Plain language summary
Psoriasis is a chronic inflammatory skin disease. It is characterised by a systemic immunological response which is mainly elicited by activated T-helper (Th)1 and Th17 lymphocytes. Like psoriasis, atherosclerosis is characterised by Th1-driven inflammation both systemically and locally in arterial walls and atherosclerotic plaques. The aim of this study was to examine the effect of weight reduction on traditional cardiovascular risk factors and on endothelial function. This study is a prospective randomised trial. The participants were randomised to either low-energy diet (n=30) providing 800–1,000 kcal/day for 8 weeks followed by 8 weeks of reduced food intake reaching 1,200 kcal/day or normal healthy foods (n=30) for 16 weeks. Results indicate that after 16 weeks, obese patients with psoriasis following the low-energy diet lost significantly more weight compared to controls encouraged to eat normal healthy foods. This resulted in significant reductions of several endpoints associated with increased cardiovascular risk. Authors conclude that certain components of the cardiovascular risk profile of obese patients with psoriasis can be effectively reduced by weight reduction.
Abstract
Psoriasis is associated with obesity and other cardiovascular risk factors including endothelial dysfunction. We aimed to investigate the effects of weight loss on the cardiovascular risk profile of obese patients with psoriasis. A randomised controlled study was conducted in which we measured the microvascular endothelial function with peripheral arterial tonometry (PAT), selected plasma markers of endothelial function, and traditional cardiovascular risk factors in 60 obese patients with psoriasis. The participants were randomised to either low-energy diet (n = 30) providing 800-1,000 kcal/day for 8 weeks followed by 8 weeks of reduced food intake reaching 1,200 kcal/day or normal healthy foods (n = 30) for 16 weeks. The intervention group lost significantly more weight than controls, which resulted in significant reductions of diastolic blood pressure, resting heart rate, total cholesterol, VLDL cholesterol, triglyceride, plasma glucose, glycated haemoglobin, and tissue plasminogen activator inhibitor. Microvascular endothelial function assessed by PAT remained unchanged. We conclude that certain components of the cardiovascular risk profile of obese patients with psoriasis can be significantly improved by weight reduction.
Methodological quality
Jadad score
:
3
Allocation concealment
:
Yes
