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

• Published in: JACC. Cardiovascular imaging Vol. 11; no. 2; pp. 349 - 357
• Main Authors: Rivers, Joshua P., Powell-Wiley, Tiffany M., Dey, Amit K., Rodante, Justin A., Chung, Jonathan H., Joshi, Aditya A., Natarajan, Balaji, Sajja, Aparna P., Chaturvedi, Abhishek, Rana, Anshuma, Harrington, Charlotte L., Teague, Heather L., Lockshin, Benjamin N., Ahlman, Mark A., Yao, Jianhua, Playford, Martin P., Gelfand, Joel M., Mehta, Nehal N.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-02-2018
• Subjects: 18F-FDG PET/CT; cardiometabolic disease; cardiovascular disease; psoriasis; vascular inflammation; visceral adiposity; cardiovascular disease; 18F-FDG PET/CT; HOMA-IR; cardiometabolic disease; psoriasis; vascular inflammation; visceral adiposity; BMI
• ISSN: 1936-878X; 1876-7591
• DOI: 10.1016/j.jcmg.2017.08.014

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.
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.
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).
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).
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.
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