Author + information
- Received June 9, 2017
- Revision received August 15, 2017
- Accepted August 16, 2017
- Published online February 5, 2018.
- Joshua P. Rivers, MSa,
- Tiffany M. Powell-Wiley, MD, MPHa,
- Amit K. Dey, MDa,
- Justin A. Rodante, PA-Ca,
- Jonathan H. Chung, BAa,
- Aditya A. Joshi, MDa,
- Balaji Natarajan, MDa,
- Aparna P. Sajja, BA, BSa,
- Abhishek Chaturvedi, MDa,
- Anshuma Rana, MDa,
- Charlotte L. Harrington, BAa,
- Heather L. Teague, PhDa,
- Benjamin N. Lockshin, MDb,
- Mark A. Ahlman, MDc,
- Jianhua Yao, PhDc,
- Martin P. Playford, PhDa,
- Joel M. Gelfand, MD, MSCEd and
- Nehal N. Mehta, MD, MSCEa,∗ ()
- aNational Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
- bDermAssociates, Silver Spring, Maryland
- cDepartment of Radiology and Imaging Sciences, National Institutes of Health Clinical Research Center, Bethesda, Maryland
- dDepartment of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
- ↵∗Address for correspondence:
Dr. Nehal N. Mehta, Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung, and Blood Institute, 10 Center Drive, Clinical Research Center, Room 5-5140, Bethesda, Maryland 20892.
Objectives The authors sought to examine the relationship between visceral adipose tissue (VAT) and vascular inflammation (VI) by 18F-Fluorodeoxyglucose (18F-FDG) positron-emission tomography (PET)/computed tomography (CT) in psoriasis (PSO). Furthermore, we evaluated whether treatment of PSO modulated VAT and VI.
Background PSO, a chronic inflammatory skin disease, is associated with VI by 18F-FDG PET/CT and increased cardiometabolic risk including adipose tissue dysregulation. Recently, VI was associated with future cardiovascular events; however, the relationship of visceral and subcutaneous adiposity with VI in PSO has yet to be evaluated.
Methods Consecutive PSO patients (N = 77) underwent 18F-FDG PET/CT scans to measure VI and abdominal adiposity. A subset of PSO patients with severe skin disease was scanned at 1 year following PSO treatment (N = 13).
Results The cohort was middle aged (51.8 ± 12.6 years), predominantly male (n = 44, 57%), had low cardiovascular risk by Framingham 10-year risk (median 4 years [interquartile range (IQR): 2 to 7 years]), and mild-to-moderate skin disease (5.2 [IQR: 3.0 to 8.5]). PSO disease severity associated with VAT (β = 0.33; p = 0.004) beyond SAT (β = 0.30; p = 0.005). VAT (β = 0.55; p < 0.001), but not SAT (β = 0.15; p = 0.11), associated with VI beyond cardiovascular risk factors. We followed a subset of severe PSO patients treated aggressively for PSO and observed improvement in PSO severity and VAT, which was associated with an improvement in VI at 1 year beyond cardiovascular risk factors (β = 0.53; p = 0.049).
Conclusions Volume-based CT measurement of VAT may capture metabolic risk associated with VI compared to subcutaneous adipose tissue in PSO. PSO treatment associated with a decrease in VAT as well as decrease in VI suggesting VAT as a relevant biomarker related to VI in PSO.
- cardiometabolic disease
- cardiovascular disease
- 18F-FDG PET/CT
- vascular inflammation
- visceral adiposity
Dr. Lockshin has received fees from Lilly, Novartis, Janssen, and Abbott. Dr. Gelfand was supported by an NIAMS grant (K24-AR-064310); has received consultant fees from Coherus (DSMB), Dermira, Janssen Biologics, Merck (DSMB), Novartis Corp., Regeneron, Sanofi, and Pfizer Inc.; has received research grants (to the Trustees of the University of Pennsylvania) from Abbvie, Janssen, Novartis Corp., Regeneron, Sanofi, Celgene, and Pfizer Inc.; has received payment for continuing medical education work related to psoriasis that was supported indirectly by Lilly and Abbvie; and is a co-patent holder of Resiquimod for treatment of cutaneous T cell lymphoma. Dr. Mehta has received funding from the National Institutes of Health Intramural Research Program (Z01 HL-06193); is a full-time U.S. Government employee; and has received research grants from Abbvie, Janssen, Novartis Corp, and Celgene. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Mr. Rivers and Dr. Powell-Wiley are joint first authors.
- Received June 9, 2017.
- Revision received August 15, 2017.
- Accepted August 16, 2017.