颗粒大小、数量和功能评估，有胰岛素抵抗和脂蛋白功能障碍的证据。这些发现可能为观察到的银屑病和CVD之间的联系提供了基础，并支持需要筛选和教育年轻患者以尽量减少后期并发症。
Psoriasis is associated with increased cardiovascular disease (CVD) in adults, but the risk profile of children with psoriasis remains to be fully characterized. We measured lipoprotein composition and function in 44 pediatric psoriasis patients and 44 age- and sex-matched healthy controls, using NMR spectroscopy and a validated ex vivo assay of high density lipoprotein (HDL) cholesterol efflux capacity (CEC). Mean age was 13.0 years and the population was ethnically diverse. Children with psoriasis had higher waist-hip ratios (0.85 vs. 0.80; p<0.002) and insulin resistance measures (log transformed HOMA-IR 0.65 vs. 0.41; p=0.07). Despite comparable traditional lipid values, having psoriasis was associated with higher apolipoprotein B concentrations (72.4 vs. 64.6; p=0.02), decreased large HDL particles (5.3 vs. 6.7; p<0.01), and reduced CEC after adjusting for age, sex, fasting glucose, HOMA-IR, systolic blood pressure, body mass index, apolipoprotein A-1, and HDL cholesterol concentration (beta -0.22, p=0.02). Pediatric psoriasis patients have a more atherogenic cardiometabolic risk profile, with evidence of insulin resistance and lipoprotein dysfunction by particle size, number, and functional assessment. These findings may provide a basis for the observed link later in life between psoriasis and CVD and support the need to screen and educate young patients to minimize later complications.