Serum concentrations of adipokines in psoriasis and cardiometabolic risk

Introduction
Psoriasis is associated with symptoms of the metabolic syndrome. Adipokines are bioactive mediators secreted by adipose tissue. They influence inflammatory reactions, insulin resistance, diabetes and atherosclerosis. Alterations in serum levels of some adipokines have been reported in patients with psoriasis.

Objective
A cross-sectional study was performed to better understand the role of adipokines in psoriasis, by assessing their levels and relationship with disease severity.

Material and methods
Serum fasting levels of six different adipokines – adiponectin, leptin, visfatin, resistin, chemerin, and retinol binding protein 4 (RBP4) – were measured in 42 patients with psoriasis and correlated with the Psoriasis Area and Severity Index, body surface area, body mass index, waist-hip ratio and lipid parameters.

Results
The results showed that adipokines did not correlate with psoriasis severity, with the exception of RBP4 concentration, which showed a statistically significant difference between patients with mild, moderate and severe psoriasis. RBP4 was elevated in moderate and severe psoriasis, what can correspond with the therapeutic effect of retinoids in psoriasis depending on fat tissue capacity. Significant negative correlations was observed between adiponectin/leptin ratio and following parameters: with body mass index (p < 0.0001), waist-hip ratio (p = 0.04) and visceral fat (p = 0.0001) and a correlation with HDL cholesterol (p = 0.0005). A total of 83.3% (35/42) showed an adiponectin/leptin ratio below 0.5, which isindicative of high cardiometabolic risk.

Conclusions
To the best of our knowledge, this is the first study assessing six different adipokines in sera of patients with psoriasis and their correlation with disease severity and metabolic syndrome components, showing increased cardiovascular risk in patients with psoriasis, based on the adiponectin/leptin ratio.