Background/Purpose: Psoriatic arthritis (PsA) is an immune-mediated inflammatory arthritis associated with psoriasis that can cause remarkable joint damage ⁽¹⁾. Subclinical cardiovascular disease (CVD) due to subclinical atherosclerosis is accelerated in PsA leading to overt cardiovascular events with increased mortality in those patients⁽²⁾. Chronic inflammation plays a crucial role in the pathogenesis of atherosclerosis in PsA, together with the conventional risk factors ⁽³⁾. Intima-media thickness of the common carotid artery, evaluated by ultrasonography, is a good indicator of generalized atherosclerosis and coronary artery disease, giving early signs of subclinical atherosclerosis ⁽⁴⁾. We aimed to investigate the role of interleukin-1 beta (IL-1β), homeostatic model assessment of insulin resistance (HOMA-IR), and insulin level as early predictors of subclinical atherosclerosis in patients with PsA.

Methods: The study included 81 patients with PsA and 69 matched healthy volunteers. Serum IL-1β, HOMA-IR, and insulin levels were assessed. Ultrasonographic measurement of carotid intima-media thickness (CIMT) was done for both common carotid arteries and the mean CIMT was calculated.

Results: Our patients and controls were matched regarding age, sex, and body mass index (BMI) (P >0.05). Our study revealed a statistically significant difference between patients and controls regarding IL-1β, HOMA-IR, insulin level, and CIMT (p < 0.05) as illustrated in table (1). There was a statistically significant positive correlation between IL-1β, HOMA-IR, insulin level, and CIMT (p< 0.05), however, no significant correlation could be detected between ESR, CRP, and CIMT (p >0.05) as shown in table (2).

Conclusion: IL-1β, HOMA-IR, and insulin levels are correlated with CIMT in PsA. So, each of them can be used as a predictor of subclinical atherosclerosis in those patients. Consequently, IL-1β targeted therapy may have a pivotal role in the prevention of subclinical CVD in PsA.

REFERENCES:

1. J. McHugh, C. Balachrishnan, S. M. Jones. Progression of peripheral joint disease in psoriatic arthritis: a 5-yr prospective study. Rheumatology. 2003;42:778–783.

2. Ramonda, A. Lo Nigro, V. Modesti, et al. Atherosclerosis in psoriatic arthritis. Auto-immunity Reviews. 2011;10:773-778.

3. M. Tobin, D. J. Veale, O. FitzGerald, et al. Cardiovascular disease and risk factors in patients with psoriasis and psoriatic arthritis. Journal of Rheumatology. 2010; 37:1386–1394.

4. Di Minno MN, Ambrosino P, Lupoli R, Di Minno A, Tasso M, Peluso R, et al. Cardiovascular risk markers in patients with psoriatic arthritis: a metaanalysis of literature studies. Ann Med. 2015; 47:346–53.

Table 1: Comparison between patients and controls regarding clinical characteristics and laboratory results. BMI, body mass index; n, number; SD, standard deviation; IL1-B,interlukin 1-B; HOMA-IR, homeostatic model assessment of insulin resistance; CIMT, carotd intima-media thichkness; kg, kilogram; m, meter; pg, picogram; ml, milliliter; uIU, micro-international unit; mm, millimeter.

Table 2: Correlation between CIMT and some parameters. ESR, erythrocyte sedimentation rate; CRP, c-reactive protein; IL-1B, interlukin-1 beta; HOMA-IR, homeostatic model assessment of insulin resistance; CIMT, carotid intima-media thickenss; pg, picogram; ml, milliliter; uIU, micro-international unit; mm, millimeter; mg, milligram; hr, hour; dl, deciliter.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/subclinical-atherosclerosis-risk-in-psoriatic-arthritis-could-it-be-prevented/