关键词: 银屑病, 复发, 血脂异常, 高脂血症, 脂肪酸结合蛋白质类, 共病现象, 代谢疾病, 代谢相关标志物

Abstract: 【Abstract】 Objective To identify factors influencing the recurrence of psoriasis, and to explore the association between the recurrence of psoriasis and metabolism-related markers. Methods A retrospective investigation was conducted on the recurrence status of patients with psoriasis vulgaris, who visited the Department of Dermatology, Peking University Third Hospital from January 2016 to April 2023. Patients with recurrence intervals > 3 months were included in the non-rapid recurrence group （non-persistent psoriasis group）, while patients with recurrence intervals ≤ 3 months were included in the rapid recurrence group （persistent psoriasis group）. General conditions and relapse triggers were analyzed between the two groups. Metabolism-related laboratory data, as well as detection results of serum fatty acid-binding protein 4 （FABP4） and FABP5 in some patients, were collected, and relationships between these indicators and psoriasis recurrence were analyzed. Comparisons between groups were performed using t test, non-parametric test or chi-square test; linear regression analysis was performed to identify possible factors influencing the FABP levels, and multivariate logistic regression analysis to identify relapse triggers. Results A total of 255 patients were collected, including 194 with non-persistent psoriasis and 61 with persistent psoriasis. There were no significant differences in gender, age （stratified every 30 years）, course of psoriasis （stratified every 10 years）, family history of psoriasis, and main therapies between the two groups （all P > 0.05）. The patients in the non-persistent psoriasis group were more prone to recurrence due to seasonal effects （χ2 = 18.98, P < 0.001）. The proportion of patients with dyslipidemia was significantly higher in the persistent psoriasis group than in the non-persistent psoriasis group （χ2 = 54.44, P < 0.001）. Compared with the non-persistent psoriasis group, the persistent psoriasis group showed significantly increased body mass index and levels of triglycerides, uric acid, and C-reactive protein （all P < 0.05）, but significantly decreased high-density lipoprotein cholesterol levels （U = 3 348.00, P < 0.001）. The levels of FABP4 and FABP5 were significantly higher in the persistent psoriasis group than in the non-persistent psoriasis group （both P < 0.05）. In the linear regression model adjusted for body mass index and dyslipidemia, FABP4 levels were associated with recurrence status of psoriasis （P < 0.001）. Multivariate logistic regression analysis revealed a significant correlation between dyslipidemia and persistent psoriasis （P < 0.001）. Conclusion The psoriasis patients with recurrence intervals ≤ 3 months may be more prone to develop metabolic diseases such as dyslipidemia, and dyslipidemia and elevated FABP4 levels may be associated with the recurrence of psoriasis.

Key words: Psoriasis, Recurrence, Dyslipidemias, Hyperlipidemia, Fatty acid-binding proteins, Comorbidity, Metabolic diseases, Metabolism-related markers