Publication:

Subclinical atherosclerosis and serum lipid levels in relation to ultrasonographic enthesopathy in psoriasis patients, a single-center and comparative cross-sectional study

Background Psoriasis is a chronic autoimmune skin disorder characterised by persistent oxidative stress and elevated serum lipid levels, which are risk factors for atherosclerosis. Carotid intima-media thickness (CIMT) is a validated measure of subclinical atherosclerosis, while chronic inflammation in psoriasis may contribute to both entheseal and vascular pathology. Hence, this study was aimed to evaluate subclinical atherosclerosis using CIMT, serum lipid levels and their correlation with ultrasonographic enthesopathy in psoriasis patients without musculoskeletal symptoms.

Methods A single-centred, comparative cross-sectional study was conducted, including 80 psoriasis patients without musculoskeletal symptoms or comorbidities and 80 age- and sex-matched healthy controls. Demographic parameters, Psoriasis Area and Severity Index (PASI), body mass index (BMI), and serum lipid profiles (total cholesterol, LDL, HDL, VLDL, triglycerides) were assessed. Ultrasonographic CIMT and entheseal sites were evaluated using OMERACT ultrasound consensus criteria. Entheseal scores were correlated with CIMT, BMI, and lipid levels, and results were compared between groups using the standard t-test.

Results Psoriasis patients (mean age: 41.56 years; mean disease duration: 5.85 years) showed significantly higher mean CIMT, LDL, VLDL, and total entheseal scores compared to controls (p<0.05). Ultrasonographic entheseal inflammation scores significantly correlated with serum triglycerides, LDL, VLDL, and CIMT, while entheseal structural scores correlated with LDL, VLDL, and CIMT (p<0.05).

Conclusions Subclinical atherosclerosis, serum lipid levels, and ultrasonographic entheseal abnormalities in psoriasis patients are significantly associated, reflecting a heightened inflammatory burden that links vascular and entheseal pathologies. These findings emphasise the need for integrated cardiovascular and musculoskeletal monitoring in psoriasis management.