Small dense low-density lipoprotein particle number (sLDL-p) predicts vascular inflammation independent of traditional lipid cardiovascular risk factors in psoriasis

Authors

• A Chaturvedi
• B Natarajan
• AK Dey
• JB Lerman
• TM Aberra
• MP Playford
• MT Kabbany
• Q Ng
• HL Teague
• JA Rodante
• AA Joshi
• NN Mehta

Abstract

Small, dense low-density lipoproteins (sLDL-p) by nuclear magnetic resonance (NMR) were recently shown to be a strong predictor of cardiovascular (CV) events. Whether this relationship is true in inflammatory states, which modulate lipoprotein structure and function, is unclear. Psoriasis (PSO), a chronic inflammatory disease associated with vascular inflammation (VI), provides a model to study how lipoprotein composition may relate to VI. 156 consecutive patients with PSO underwent 18-FDG PET/CT scans to measure aortic target-to-background ratio (TBR). We measured NMR (LipoScience), divided the cohort into tertiles of VI and compared using ANOVA test. The top tertile for TBR had cardiometabolic dysfunction including high BMI, insulin resistance, and low HDL-c. In this group, NMR measures revealed a pro-atherogenic profile, including low HDL-particle number (HDL-p) and size (HDL-z), high LDL-particle number (LDL-p) and small LDL size (LDL-z). Total LDL-p (β=0.16, p=0.04) and small LDL-p (β=0.18, p=0.02) were associated with VI beyond adjustment for age, sex, systolic BP, smoking, CRP, metabolic syndrome, PSO treatment, and statins. Likelihood ratio testing revealed sLDL-p (χ2=5.54, p=0.02) to provide value in predicting VI. VI in PSO is associated with sLDL-p beyond traditional lipid risk factors. These findings suggest NMR may add value in capturing the effect of inflammatory lipid modulation. Larger outcome studies are needed to confirm these findings.

Scientific Focus Area: Epidemiology

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