Dependence of indicators of the biochemical profile of children with psoriasis on the severity of the pathological process
Summary. Objective — to assess indicators of a metabolic panel in children with psoriasis depending on the severity of the disease process. Materials and methods. A metabolic panel, including total protein level, total bilirubin, cholesterol, liver enzymes (alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase (GGT), triglycerides, low-density lipoproteins, creatinine, urea, uric acid (UA), was done in 108 children, who underwent inpatient treatment. PASI, BSA and PGA indices were calculated. Study records were statistically processed using the «Statistica 13.3» («StatSoft Inc.»). Results. The analysis of metabolic panel results, obtained in children with psoriasis, revealed that the mean values (total bilirubin, cholesterol, alanine aminotransferase, aspartate aminotransferase, GGT, triglycerides, low-density lipoproteins, creatinine, urea, UA) remain within normal age limits, however make significant difference to identic indicators in children from the control group. In case of an increase in the PASI index in children with psoriasis, the level of UA increases as well, particularly in groups of children with PASI ranging from 10 to 20 and more than 20, the mean level of UA is significantly higher than the value in the control group and mean value in the group of children having PASI up to 10. With an increase in the PASI index, GGT levels rise as well, which, in groups of children with PASI varying from 10 to 20 and more than 20, makes a statistically significant difference to the same indicator in the control group, and in children with PASI higher than 20 — significantly higher than the values in other groups. After the intensification of psoriatic skin lesions (in accordance with the PGA index), mean GGT levels gradually increase, there is a statistically significant difference between the mean levels of serum GGT in children having 3–4-point PGA index and the indicator in controls. The highest mean value of UA was reported in children holding 3-point PGA index, significantly exceeding mean values in groups of children having 1–2- and 4-point PGA index. In the group of children with psoriasis, metabolic panel indicators did not make any statistical difference depending on the BSA index and can be comparable with indicators in the control group, except for GGT values. This indicator, in children with psoriasis of both groups, significantly exceeds the same indicator in controls according to the BSA index. Conclusions. Regardless of metabolic panel results ranging within age limits, there are signs of impaired UA metabolism and the damage to hepatic cell membranes (as evidenced by increased GGT levels) and they become more intensive with an increase in the severity of the disease process, as well as lead to the durable exacerbation of psoriasis and the resistance to the medication prescribed.
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