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Serum Levels of Homocysteine in Young Psoriasis Patients Naïve for Conventional Systemic and Biologic Therapy

Introduction: Psoriasis is an immune-mediated chronic inflammatory disease, affecting approximately 1-3% of the population worldwide. Psoriasis patients are more likely to be diagnosed with cardiovascu- lar diseases and hyperhomocysteinemia ; however, it remains elusive weather serum homocysteine levels correlate to disease activity and duration of disease. The aim of this study was to investigate serum levels of homocysteine in young patients with plaque psoriasis naïve for conventional systemic and biologic therapy. An additional aim was to determine correlation of homocysteine levels with disease severity, inflammation, folic acid and vitamin B12 supplies. Materials and methods: 26 subjects were enrolled to participate in this case-control study, including 13 adult psoriatic patients naïve for systemic therapy, without comorbidities, malignancies and infectious diseases, and 13 healthy unrelated, age and sex- matched volunteers. The disease severity and life quality were assessed using standardized tools – Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI), respectively. Venous blood was collected and processed for analysis of differential blood count (DBC), erythrocyte sedimentation rate (ESR), C reactive protein (hsCRP), serum levels of homocysteine, vitamin B12 and folic acid in the routine clinical laboratory. Results Studied cohort consisted of young participants with average age around 35 years. According to the PASI index, disease severity ranged from mild (2.10) to moderate (15.2). There was no significant difference in hsCRP and DBC levels between the groups. Psoriasis patients had significantly higher levels of homocysteine compared to healthy subjects, but there was no evidence of hyperhomocystein- emia related to psoriasis. All subjects had normal serum levels of vitamin B12 and folic acid. A moderate negative correlation was found between plasma homocysteine level and vitamin B12 and folic acid. Furthermore, homocysteine levels did not correlate to hsCRP, total leukocytes, and thrombocytes count, but did significantly positively correlate to ESR. Conclusions: The risk of cardiovascular diseases should be considered among all psoriasis patients, regardless of age and disease severity, but larger prospective controlled studies are needed to estimate the role of homocysteine in cardiovascular morbidity and mortality in psoriatic patients.

psoriasis ; homocysteine ; folic acid ; cardiovascular disease

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