ASSOCIATION OF SYSTEMIC INFLAMMATORY MARKERS WITH SEVERITY OF PSORIASIS AND THEIR ROLE IN PREDICTING CARDIOVASCULAR RISK
Main Article Content
Keywords
Psoriasis, systemic inflammation, C-reactive protein, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, cardiovascular risk
Abstract
Background: Psoriasis is a chronic inflammatory skin disease increasingly recognized as a systemic disorder with heightened cardiovascular (CV) risk. Systemic inflammatory markers, including C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), have been proposed as potential indicators of both disease severity and cardiometabolic burden. This study aimed to assess the association of systemic inflammatory markers with psoriasis severity and evaluate their predictive value for cardiovascular risk.
Materials and Methods: A cross-sectional observational study was conducted on 210 patients with clinically diagnosed psoriasis attending a tertiary care center. Disease severity was graded using the Psoriasis Area and Severity Index (PASI) into mild (n=70), moderate (n=82), and severe (n=58) groups. Laboratory parameters including CRP, erythrocyte sedimentation rate (ESR), NLR, and PLR were measured and compared across groups. Cardiovascular risk was estimated using the Framingham risk score. Statistical analysis included ANOVA, Pearson correlation, and logistic regression, with p<0.05 considered significant.
Results: Mean CRP levels were significantly higher in severe psoriasis (11.6 ± 3.2 mg/L) compared to moderate (7.8 ± 2.5 mg/L) and mild (4.2 ± 1.9 mg/L) cases (p<0.001). Similarly, NLR increased progressively with severity (mild: 2.1 ± 0.6; moderate: 3.3 ± 0.9; severe: 4.5 ± 1.2; p<0.001). PLR also showed a rising trend (mild: 115 ± 28; moderate: 139 ± 34; severe: 168 ± 41; p=0.002). A strong positive correlation was found between PASI and CRP (r=0.62), NLR (r=0.58), and PLR (r=0.49). Logistic regression revealed CRP ≥10 mg/L and NLR ≥4.0 as independent predictors of high cardiovascular risk (OR=2.7, 95% CI: 1.6–4.5; OR=2.3, 95% CI: 1.3–3.9, respectively).
Conclusion: Systemic inflammatory markers such as CRP, NLR, and PLR correlate significantly with psoriasis severity and may serve as accessible, cost-effective tools for identifying patients at elevated cardiovascular risk. Incorporating these markers into routine evaluation could improve risk stratification and early preventive strategies in psoriatic patients.
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Dr Ritu B Sureja
M.D. Dermatology, Department of Dermatology, M K Shah Medical College, Ahmedabad, Gujarat, India
Dr Jeet B Sureja
Third Year Resident Doctor, Department of Medicine, GCS Medical College, Ahmedabad, Gujarat, India
Dr Pipalia Milind R
MBBS, GCS Medical College, Ahmedabad, Gujarat, India
Dr Bhaveshkumar R Sureja
Professor and Head, Department of Medicine, GMERS Medical College, Junagadh, Gujarat, India