{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T12:43:03Z","timestamp":1763037783877,"version":"3.41.2"},"reference-count":56,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T00:00:00Z","timestamp":1656547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Psoriasis is associated with a high prevalence of cardiovascular disease in Caucasians, but only a few studies from sub-Saharan Africa have investigated the prevalence of cardiovascular disease in patients with psoriasis. Abdominal aortic calcification (AAC) is a strong predictor of future cardiovascular events and all-cause mortality in the general population. We investigated the prevalence and risk factors for AAC in a predominantly non-Caucasian cohort of South African patients with psoriasis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross-sectional case-control study of adult psoriasis patients (<jats:italic>n<\/jats:italic> = 69) and controls (<jats:italic>n<\/jats:italic> = 80), matched for gender, ethnicity and body mass index, attending tertiary Dermatology and Rheumatology clinics in Johannesburg, South Africa. Demographic, anthropometric, clinical and biochemical data were recorded. All participants underwent non-contrast abdominal CT scans. Images were assessed for AAC at the supra-coeliac aorta, supra-mesenteric aorta and aortic bifurcation using Horos DICOM viewer software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Abdominal aortic calcification at any site was more prevalent in the psoriasis than control group (47.8% vs 22.5%, <jats:italic>p<\/jats:italic> &amp;lt; 0.005). The aortic bifurcation was the commonest site for AAC in both groups, but more prevalent in the psoriasis group (42.0% vs 21.3%, <jats:italic>p<\/jats:italic> &amp;lt; 0.005). The psoriasis group was also more likely to smoke, have hypertension and type 2 diabetes (56.5% vs 25.0%, <jats:italic>p<\/jats:italic> &amp;lt; 0.005; 72.0% vs 55.0%, <jats:italic>p<\/jats:italic> &amp;lt; 0.005; 24.6% vs 3.80%, <jats:italic>p<\/jats:italic> &amp;lt; 0.0005, respectively). Multivariable logistic regression analysis demonstrated that age, smoking and type 2 (T2DM) diabetes were independently associated with AAC (odds ratio (95% CIs): 1.16 (1.07, 1.20), 4.30 (2.15, 8.61) and 3.45 (1.09, 15.7) respectively), but psoriasis was not. Forward regression analysis demonstrated that smoking attenuated the association of psoriasis with AAC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings show AAC to be more common in psoriasis patients compared to controls. Age, T2DM and smoking were independent predictors of AAC. Smoking cessation is essential in psoriatic patients to reduce the risk of cardiovascular events. The clinical utility of AAC detection by CT imaging to risk stratify for hard cardiovascular outcomes needs to be explored.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.890195","type":"journal-article","created":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T09:08:57Z","timestamp":1656580137000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Prevalence and Predictors of Abdominal Aorta Calcification in Patients With Psoriasis\u2014A Case Control Study"],"prefix":"10.3389","volume":"9","author":[{"given":"Sofia","family":"Ramos","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheetal","family":"Daya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nigel J.","family":"Crowther","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lushen","family":"Pillay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Tikly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nasrin","family":"Goolam Mahyoodeen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1056\/NEJMra0804595","article-title":"Psoriasis","volume":"361","author":"Nestle","year":"2009","journal-title":"N Engl J Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jaad.2016.07.064","article-title":"Psoriasis and comorbid diseases Part I","volume":"76","author":"Takeshita","year":"2017","journal-title":"Epidemiology J Am Acad Dermatol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11926-017-0692-2","article-title":"Cardiometabolic disorders in psoriatic disease","volume":"19","author":"Sobchak","year":"2017","journal-title":"Curr Rheumatol Rep."},{"key":"B4","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1136\/annrheumdis-2011-200567","article-title":"Cardiovascular and metabolic risks in psoriasis and psoriatic arthritis: pragmatic clinical management based on available evidence","volume":"71","author":"Johnsson","year":"2012","journal-title":"Ann Rheum Dis"},{"key":"B5","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1111\/ijd.14348","article-title":"High burden of the metabolic syndrome and its component disorders in South Africans with psoriasis","volume":"58","author":"Goolam Mahyoodeen","year":"2019","journal-title":"Int J Dermatol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1590\/abd1806-4841.20186168","article-title":"Prevalence of smoking, alcohol consumption and metabolic syndrome in patients with psoriasis","volume":"93","author":"Adi\u015fen","year":"2018","journal-title":"An