Evaluation of serum lipid, lipoprotein, and apolipoprotein levels in psoriatic patients: a systematic review and meta-analysis of case-control studies

Introduction
Psoriasis is a T cell-mediated inflammatory skin disease in which fatty acids may be a link between psoriasis and its comorbidity.

Aim
The present meta-analysis aimed to evaluate lipid, lipoprotein, and apolipoprotein levels in the psoriatic patients compared with the control subjects.

Material and methods
Four databases, including Web of Science, Scopus, PubMed, and Cochrane Library were searched until July 2017. All records analysed were case-control studies. The quality of the questionnaires was evaluated using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was done by Rev Man 5.3 using mean difference (MD) and 95% confidence intervals (CIs).

Results
Out of 580 studies identified in four databases, 49 studies were included and analysed in this meta-analysis. The results showed that MD of total cholesterol, triglyceride, LDL, VLDL, HDL, Lp(a), Apo A1, and Apo B levels in the patients compared with the controls were (MD = 13.74 mg/dl; 95% CI: 7.72–19.75; p < 0.00001), (MD = 26.04 mg/dl; 95% CI: 20.77–31.31; p < 0.00001), (MD = 11.41 mg/dl; 95% CI: 6.26–16.57; p < 0.0001), (MD = 4.82 mg/dl; 95% CI: 3.63–6.00; p < 0.00001), (MD = –2.78 mg/dl; 95% CI: –4.53 – –1.03; p < 0.002), (MD = 8.51 mg/dl; 95% CI: 4.86–12.17; p < 0.0001), (MD = –6.60 mg/dl; 95% CI: –13.96 – 0.75; p < 0.08), and (MD = 9.70 mg/dl; 95% CI: 3.02–16.39; p < 0.004), respectively.

Conclusions
This meta-analysis identified abnormality of serum lipid, lipoprotein, and apolipoprotein profiles in psoriatic patients compared with the controls as well as possibly a greater risk of atherosclerosis and cardiovascular (CV) accidents in the patients.