The difference of lipid profiles between psoriasis with arthritis and psoriasis without arthritis and sex-specific downregulation of methotrexate on the apolipoprotein B/apolipoprotein A-1 ratio

Arthritis Research & Therapy

Nikhil Yawalkar¹  Hui Deng²  Ke Yang³  Yao Hu⁴  Qiong Huang⁵  Siyuan Wu⁵  Ling Han⁵  Zhenghua Zhang⁵  Kexiang Yan⁵  Zhizhong Zheng⁵  Xu Fang⁵  Bing Wang⁵ 

[1] Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland;Department of Dermatology, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, 200223, Shanghai, China;Department of Information, Huashan Hospital, Fudan University, 200040, Shanghai, China;Department of Laboratory Medicine, Huashan Hospital, Fudan University, 200040, Shanghai, China;Institute of Dermatology and Department of Dermatology, Huashan Hospital, Fudan University, No. 12 Middle Wulumuqi Road, 200040, Shanghai, China;

关键词: Psoriatic arthritis;    Psoriasis;    Apolipoproteins;    Lipid profiles;    Methotrexate;   

DOI  :  10.1186/s13075-021-02715-4

来源: Springer

【 摘 要 】

BackgroundMethotrexate (MTX) has a protective effect against cardiovascular diseases (CVD), but the mechanism is unclear.ObjectiveTo investigate the effect of MTX on lipid profiles and the difference between psoriasis without arthritis (PsO) and psoriatic arthritis (PsA).MethodsIn this prospective study, we recruited 288 psoriatic patients (136 PsA and 152 PsO) who completed 12 weeks of MTX treatment. Total cholesterol (TC), triglycerides (TG), lipoprotein A [LP(a)], high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein (LDL), apolipoprotein A1 (ApoA1), and ApoB were measured.ResultsCompared with sex- and age-matched healthy controls, psoriatic patients had significantly (p < 0.0001) higher levels of proatherogenic lipids and lower levels of anti-atherogenic lipids. PsA patients had a higher ApoB/ApoA1 ratio than PsO patients (p < 0.05). Stepwise regression analysis found a positive correlation between the inflammatory marker hCRP and the Psoriasis Area Severity Index (PASI), ApoB/ApoA1 ratio, BMI, and smoking. ApoB was positively associated with concomitant arthritis, diabetes, and hypertension. MTX decreased the levels of pro-atherogenic and anti-atherogenic lipids. However, a significant reduction of the ApoB/ApoA1 ratio by MTX was only observed in male patients.ConclusionPsA patients had a significantly higher percentage of concomitant disease than PsO. The decrease of MTX on CVD might be related with sex.Trial registrationChiCTR2000036192

【 授权许可】

CC BY