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Subclinical Impairment of Cardiovascular System in Patients With Psoriasis

Completed
Conditions
Endothelial Dysfunction
Insulin Resistance
Thrombocyte Disorders
Inflammation
Psoriasis
Metabolic Disturbance
Coagulation Disorder
Registration Number
NCT05957120
Lead Sponsor
University Medical Centre Ljubljana
Brief 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.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
100
Inclusion Criteria
  • patients with psoriasis aged 30 to 45 years in stable phase of the disease for at least last 6 months
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Exclusion Criteria
  • any treatment besides treatment of psoriasis
  • carotid disease
  • heart failure
  • atrial fibrillation
  • diabetes type 1 or 2
  • cardiovascular event in the past
  • chronic kidney disease stage 3, 4, 5 or end-stage kidney disease
  • psoriatic arthritis or any other rheumatic disease
  • malignancy
  • menopause in women
  • other chronic inflammatory diseases
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Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Arterial function - arterial stiffnessthrough study completion, an average of 6 months

Arterial stiffness (pulse wave velocity)

Endothelial activationthrough study completion, an average of 6 months

Circulating markers of endothelial activation (E-selectin, vascular cell adhesion molecule-1 (VCAM-1), Endothelial cell adhesion molecules (ECAMs))

Arterial function - endothelial functionthrough study completion, an average of 6 months

Endothelial function (flow-mediated dilation)

Secondary Outcome Measures
NameTimeMethod
Inflammationthrough study completion, an average of 6 months

Circulating markers of inflammation (tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-6, IL-12, IL-17, IL-23, high sensitivity C-reactive protein (hs-CRP), interferon-gamma, TNF-related activation-inducing ligand (TRANCE), TNF-related apoptosis-inducing ligand (TRAIL), Growth/differentiation factor-15 (GDF-15), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR))

Insulin resistancethrough study completion, an average of 6 months

Circulating markers of insulin resistance (fasting glucose, insulin), HOMA-IR equation (Homeostatic Model Assessment for Insulin Resistance)

Activation of coagulationthrough study completion, an average of 6 months

Coagulation assay (overall coagulation potential (OCP) assay)

Platelet activation (2)through study completion, an average of 6 months

Circulating markers of platelet activation (P-selectin)

Metabolic disturbancesthrough study completion, an average of 6 months

Parameters of (pre)metabolic syndrome (TyG (triglyceride-glucose index))

Activation of hemostasisthrough study completion, an average of 6 months

Hemostatic assay (overall hemostasis potential (OHP) assay)

Coagulationthrough study completion, an average of 6 months

Circulating markers of coagulation activation (D-dimer, fibrinogen)

Metabolic disturbances - dyslipidemiathrough study completion, an average of 6 months

Parameters of (pre)metabolic syndrome (lipid panel)

Liver steatosisthrough study completion, an average of 6 months

Laboratory markers (aspartate aminotransferase (AST), Alanine Aminotransferase (ALT), Fib4 score (Fibrosis-4))

Platelet activation (1)through study completion, an average of 6 months

Circulating markers of platelet activation (mean platelet volume (MPV)

Trial Locations

Locations (1)

University Medical Centre Ljubljana

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Ljubljana, Slovenia

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