Subclinical Impairment of Cardiovascular System in Patients With Psoriasis
Condition: Psoriasis; Inflammation; Endothelial Dysfunction; Metabolic Disturbance; Insulin Resistance; Coagulation Disorder; Thrombocyte Disorders
MeSH terms: Hemostatic Disorders; Blood Coagulation Disorders; Blood Platelet Disorders; Psoriasis; Insulin Resistance; Inflammation
Study type: Observational

Summary: 
      A cross-sectional study will be conducted, which will include 80 young patients with
      psoriasis, aged 30-45 years, treated with five different types of antipsoriatic treatment,
      and 20 healthy patients. All 100 subjects will be subjected to anthropometric measurements,
      blood will be collected for laboratory tests, and an imaging test will be performed to
      determine the function of the endothelium and arterial stiffness. The results will then be
      statistically analyzed.
    

Detailed description: 
      Research design: A cross-sectional study will be conducted, which will include 80 young
      patients with psoriasis, aged 30-45 years, without other chronic diseases, treated with five
      different types of treatment (local therapy, methotrexate, inhibitor of tumor necrosis factor
      α, inhibitor of interleukin 17 and inhibitor of interleukin 23), and 20 healthy patients aged
      30-45 years. All 100 subjects will be subjected to anthropometric measurements (measurement
      of weight, height, systolic and diastolic blood pressure, heart rate, waist circumference),
      blood will be collected for laboratory tests (full blood count with differential, CRP, serum
      electrolytes, lipid panel, fasting glucose, HbA1c, alanine aminotransferase, aspartate
      aminotransferase, creatinine, urea, TNF-alpha, IL-6, IL-12, IL-17, IL-23, hsCRP, IFN-gamma,
      TRANCE, TRAIL, GDF-15, D-dimer, fibrinogen, overall haemostasis potential, overall
      coagulation potential, VCAM-1, ECAMs), and an imaging test (flow-mediated dilation and
      measurement of pulse wave velocity) will be performed to determine the function of the
      endothelium and arterial stiffness. The results will then be statistically analyzed.

      Aim of the study: The impact of chronic systemic inflammation in psoriasis on subclinical
      defects in the cardiovascular system (endothelial dysfunction, arterial stiffness, insulin
      resistance, platelet activation, and coagulation activation) and their effects on each other
      will be studied. In addition, the effect of the five main types of psoriasis treatment on all
      listed subclinical defects of the cardiovascular system will be investigated. Moreover, it
      will be investigated whether the type of treatment affects systemic inflammation in psoriasis
      in the same manner.

      Expected results: It is expected that all five groups of patients will differ from each other
      in terms of the degree of subclinical impairment of the cardiovascular system, depending on
      the expression of psoriasis and the type of treatment they receive. This will form the basis
      for establishing preventive measures against cardiovascular diseases in patients with
      psoriasis.
    

Observational model: Cohort
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        5 groups of patients with psoriasis that are treated in our hospital with either local
        treatment, methotrexate, adalimumab, secukinumab or guselkumab will be included in the
        study. Included patients will be aged 30 to 45 years and will be without other chronic
        disease besides psoriasis and without other treatment besides antipsoriatic treatment to
        investigate the isolated effect of psoriasis on observed parameters (endothelial function,
        endothelial activation, inflammation, insulin resistance, metabolic disturbances,
        activation of coagulation and activation of platelets).
      
Biospecimen description: 
      Withdrawal of blood for laboratory analysis
    
Keywords: Psoriasis; Endothelial dysfunction; Inflammation; Insulin resistance; Biologic therapy