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Visceral Adiposity in Psoriasis is Associated With Vascular Inflammation by 18F-Fluorodeoxyglucose Positron-Emission Tomography/Computed Tomography Beyond Cardiometabolic Disease Risk Factors in an Observational Cohort Study
Authors:Joshua P Rivers  Tiffany M Powell-Wiley  Amit K Dey  Justin A Rodante  Jonathan H Chung  Aditya A Joshi  Balaji Natarajan  Aparna P Sajja  Abhishek Chaturvedi  Anshuma Rana  Charlotte L Harrington  Heather L Teague  Benjamin N Lockshin  Mark A Ahlman  Jianhua Yao  Martin P Playford  Joel M Gelfand  Nehal N Mehta
Institution:1. National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland;2. DermAssociates, Silver Spring, Maryland;3. Department of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, Maryland;4. Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
Abstract:

Objectives

The authors sought to examine the relationship between visceral adipose tissue (VAT) and vascular inflammation (VI) by 18F-Fluorodeoxyglucose (18F-FDG) positron-emission tomography (PET)/computed tomography (CT) in psoriasis (PSO). Furthermore, we evaluated whether treatment of PSO modulated VAT and VI.

Background

PSO, a chronic inflammatory skin disease, is associated with VI by 18F-FDG PET/CT and increased cardiometabolic risk including adipose tissue dysregulation. Recently, VI was associated with future cardiovascular events; however, the relationship of visceral and subcutaneous adiposity with VI in PSO has yet to be evaluated.

Methods

Consecutive PSO patients (N = 77) underwent 18F-FDG PET/CT scans to measure VI and abdominal adiposity. A subset of PSO patients with severe skin disease was scanned at 1 year following PSO treatment (N = 13).

Results

The cohort was middle aged (51.8 ± 12.6 years), predominantly male (n = 44, 57%), had low cardiovascular risk by Framingham 10-year risk (median 4 years interquartile range (IQR): 2 to 7 years]), and mild-to-moderate skin disease (5.2 IQR: 3.0 to 8.5]). PSO disease severity associated with VAT (β = 0.33; p = 0.004) beyond SAT (β = 0.30; p = 0.005). VAT (β = 0.55; p < 0.001), but not SAT (β = 0.15; p = 0.11), associated with VI beyond cardiovascular risk factors. We followed a subset of severe PSO patients treated aggressively for PSO and observed improvement in PSO severity and VAT, which was associated with an improvement in VI at 1 year beyond cardiovascular risk factors (β = 0.53; p = 0.049).

Conclusions

Volume-based CT measurement of VAT may capture metabolic risk associated with VI compared to subcutaneous adipose tissue in PSO. PSO treatment associated with a decrease in VAT as well as decrease in VI suggesting VAT as a relevant biomarker related to VI in PSO.
Keywords:cardiometabolic disease  cardiovascular disease  psoriasis  vascular inflammation  visceral adiposity  BMI  body mass index  HOMA-IR  homeostasis model assessment of insulin resistance
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