Urinary orosomucoid: a new marker of cardiovascular risk in psoriatic patients?
Received 10 December 2018
Accepted for publication 25 April 2019
Published 5 July 2019 Volume 2019:15 Pages 831—837
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Professor Garry Walsh
Balázs Németh,1,2 Iván Péter,1 Imre Boncz,1 Anna Jagicza,1 István Kiss,2 Ágnes Csergő,2 Tamás Kőszegi,3,4 Péter Kustán,3,4 Iván G Horváth,5 Zénó Ajtay1,5
1Dermatology Unit, Zsigmondy Vilmos SPA Hospital, Harkány, Hungary; 2Department of Public Health Medicine, Medical School, University of Pécs, Pécs, Hungary; 3Department of Laboratory Medicine, Medical School, University of Pécs, Pécs, Hungary; 4János Szentágothai Research Centre, University of Pécs, Pécs, Hungary; 5Heart Institute, Medical School, University of Pécs, Pécs, Hungary
Purpose: Psoriasis is one of the most common lifelong lasting dermatologic diseases. According to the latest studies, psoriatic patients have a higher risk of developing cardiovascular diseases. Psoriasis is considered as a systemic inflammatory disease. Several oxidative stress markers have been shown to be elevated in psoriasis. However, a panel of biomarkers has not been used yet. This study was aimed at exploring the connection between a panel of biomarkers (C-reactive protein, asymmetric dimethylarginine, uric acid, total antioxidant capacity, malondialdehyde, and orosomucoid [ORM]) and cardiovascular risk in psoriatic patients.
Patients and methods: The inclusion criterion was the onset of psoriasis with skin lesions. Exclusion criteria were impaired renal function (eGFR<60 mL/min/1.73 m2,), acute inflammations (urinary, respiratory, skin inflammation, etc), autoimmune disorders (rheumatoid arthritis, systemic lupus erythematosus, or inflammatory bowel disease), and any kind of biological antipsoriatic treatment. Patients with a medical history of myocardial infarction, coronary heart disease, stroke, transient ischemic attack, and carotid artery stenosis were also excluded. Biomarkers were measured by routine procedures, ELISA and HPLC. QRISK®2-2017 was used to assess 10-year risk of cardiovascular disease development. Psoriasis severity was measured by the Psoriasis Area and Severity Index.
Results: One hundred and fourteen psoriatic patients were enrolled. Only urinary orosomucoid and urinary orosomucoid/urinary creatinine (u-ORM/u-CREAT) ratio showed significant correlation with QRISK score (u-ORM, r=0.245; u-ORM/u-CREAT, r=0.309). When comparing mild psoriatic patients to moderate psoriatic patients, significant differences could only be found in u-ORM and u-ORM/u-CREAT ratio.
Conclusion: There seems to be a connection between urinary ORM and cardiovascular risk. U-ORM and u-ORM/u-CREAT ratio could be used as an indicator of low-grade inflammation in mild and moderate psoriasis. However, it is the 10-year follow-up of cardiovascular events that will determine the usefulness of this biomarker panel.
Keywords: psoriasis, orosomucoid, oxidative stress, C-reactive protein, biomarker, cardiovascular risk
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