Directly quantified abdominal subcutaneous adipose tissue volume is negatively associated with subclinical coronary artery disease in men with psoriasis

Background

Psoriasis is a common chronic inflammatory condition associated with an increased risk of obesity and higher coronary atherosclerosis burden by coronary computed tomography angiography (CCTA). Prior studies have shown that the ability to expand subcutaneous adipose tissue (SAT) may serve to identify individuals at a lower risk of atherosclerotic cardiovascular disease. However, the relationship between abdominal SAT and high-risk subclinical coronary artery disease requires exploration.

Purpose

To characterize the relationship between abdominal SAT volume measured on low-dose computed tomography, and coronary artery disease assessed as noncalcified and lipid-rich necrotic core burden by CCTA in psoriasis.

Methods

We performed a cross-sectional study of 232 participants with psoriasis and without known cardiovascular disease. All participants underwent CCTA to characterize coronary artery disease burden and low dose abdominal computed tomography to quantify subcutaneous adipose tissue volumes. Fat depot volumes were first adjusted in a sex specific manner for each participant's body mass index in a linear regression model. The residual values from the sex stratified linear regression models were used for analyses. Coronary artery disease burden was quantified in the three main coronary arteries (QAngio, Medis, The Netherlands) and averaged. Analyses were performed with StataIC 16 (Stata Corp., College Station, TX, USA).

Results

Of the 232 participants, 92 (40%) were women and the average age was 50 years. In women, there was a positive correlation between abdominal SAT and systemic inflammation as assessed by hs-CRP (r=0.30; p=0.004) and GlycA (r=0.29; p=0.007) as well as total cholesterol (r=0.24; p=0.02) and LDL cholesterol (r=0.22; p=0.04). In men, abdominal SAT correlated with hs-CRP (r=0.18; p=0.04) and insulin resistance as assessed by the homeostatic model for insulin resistance (r=0.17; p=0.04). In models fully adjusted for traditional cardiovascular risk factors, abdominal SAT volume negatively associated with noncalcified and lipid-rich necrotic core burden in men (β=−0.17; p=0.03, β=−0.21; p=0.02, respectively), but not women (β=−0.04; p=0.72, β=0.05; p=0.68, respectively) with psoriasis (Table).

Conclusions

In psoriasis, for a given body mass index, abdominal SAT negatively associated with coronary atherosclerosis burden in men. The observed sex-specific effects on subclinical coronary artery disease warrant further study of abdominal SAT in states of chronic inflammation.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Heart, Lung and Blood Institute Intramural Research Program in Bethesda, Maryland