Bilirubin Levels and Their Association with Carotid Intima Media Thickness and High-Sensitivity C-reactive Protein in Patients with Psoriasis Vulgaris.

Balta, Sevket; Balta, Ilknur; Mikhailidis, Dimitri; Ozturk, Cengiz; Demirkol, Sait; Celik, Turgay; Kilic, Selim; Demir, Mustafa; Iyisoy, Atila

Background: Psoriasis vulgaris is associated with an increased risk of atherosclerosis. Carotid intima-media thickness (cIMT) may predict atherosclerosis. Aims: We assessed the correlation between bilirubin (a potent endogenous antioxidant) levels and cIMT in patients with psoriasis vulgaris. We also compared the levels of serum total bilirubin (TBil) and its fractions in control subjects and patients with psoriasis. Methods: We enrolled 115 participants (60 patients with psoriasis vulgaris and 55 control subjects). The levels of indirect bilirubin were calculated as the difference between TBil and direct bilirubin values. cIMT was measured in both common carotid arteries. Results: TBil levels were lower in patients with psoriasis than in the control group [median (range) 0.55 (0.30-1.23) vs. 0.59 (0.30-1.44) mg/dL] as were indirect bilirubin [0.43 (0.22-1.00) vs. 0.48 (0.25-1.12) mg/dL] and direct bilirubin [0.10 (0.01-0.23) vs. 0.13 (0.03-0.32) mg/dL]. Only direct bilirubin differed significantly ( p = 0.0002) but the number of patients with higher values of TBil and indirect bilirubin were significantly greater in the control group ( p = 0.0019 by the Fisher's test). The patients with psoriasis had a significantly greater cIMT compared with control subjects (0.54 ± 0.08 vs. 0.50 ± 0.07 mm, p = 0.005). High-sensitivity C-reactive protein levels were higher in patients with psoriasis compared with controls (2.95 ± 3.50 and 0.99 ± 0.72 mg/L, p < 0.001). There was a negative correlation between cIMT and TBil levels ( r = −0.383, p < 0.01). The results of the correlations were reinforced by multiple regression analysis. Conclusion: To our knowledge, this is the first study to assess the association between TBil and cIMT in patients with psoriasis. Our results support the concept that psoriasis vulgaris is associated with an increased risk of atherosclerosis.

TURKEY; ATHEROSCLEROSIS risk factors; ANTHROPOMETRY; BILIRUBIN; C-reactive protein; CAROTID artery; CHI-squared test; ECHOCARDIOGRAPHY; FISHER exact test; PHYSICAL diagnosis; PSORIASIS; SELF-evaluation; U-statistics; MULTIPLE regression analysis; CROSS-sectional method; SEVERITY of illness index; CASE-control method; DATA analysis software; CAROTID intima-media thickness; DISEASE complications

American Journal of Clinical Dermatology, 2014, Vol 15, Issue 2, p137

1175-0561

Academic Journal

10.1007/s40257-014-0069-5