既往观察发现，牛皮癣或称银屑癣（psoriasis）患者易患心肌梗死、中风或因心血管病而死亡。日前又有研究进一步明确了为何“牛皮癣患者易患冠心病，如心绞痛或心肌梗死”？这是因为“牛皮癣所引发的炎症可以改变高密度脂蛋白（high-density lipoprotein ，HDL）的结构，及其弱化其功能，进而干扰、甚至阻断其发挥抗动脉粥样硬化的功效”。事实上，不仅牛皮癣，类风湿性关节炎、甚至肥胖亦可因引起炎症而干扰高密度脂蛋白的功效进而影响患者之心脑血管健康，值得关注啊！

Does Psoriasis Thwart the Benefits of 'Good' Cholesterol?

Chronic skin condition may be associated with changes in HDL composition, researchers say

THURSDAY, Nov. 17 (HealthDay News) -- Inflammation caused by psoriasis may trigger changes in a person's cholesterol, including weakening the function of high-density lipoprotein (HDL), the "good" cholesterol, new research suggests.

The researchers said that, if confirmed, their findings could help explain why people with psoriasis -- a chronic skin condition -- are at greater risk for heart attack, stroke and cardiovascular death, especially if the psoriasis is moderate to severe.

"Anecdotally, many researchers have observed that HDL levels may be lower in states of inflammation, such as rheumatoid arthritis, psoriasis and even obesity," study author Dr. Nehal Mehta, director of the Inflammatory Risk Clinic in the preventive cardiology program at the University of Pennsylvania, said in a university news release.

"However, these new findings suggest that in addition to lower levels, chronic inflammation associated with conditions like psoriasis may change the composition and decrease the function of HDL as well," Mehta added.

In the study, the researchers measured cholesterol levels in 78 people with psoriasis and examined the number and size of the cholesterol particles. The results were compared to those of 84 people who didn't have the skin condition.

The investigators found that patients with psoriasis had a greater number of low-density lipoprotein (LDL), or "bad" cholesterol particles unrelated to other risk factors or obesity. The researchers also noted these particles were smaller.

　　In a second study, the researchers examined how well the participants' HDL removed cholesterol from cells involved in atherosclerosis, or "hardening of the arteries." 　The findings revealed that having psoriasis was associated with a reduction in the protective benefit of good cholesterol by about 25 percent.

While the study uncovered an association between psoriasis and HDL function, it did not prove a cause-and-effect relationship, and the researchers say more study is needed to confirm the link.

"We've been able to show that psoriasis is an important risk factor for vascular disease, and now we may finally be able to identify and ultimately treat the pathways by which psoriasis increases these risks," senior study author Dr. Joel M. Gelfand, an assistant professor of dermatology and epidemiology, noted in the news release.

The study was presented Wednesday at the American Heart Association annual meeting in Orlando, Fla. Because this research was presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

SOURCE: University of Pennsylvania, news release, Nov. 16, 2011