Bras Dermatol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"441","DOI":"10.3899\/jrheum.111245","article-title":"Epidemiology and potential pathomechanisms of cardiovascular comorbidities in psoriasis: a report from the GRAPPA 2010 Annual Meeting","volume":"39","author":"Boehncke","year":"2012","journal-title":"J Rheumatol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"2273","DOI":"10.1161\/ATVBAHA.113.301844","article-title":"Progression of carotid intima-media thickness as predictor of vascular events: Results from the IMPROVE study","volume":"33","author":"Baldassarre","year":"2013","journal-title":"Arterioscler Thromb Vasc Biol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/j.1468-3083.2011.04410.x","article-title":"The concept of psoriasis as a systemic inflammation: Implications for disease management","volume":"26","author":"Reich","year":"2012","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1136\/annrheumdis-2012-201497","article-title":"The burden of carotid artery plaques is higher in patients with psoriatic arthritis compared with those with psoriasis alone","volume":"72","author":"Eder","year":"2013","journal-title":"Ann Rheum Dis."},{"key":"B11","doi-asserted-by":"publisher","first-page":"S49","DOI":"10.1161\/01.cir.0000437741.48606.98","article-title":"2013 ACC\/AHA guideline on the assessment of cardiovascular risk","volume":"129","author":"Goff","year":"2014","journal-title":"Circulation"},{"key":"B12","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/S0735-1097(97)00147-2","article-title":"Comparison of electron beam computed tomography with intracoronary ultrasound and coronary angiography for detection of coronary atherosclerosis","volume":"30","author":"Baumgart","year":"1997","journal-title":"J Am Coll Cardiol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"86","DOI":"10.5527\/wjn.v6.i3.100","article-title":"Role of different imaging modalities of vascular calcification in predicting outcomes in chronic kidney disease","volume":"6","author":"Disthabanchong","year":"2017","journal-title":"World J Nephrol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1097\/00000658-198502000-00001","article-title":"Patterns of atherosclerosis and their surgical significance","volume":"201","author":"Debakey","year":"1985","journal-title":"Ann Surg."},{"key":"B15","doi-asserted-by":"publisher","first-page":"e200","DOI":"10.1016\/S2665-9913(20)30009-6","article-title":"Psoriatic arthritis in developing and resource-poor countries","volume":"2","author":"Maharaj","year":"2020","journal-title":"Lancet Rheumatol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5830\/CVJA-2017-055","article-title":"Double trouble: psoriasis and cardiometabolic disorders","volume":"28","author":"Mahyoodeen","year":"2017","journal-title":"Cardiovasc J Afr."},{"key":"B17","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1093\/clinchem\/18.6.499","article-title":"Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge","volume":"18","author":"Friedewald","year":"1972","journal-title":"Clin Chem."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"Harmonizing the metabolic syndrome: A joint interim statement of the international diabetes federation task force on epidemiology and prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International","volume":"120","author":"Alberti","year":"2009","journal-title":"Circulation."},{"key":"B19","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.2337\/dci17-0007","article-title":"Standards of medical care in diabetes-2017","volume":"40","author":"Herman","year":"2017","journal-title":"Diabetes Care"},{"key":"B20","doi-asserted-by":"publisher","first-page":"975","DOI":"10.7196\/SAMJ.2018.v108i11.13383","article-title":"South African dyslipidaemia guideline consensus statement: 2018 update A joint statement from the South African Heart Association (SA Heart) and the Lipid and Atherosclerosis Society of Southern Africa (LASSA)","volume":"108","author":"Klug","year":"2018","journal-title":"SAMJ."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1218","DOI":"10.2340\/00015555-3327","article-title":"Relationship of visceral fat and adipokines with cardiometabolic diseases in psoriasis","volume":"99","author":"Goolam Mahyoodeen","year":"2019","journal-title":"Acta Derm Venereol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1111\/j.1468-3083.2009.03481.x","article-title":"Subclinical atherosclerosis in patients with chronic psoriasis: A potential association","volume":"24","author":"El-Mongy","year":"2010","journal-title":"J Eur Acad Dermatol Venereol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"346","DOI":"10.3109\/07853890.2015.1031822","article-title":"Cardiovascular risk markers in patients with psoriatic arthritis: a meta-analysis of literature studies","volume":"47","author":"Di Minno","year":"2015","journal-title":"Ann Med."},{"key":"B24","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1016\/j.atherosclerosis.2014.10.008","article-title":"Increased subclinical atherosclerosis in patients with chronic plaque psoriasis","volume":"237","author":"Evensen","year":"2014","journal-title":"Atherosclerosis."