Metabolic Syndrome Clinical Trial
Official title:
Assessor-Blinded Study of the Metabolic Syndrome and Surrogate Markers of Increased Cardiovascular Risk in Children With Moderate to Severe Psoriasis Compared With Age Matched Population of Children With Warts
The objective of this study is to assess whether there is an increased risk of the metabolic syndrome in children with psoriasis compared to children without psoriasis.
Adult patients with psoriasis, especially those who are young and with severe disease, have
an increased prevalence of myocardial infarction and metabolic syndrome, and increased
mortality. Tumor Necrosis Factor (TNF) and other inflammatory cytokines are felt to play an
important role not only in the pathogenesis of psoriasis and psoriatic arthritis, but in the
pathogenesis of the metabolic syndrome and increased cardiovascular mortality and morbidity.
However, the prevalence of metabolic syndrome and surrogate markers of increased
cardiovascular risk, such as lower flow-mediated dilation (FMD) during reactive hyperemia,
measured by high-resolution brachial artery ultrasound, lower hyperemia-induced, pulse wave
amplitudes as measured by finger plethysmograph peripheral artery tonometry, and elevated
blood CRP levels, in children with psoriasis, are unknown.
We will use the definition of metabolic syndrome described by de Ferranti: Participants are
defined as having metabolic syndrome if they meet or exceed the criteria for 3 or more of the
following 5 variables: 1) triglycerides ≥1.1 mmol/L; 2) HDL cholesterol <1.3 mmol/L; 3)
fasting blood glucose ≥6.1 mmol/L; 4) waist circumference (cm) >75th percentile for age and
sex; and 5) systolic or diastolic blood pressure (mm Hg) >90th percentile for age, sex, and
height.
The following two noninvasive procedures will be used to assess additional cardiovascular
risk: flow mediated dilation (FMD) and finger plethysmography peripheral artery tonometry
(PAT). These procedures have been used extensively to measure adults for clinical study
purposes for many years.
As a control group, we will compare children with psoriasis to age-, race-,and gender-matched
children with warts.
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