Background: Psoriasis is associated with an atherogenic lipid profile but longitudinal changes in lipids around\r\ndisease onset are unknown. The purpose of our study is to examine the effect of psoriasis onset on serum lipid\r\nprofiles.\r\nMethods: We compared changes in lipid profiles in a population based incident cohort of 689 patients with\r\npsoriasis and 717 non-psoriasis subjects. All lipid measures performed 5 years before and after psoriasis incidence/\r\nindex date were abstracted. Random-effects models adjusting for age, sex and calendar year were used to examine\r\ntrends in lipid profiles.\r\nResults: There were significant declines in total cholesterol (TC) and low-density lipoprotein (LDL) levels during the\r\n5 years before and after psoriasis incidence/index date in both the psoriasis and the non-psoriasis cohorts, with a\r\ngreater decrease noted in the TC levels (p=0.022) and LDL (p=0.054) in the non-psoriasis cohort. High-density\r\nlipoprotein (HDL) levels increased significantly both before and after psoriasis incidence date in the psoriasis cohort.\r\nTriglyceride (TG) levels were significantly higher (p<0.001), and HDL levels significantly lower (p=0.013) in patients\r\nwith psoriasis compared to non-psoriasis subjects. There were no differences in prescriptions for lipid lowering\r\ndrugs between the two cohorts.\r\nConclusions: Patients with psoriasis had a significant decrease in TC and LDL levels during the 5 years before\r\npsoriasis incidence. Higher mean TG and lower mean HDL levels were noted in the 5 years before psoriasis\r\nincidence. These changes are unlikely to be caused by lipid lowering treatment alone and require further\r\nexploration.
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