Dyslipidemia and metabolic syndrome in patients with lichen planus: A case-control study
Keywords:
Lichen planus, dyslipidemia, metabolic syndromeAbstract
Objectives 1) To study the lipid levels in patients with lichen planus and controls, to find the association of lichen planus with dyslipidemia and to find the association of lichen planus with metabolic syndrome. Methods This was a case-control study involving a total of 100 patients, consecutively visiting the Outpatient Dermatology Department at Karnataka Institute of Medical Sciences Hubli, Karnataka. Men and women with age more than 18 years (50 cases with Lichen planus and 50 controls without lichen planus and had other skin diseases mainly nevi, seborrheic keratosis, verruca vulgaris). Results  We found significantly higher levels of triglycerides (153.03 vs 107.91 p value 0.008), total cholesterol (158.49 vs 143.47 p value 0.018), VLDL (30.61 vs 22.75 p value0.021) and significantly lower levels of HDL (38.86 vs 45.78 p value<0.001). Both TG/HDL ratio (4.26 vs 3.19) and LDL/HDL ratio (2.45 vs 1.78) were significantly higher with a p value of <0.0001. ATP-III criteria for metabolic syndrome were met by 6% of the patients with LP versus 2% of the controls (p value=0.617), suggesting no association between metabolic syndrome and lichen planus. The prevalence of dyslipidemia in patients with LP was 38% for cases and 6% for controls (p value< 0.001). A multivariate logistic regression model demonstrated that LP was associated with dyslipidemia, even after controlling for confounders, including age, gender, BMI and FBS levels (OR=11.53 95%, CI=2.80-47.55, p value<0.001). Conclusion The results obtained in our study support the association of dyslipidemia in lichen planus which was seen even after controlling the confounding factors. The study also highlights the importance of routine screening of dyslipidemia since early intervention may reduce the risk and complications of cardiovascular disease later in life. However, there was no association seen between lichen planus and metabolic syndrome. Further studies are required to establish this finding.References
Daoud MS, Pittelkow MR. Lichen planus. In: Goldsmith L, Katz S, Gilchrest B, Paller A, Leffell D, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8th ed. New York: McGraw-Hill: 2012. P. 296.
Gorouhi F, Davari P, Fazel N. Cutaneous and mucosal lichen planus: A comprehensive review of clinical subtypes, risk factors, diagnosis, and prognosis. Sci World J. 2014:742826.
Kubiak KW, Reich A. Mediators of pruritus in lichen planus. Autoimmune Dis. 2013;2013:941431.
Palit A, Inamadar AC. Pathogenesis of Lichen Planus. In: Khopkar U, Valia A. Lichen Planus, 1st edition. Delhi: Jaypee; 2013. p2
Bakry OA, Shoeib MAM, El Shafiee MK, Hassan A. Androgenetic alopecia, metabolic syndrome, and insulin resistance: Is there any association? A case-control study. Indian Dermatol Online J. 2014;5:276-81.
Su LH, Chen TH. Association of androgenetic alopecia with metabolic syndrome in men: a community-based survey. Br J Dermatol. 2010;163:371-7.
Padhi T, Garima. Metabolic syndrome and skin: Psoriasis and beyond. Indian J Dermatol. 2013;58:299-305.
Nisa N, Qazi MA. Prevalence of metabolic syndrome in patients with psoriasis. Indian J Dermatol Venereol Leprol. 2010;76:662-5.
Zindac I, Albayrak O, Kavala M, Kocaturk E, Can B, Sudogan S et al. Prevalence of metabolic syndrome in patients with psoriasis. Sci World J. 2012 (2012):312463.
Langan SM, Seminara NM, Shin DB, Troxel AB, Kimmel SE, Mehta NN et al. Prevalence of metabolic syndrome in patients with psoriasis: A population-based study in the United Kingdom. J Invest Dermatol. 2012;132:556-62.
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol Education Program (NCEP) Expert Panel On Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486-97.
Esteve E, Ricart W, Real JMF. Dyslipidemia and inflammation: an evolutionary conserved mechanism. Clin Nutr. 2005;24:16-31.
Shenoy C, Shenoy MM, Rao GK. Dyslipidemia in Dermatological disorders. North Am J Med Sci. 2015;7:421-6.
Arias-Santiago S, BuendÃa-Eisman A, Aneiros-Fernández J, Girón-Prieto MS, Gutiérrez-Salmerón MT, Mellado VG et al. Cardiovascular risk factors in patients with lichen planus. Am J Med. 2011;124:543-8.
Arias-Santiago S, BuendÃa-Eisman A, Aneiros-Fernández J, Girón-Prieto MS, Gutiérrez-Salmerón MT, Mellado VG, Naranjo-Sintes R. J Eur Acad Dermatol Venereol. 2011;25:1398-1401.
Polić MV, Miskulin M, Solić K, Pluzarić V, Sikora M, Atalić B. Serum lipids and lichen planus. Coll Antropol. 2014;38:595-9.
Lemieux I, Lamarche B, Couillard C, Pascot A, Cantin B, Bergeron J et al. Total cholesterol/HDL cholesterol ratio vs LDL cholesterol/HDL cholesterol ratio as indices of ischemic heart disease risk in men: the Quebec Cardiovascular Study. Arch Intern Med. 2011;161:2685-2692.
In: Vasudevan DM, Sreekumari S, Vaidyanathan K, Editors. Textbook of Biochemistry for Medical Students. 7th edition. Delhi: Jaypee; 2013.
Atefi N, Majedi M, Peyghambari S, Ghourchian S. Prevalence of diabetes mellitus and impaired fasting blood glucose in patients with lichen planus. Medical J Islamic Repub Iran. 2012;26:22-6.
Seyhan M, Ozcan H, Sahin I, Bayram N, Karincaoglu Y. High prevalence of glucose metabolism disturbance in patients with lichen planus. Diab Res Clin Prac. 2007;77:198-202.
Lowe NJ, Cudworth AG, Clough SA, Bullen MF. Carbohydrate metabolism in lichen planus. Br J Dermatol. 1976;95:9-12.
