Asian Journal of Advances in Medical Science

Psoriasis is a chronic relapsing inflammatory skin disorder that has been associated with dysregulated immune response, and tumor necrosis factor-alpha (TNF-α) has long been accepted as one of the essential contributors to disease pathogenesis. Evidence in favor of a clinical link between psoriasis and dyslipidemia has recently emerged, although previous studies reported conflicting results hampering the establishment of an association. This study was conducted to assess serum TNF-α levels and their relation with lipid profile parameter among psoriatic patients and healthy control. The study design was a case-control clinical study comprising of100 subjects, which were divided in 2 groups, fifty patients of psoriasis (cases) and 50 healthy matched case controls for age, sex and body mass index (BMI). Serum TNF-α was measured by enzyme-linked immunosorbent assay (ELISA) and lipid profiles including total cholesterol (TC), triglycerides (TG),low-density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were performed based on standard enzymatic methods. Statistical analyses were conducted using independent t-tests, Pearson correlation coefficients and multivariate regression models. The serum levels of TNF-α were significantly higher in psoriasis patients (185.42 ± 48.35 pg/mL) than in controls (64.28 ± 18.76 pg/mL, p < 0,01). On the other hand, lipid abnormalities were common in the psoriasis group and its TC (218.64 ± 42.18 mg/dL vs. 182.35 ± 28.47 mg/dL, p < 0.001), TG (168.92 ± 51.23 mg/dL vs. 118.45 ± 32.18 mg/dL, p <0.001) and LDL-C (142·58±36·24 mg/dL vs .108·72±24·35 mg/Dl, p<0 ·001) although HDL-C levels decreased (42·18±9·35mg /dL vs. 52·64±10·28 mg /dl , p<0 ·001). The relationship between TNF-α and TC (r = 0.682, p < 0.001), TG (r = 0.714, p < 0.001), LDL-C (r = 0.658, p < 0.001) was found to be strong positive correlations and the relationship with HDL-C (r = − 0.542; P < 0.001) was a negative correlation. Patients with psoriasis present high levels of TNF-α associated with dyslipidemia. Furthermore, the tight correlations among TNF-α and lipid markers reinforce the interrelationship between inflammation and metabolic dyslipidemia in the pathophysiologic process of psoriasis, demonstrating that comprehensive cardiovascular risk assessment should be applied to all patients with this disease.