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1001\/jamadermatol.2016.2907","article-title":"Comparison of coronary artery calcium scores between patients with psoriasis and type 2 diabetes","volume":"152","author":"Mansouri","year":"2016","journal-title":"JAMA Dermatol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1234","DOI":"10.3389\/fimmu.2018.01234","article-title":"Potential immunological links between psoriasis and cardiovascular disease","volume":"9","author":"Sajja","year":"2018","journal-title":"Front Immunol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"157","DOI":"10.3892\/ijmm.2019.4173","article-title":"Abnormal expression of SIRTs in psoriasis: Decreased expression of SIRT 1-5 and increased expression of SIRT 6 and 7","volume":"44","author":"Fan","year":"2019","journal-title":"Int J Mol Med."},{"key":"B28","doi-asserted-by":"publisher","first-page":"157","DOI":"10.3390\/life10090157","article-title":"Histone deacetylase 1 and sirtuin 1 expression in psoriatic skin: a comparison between guttate and plaque psoriasis","volume":"10","author":"Hwang","year":"","journal-title":"Life (Basel)."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.1161\/CIRCRESAHA.116.308895","article-title":"Age-associated sirtuin 1 reduction in vascular smooth muscle links vascular senescence and inflammation to abdominal aortic aneurysm","volume":"119","author":"Chen","year":"2016","journal-title":"Circ Res."},{"key":"B30","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1161\/ATVBAHA.111.235234","article-title":"Calcified atherosclerosis in different vascular beds and the risk of mortality","volume":"32","author":"Allison","year":"2012","journal-title":"Arterioscler Thromb Vasc Biol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1529","DOI":"10.1161\/01.CIR.103.11.1529","article-title":"Abdominal aortic calcific seposits are an important predictor of vascular morbidity and mortality","volume":"103","author":"Wilson","year":"2001","journal-title":"Circulation"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1610","DOI":"10.1001\/jama.2010.461","article-title":"Coronary artery calcium score and risk classification for coronary heart disease prediction: the multi-ethnic study of atherosclerosis","volume":"303","author":"Polonsky","year":"2010","journal-title":"JAMA."},{"key":"B33","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1148\/radiol.2018180562","article-title":"Pickhardt PJ. Does nonenhanced CT-based quantification of abdominal aortic calcification outperform the Framingham risk score in predicting cardiovascular events in asymptomatic adults?","author":"O'Connor","year":"2018","journal-title":"Radiology."},{"key":"B34","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.1161\/ATVBAHA.114.303268","article-title":"Abdominal aortic calcium, coronary artery calcium, and cardiovascular morbidity and mortality in the multi-ethnic study of atherosclerosis","volume":"34","author":"Criqui","year":"2014","journal-title":"Arter Thromb Vasc Biol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.atherosclerosis.2020.01.012","article-title":"Abdominal aortic calcification (AAC) and ankle-brachial index (ABI) predict health care costs and utilization in older men, independent of prevalent clinical cardiovascular disease and each other","volume":"295","author":"Schousboe","year":"2020","journal-title":"Atherosclerosis."},{"key":"B36","doi-asserted-by":"publisher","first-page":"248","DOI":"10.4082\/kjfm.17.0098","article-title":"Du, Yoon SJ. Relationship between smoking and abdominal aorta calcification on computed tomography","volume":"40","author":"Jung","year":"2019","journal-title":"Korean J Fam Med."},{"key":"B37","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1111\/bjd.12670","article-title":"Psoriasis and smoking: a systematic review and meta-analysis","volume":"170","author":"Armstrong","year":"2014","journal-title":"Br J Dermatol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1111\/bjd.13013","article-title":"Demography, baseline disease characteristics and treatment history of patients with psoriasis enrolled in a multicentre, prospective, disease-based registry (PSOLAR)","volume":"171","author":"Kimball","year":"2014","journal-title":"Br J Dermatol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1580","DOI":"10.1001\/archderm.141.12.1580","article-title":"Relationship between smoking and the clinical severity of psoriasis","volume":"141","author":"Fortes","year":"2005","journal-title":"Arch Dermatol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1080\/1744666X.2019.1543591","article-title":"The relationship between smoking, psoriasis and psoriatic arthritis","volume":"15","author":"Pezzolo","year":"2019","journal-title":"Expert Rev Clin Immunol."},{"key":"B41","doi-asserted-by":"publisher","first-page":"65","DOI":"10.2147\/PTT.S85189","article-title":"Psoriasis: Targets and therapy dovepress psoriasis and smoking: links and risks","volume":"6","author":"Naldi","year":"2016","journal-title":"Psoriasis Targets Ther."