The Impact of Smoking on Selected Serum Adipokines in Patients with Psoriasis

Czech version

Authors: S. Vachatová ¹; K. Ettler ¹; L. Borská ²; J. Krejsek ³; C. Andrýs ³; Eva Čermáková ⁴; V. Řeháček ⁵; Z. Fiala ⁶
Authors‘ workplace: Klinika nemocí kožních a pohlavních, Fakultní nemocnice Hradec Králové, Univerzita Karlova, Lékařská fakulta v Hradci Králové přednosta doc. MUDr. Miloslav Salavec, CSc. ¹; Ústav patologické fyziologie, Univerzita Karlova, Lékařská fakulta v Hradci Králové přednosta prof. MUDr. Miroslav Kuba, CSc. ²; Ústav klinické imunologie a alergologie, Fakultní nemocnice Hradec Králové, Univerzita Karlova, Lékařská fakulta v Hradci Králové přednosta prof. RNDr. Jan Krejsek, CSc. ³; Ústav lékařské biofyziky, Univerzita Karlova, Lékařská fakulta v Hradci Králové přednosta doc. Ing. Josef Hanuš, CSc. ⁴; Transfuzní oddělení Fakultní nemocnice Hradec Králové primář MUDr. Vít Řeháček ⁵; Ústav hygieny a preventivního lékařství, Univerzita Karlova, Lékařská fakulta v Hradci Králové přednosta prof. Ing. Zdeněk Fiala, CSc. ⁶
Published in: Čes-slov Derm, 92, 2017, No. 6, p. 264-274
Category: Pharmacologyand Therapy, Clinical Trials

Overview

Psoriasis is a chronic relapsing inflammatory disease affecting 2–3% of European population. The components of metabolic syndrome (MetS) include obesity, dylipidemia, high blood pressure and insulin resistence. MetS can increase the risk of cardiovascular disease and diabetes mellitus type II (DM2T) which prevalence is 25–30% in developed countries. Smoking is closely related to MetS: smokers are at higher risk of MetS. Patients with psoriasis are more likely to be smokers and have higher risk of developing MetS. Link between psoriasis and MetS can be explained by subclinical inflammation and elevation of adipokines levels, present in both diseases. Smoking activates inflammatory processes via oxidative stress that contributes to chronicity of psoriasis. The aim of this study was to compare inflammatory markers – C-reactive protein (CRP), leptin, adiponectin, resistin and lipoprotein associated phospholipase A2 (LpPLA2) as well as the factors of MetS between patients with psoriasis (PP) and the control group (CG) witht respect to positivity of MetS and smoking history. PP have a statistically non-significant higher tendency to smoke. In the PP group 40.5% of patients smoked and in the control group only 30.8% of individuals. Next, significantly higher psoriasis area and severity index (PASI, p < 0.05) was measured in patients without MetS, who smoked in comparison to non-smoking controls without MetS. This finding confirm a direct link between psoriasis and smoking regardless of the presence of MetS. We detected significantly higher levels of pro-inflammatory markers CRP (p < 0.01) and leptin (p < 0.05) and proatherogenic marker Lp-PLA2 (p < 0.01) in the group of PP non-smokers suffering with MetS in comparsion to non-smoking CG suffering with MetS. Levels of CRP (p = 0.001), Lp-PLA2 (p < 0.001), leptin (p = 0.006) and resistin (p = 0.005) were statistically significantly related to psoriasis. According to our study psoriasis and obesity are related due to significantly higher BMI (p < 0.05) in PP nonsmokers with MetS in comparsion to CG nonsmokers with MetS. In conclusion we can state that psoriasis is an inflammatory state related to obesity regardless of smoking history, but the severity of psoriasis is aggravated by smoking.

Key words:
psoriasis – obesity – metabolic syndrome – smoking – C-reactive protein – lipoprotein associated phospholipase A2 – adiponectin – leptin – resistin

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