AUTHOR=Berg Alexander R. , Petrole Rylee F. , Li Haiou , Sorokin Alexander V. , Gonzalez-Cantero Alvaro , Playford Martin P. , Mehta Nehal N. , Teague Heather L. 

TITLE=Cholesterol efflux capacity is associated with lipoprotein size and vascular health in mild to moderate psoriasis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1041457

DOI=10.3389/fcvm.2023.1041457

ISSN=2297-055X

ABSTRACT=<sec><title>Background and objective</title><p>Psoriasis is a systemic inflammatory condition with poor cholesterol transport measured by cholesterol efflux capacity (CEC) that is associated with a heightened risk of cardiovascular disease (CVD). In psoriasis patients, we sought to characterize the lipoprotein profile by size using a novel nuclear magnetic resonance algorithm in patients with low CEC compared to normal CEC.</p></sec><sec><title>Methods</title><p>Lipoprotein profile was assessed using the novel nuclear magnetic resonance LipoProfile-4 deconvolution algorithm. Aortic vascular inflammation (VI) and non-calcified burden (NCB) were characterized <italic>via</italic> positron emission tomography-computed tomography and coronary computed tomography angiography. To understand the relationship between lipoprotein size and markers of subclinical atherosclerosis, linear regression models controlling for confounders were constructed.</p></sec><sec><title>Results</title><p>Psoriasis patients with low CEC had higher more severe psoriasis (<italic>p</italic> = 0.04), VI (<italic>p</italic> = 0.04) and NCB (<italic>p</italic> = 0.001), concomitant with smaller high-density lipoprotein (HDL) (<italic>p</italic> &lt; 0.001) and low-density lipoprotein (LDL) particles (<italic>p</italic> &lt; 0.001). In adjusted models HDL size (<italic>β</italic> = −0.19; <italic>p</italic> = 0.02) and LDL size (<italic>β</italic> = −0.31; <italic>p</italic> &lt; 0.001) associated with VI and NCB. Lastly, HDL size strongly associated with LDL size in fully adjusted models (<italic>β</italic> = −0.27; <italic>p</italic> &lt; 0.001).</p></sec><sec><title>Conclusion</title><p>These findings demonstrate that in psoriasis, low CEC associates with a lipoprotein profile comprised of smaller HDL and LDL particles which correlates with vascular health and may be driving early onset atherogenesis. Further, these results demonstrate a relationship between HDL and LDL size and provide novel insights into the complexities of HDL and LDL as biomarkers of vascular health.</p></sec>