},{"key":"B42","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.jdermsci.2013.02.006","article-title":"TNIP1\/ANXA6 and CSMD1 variants interacting with cigarette smoking, alcohol intake affect risk of psoriasis","volume":"70","author":"Yin","year":"2013","journal-title":"J Dermatol Sci."},{"key":"B43","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1152\/ajplung.00308.2006","article-title":"Sirtuin regulates cigarette smoke-induced proinflammatory mediator release via RelA\/p65 NF-B in macrophages in vitro and in rat lungs in vivo: implications for chronic inflammation and aging","volume":"292","author":"Yang","year":"2007","journal-title":"Am J Physiol Lung Cell Mol Physiol."},{"key":"B44","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1016\/j.freeradbiomed.2021.02.013","article-title":"Cigarette smoke-inactivated SIRT1 promotes autophagy-dependent senescence of alveolar epithelial type 2 cells to induce pulmonary fibrosis","volume":"166","author":"Zhang","year":"2021","journal-title":"Free Radic Biol Med."},{"key":"B45","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.clindermatol.2017.09.005","article-title":"Psoriasis and the metabolic syndrome","volume":"36","author":"Gisondi","year":"2018","journal-title":"Clin Dermatol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1002\/acr.20363","article-title":"Prevalence of atherosclerotic risk factors and the metabolic syndrome in patients with chronic inflammatory arthritis","volume":"63","author":"Mok","year":"2011","journal-title":"Arthritis Care Res."},{"key":"B47","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1002\/acr.22926","article-title":"Risk of cardiovascular morbidity in patients with psoriatic arthritis: A meta-analysis of observational studies","volume":"69","author":"Polachek","year":"2017","journal-title":"Arthritis Care Res."},{"key":"B48","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1097\/CRD.0000000000000048","article-title":"The heartbreak of psoriasis a review of cardiovascular risk in patients with psoriasis","volume":"23","author":"Benson","year":"2015","journal-title":"Cardiol Rev."},{"key":"B49","doi-asserted-by":"publisher","first-page":"1735","DOI":"10.1001\/jama.296.14.1735","article-title":"Risk of myocardial infarction in patients with psoriasis","volume":"296","author":"Gelfand","year":"2006","journal-title":"JAMA."},{"key":"B50","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1093\/eurheartj\/ehp567","article-title":"Patients with severe psoriasis are at increased risk of cardiovascular mortality: cohort study using the general practice research database","volume":"31","author":"Mehta","year":"2010","journal-title":"Eur Heart J."},{"key":"B51","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1016\/j.jaad.2006.09.017","article-title":"The association between psoriasis, diabetes mellitus, and atherosclerosis in Israel: a case-control study","volume":"56","author":"Shapiro","year":"2007","journal-title":"J Am Acad Dermatol."},{"key":"B52","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1111\/j.1365-2133.2009.09281.x","article-title":"More than skin deep: atherosclerosis as a systemic manifestation of psoriasis","volume":"161","author":"Alexandroff","year":"2009","journal-title":"Br J Dermatol."},{"key":"B53","doi-asserted-by":"publisher","first-page":"2667","DOI":"10.1161\/ATVBAHA.115.306460","article-title":"Severity of psoriasis associates with aortic vascular inflammation detected by FDG PET\/CT and neutrophil activation in a prospective observational study","volume":"35","author":"Naik","year":"2015","journal-title":"Arterioscler Thromb Vasc Biol."},{"key":"B54","doi-asserted-by":"publisher","first-page":"2347","DOI":"10.1038\/jid.2013.131","article-title":"Psoriasis is not associated with atherosclerosis and incident cardiovascular events: the Rotterdam study","volume":"133","author":"Dowlatshahi","year":"2013","journal-title":"J Invest Dermatol."},{"key":"B55","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1016\/j.jaad.2013.06.053","article-title":"Meta-analysis of psoriasis, cardiovascular disease, and associated risk factors","volume":"69","author":"Miller","year":"2013","journal-title":"J Am Acad Dermatol."},{"key":"B56","doi-asserted-by":"publisher","first-page":"2211","DOI":"10.3390\/ijms18102211","article-title":"Psoriasis and cardiovascular comorbidities: focusing on severe vascular events, cardiovascular risk factors and implications for treatment","volume":"18","author":"Hu","year":"2017","journal-title":"Int J Mol Sci."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.890195\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T09:08:59Z","timestamp":1656580139000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.890195\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,30]]},"references-count":56,"alternative-id":["10.3389\/fmed.2022.890195"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.890195","relation":{},"ISSN":["2296-858X"],"issn-type":[{"type":"electronic","value":"2296-858X"}],"subject":[],"published":{"date-parts":[[2022,6,30]]},"article-number":"890195"}}