Am J Cardiovasc Dis 2012;2(4):285-292

Original Article
Aortic vascular inflammation in psoriasis is associated with HDL particle
size and concentration: a pilot study

YiDing Yu, Nikhil Sheth, Parasuram Krishnamoorthy, Babak Saboury, Anna Raper, Amanda Baer, Rachel Ochotony, Julia
Doveikis, Stephanie DerOhannessian, Abby S Van Voorhees, Drew A Torigian, Abass Alavi, Joel M Gelfand, Nehal N Mehta

Cardiovascular Institute, University of Pennsylvania, 6 Penn Tower, Philadelphia, Pennsylvania, USA; Department of
Radiology, University of Pennsylvania, 3400 Spruce St., Philadelphia, Pennsylvania, USA; Department of Dermatology,
University of Pennsylvania, 14 Penn Tower, Philadelphia, Pennsylvania, USA; Department of Epidemiology and
Biostatistics, University of Pennsylvania, 8 Blockley Hall, Philadelphia, Pennsylvania, USA; Center for Clinical Epidemiology
and Biostatistics, University of Pennsylvania, 8 Blockley Hall, Philadelphia, Pennsylvania, USA; Department of Medicine,
University of Pennsylvania, 100 Centrex; Institute for Translational Medicine and Therapeutics, Maloney 8, University of
Pennsylvania Philadelphia, Pennsylvania, USA

Received June 22, 2012; accepted September 9, 2012; Epub October 23, 2012; Published November 15, 2012

Abstract: Psoriasis is a model Th1-mediated inflammatory disease associated with increased incidence of stroke and
cardiovascular disease (CVD). The mechanism behind these associations is unknown, however abnormal HDL particle
composition measured by nuclear magnetic resonance (NMR) spectroscopy has been shown to be associated with CVD.
Using [18F]-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT), a validated
surrogate marker of CVD, we assessed whether HDL particle size and concentration were associated with vascular
inflammation in patients with psoriasis. Patients with psoriasis were prospectively enrolled (439 aortic samples from 10
patients). Lipoprotein profiles using NMR spectroscopy were obtained and the relationship between vascular inflammation
within the thoracic aorta by FDG-PET/CT was analyzed for association with lipoprotein particle characteristics. The plasma
total cholesterol (206 mg/dL (IQR 154-229)), LDL (105 (90-161)), and triglyceride levels were within normal range (151 (94-
191)) while HDL levels were low (28.9 (27.2-31.3)); however, the NMR profile demonstrated an atherogenic profile with
increased small LDL and HDL particles. Total HDL particle concentration (p<0.001) and HDL particle size (p<0.001) were
associated with decreased aortic inflammation, while concentration of small HDL particles was associated with increased
inflammation (p<0.001). The association of total HDL particle concentration (β -0.0113, p=0.002) and small HDL particle
concentration (β 0.026, p<0.001) with aortic inflammation persisted following adjustment for CVD risk factors. Total HDL
particle concentration and small HDL particle concentration were associated with vascular inflammation within the thoracic
aorta in psoriasis. These findings suggest that HDL particle characteristics may play an important role in psoriatic vascular
inflammation and CVD. (AJCD1206005).

Keywords: Psoriasis, inflammation, atherosclerosis, high-density lipoprotein cholesterol particle, FDG PET CT


Address all correspondence to:
Dr. Nehal N Mehta
Preventive Cardiology, Director of Inflammatory Risk
Division of Cardiovascular Medicine
Center for Clinical Epidemiology and Biostatistics
University of Pennsylvania School of Medicine
6 Penn Tower, Philadelphia, Pennsylvania, 19104.
Tel: +1.215.662.7988; Fax: +1.215.349.5927;
E-mail: nehal.mehta@uphs.upenn.edu
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