GlycA Is a Novel Biomarker of Inflammation and Subclinical Cardiovascular Disease in Psoriasis.

Abstract

RATIONALE:

GlycA, an emerging inflammatory biomarker, predicted cardiovascular events in population-based studies. Psoriasis, an inflammatory disease associated with increased cardiovascular risk, provides a model to study inflammatory biomarkers in cardiovascular disease (CVD). Whether GlycA associates with psoriasis and how it predicts subclinical CVD beyond high-sensitivity C-reactive protein in psoriasis is unknown.

OBJECTIVE:

To investigate the relationships between GlycA and psoriasis and between GlycA and subclinical CVD.

METHODS AND RESULTS:

Patients with psoriasis and controls (n=412) participated in a 2-stage study. We measured GlycA by nuclear magnetic resonance spectroscopy. National Institutes of Health (NIH) participants underwent 18-F Fluorodeoxyglucose Positron Emission Tomography Computed Tomography (18-FDG PET/CT) scans to assess vascular inflammation (VI) and coronary computed tomographic angiography to quantify coronary artery disease burden. Psoriasis cohorts were young (mean age=47.9), with low cardiovascular risk and moderate skin disease. high-sensitivity C-reactive protein and GlycA were increased in psoriasis compared with controls (GlycA: [PENN: 408.8±75.4 versus 289.4±60.2, P<0.0001; NIH: 415.8±63.2 versus 346.2±46, P<0.0001]) and demonstrated a dose-response with psoriasis severity. In stage 2, VI (β=0.36, P<0.001) and coronary artery disease (β=0.29, P=0.004) associated with GlycA beyond CV risk factors in psoriasis. In receiver operating characteristic analysis, GlycA added value in predicting VI (P=0.01) and coronary artery disease (P<0.01). Finally, initiating anti-tumor necrosis factor therapy (n=16) reduced psoriasis severity (P<0.001), GlycA (463.7±92.5 versus 370.1±78.5, P<0.001) and VI (1.93±0.36 versus 1.76±0.19, P<0.001), whereas GlycA remained associated with VI (β=0.56, P<0.001) post treatment.

CONCLUSIONS:

GlycA associated with psoriasis severity and subclinical CVD beyond traditional CV risk and high-sensitivity C-reactive protein. Moreover, psoriasis treatment reduced GlycA and VI. These findings support the potential use of GlycA in subclinical CVD risk assessment in psoriasis and potentially other inflammatory diseases.

• Authors: Aditya A Joshi, Joseph B Lerman, Tsion M Aberra, Mehdi Afshar, Heather L Teague, Justin A Rodante, Parasuram Krishnamoorthy, Qimin Ng, Tarek Z Aridi, Taufiq Salahuddin, Balaji Natarajan, Benjamin N Lockshin, Mark A Ahlman, Marcus Y Chen, Daniel J Rader, Muredach P Reilly, Alan T Remaley, David A Bluemke, Martin P Playford, Joel M Gelfand, Nehal N Mehta
• Journal: Circulation research (Circ Res) Vol. 119 Issue 11 Pg. 1242-1253 (Nov 11 2016) ISSN: 1524-4571 [Electronic] United States
• PMID: 27654120 (Publication Type: Journal Article)
• Copyright: © 2016 American Heart Association, Inc.

Chemical References

• Biomarkers
• Inflammation Mediators

Topics

• Adult
• Biomarkers (blood)
• Cardiovascular Diseases (blood, diagnosis, epidemiology)
• Cohort Studies
• Cross-Sectional Studies
• Female
• Humans
• Inflammation (blood, diagnosis)
• Inflammation Mediators (blood)
• Male
• Middle Aged
• Psoriasis (blood, diagnosis, epidemiology)
• Risk Factors