Summary
Patients with psoriasis have an increased risk of coronary heart disease and stroke. It has been suggested that psoriasis causes raised blood levels of homocysteine. High levels of homocysteine are linked to atherosclerosis ("furring up" of the arteries). The breakdown of homocysteine is dependent on folic acid and vitamin B12. Low blood levels of folic acid have been reported in psoriasis, partly due to its consumption by increased cell turnover in the skin and partly due to reduced absorption in the gut. The authors, based in Taiwan, reviewed the published studies and confirmed that patients with psoriasis indeed had high levels of homocysteine and low levels of folic acid in their blood compared with controls (people without psoriasis). There was no difference in the blood levels of vitamin B12 between psoriasis patients and controls. The authors express a note of caution, since many other confounding factors may affect the results. However, they recommend testing homocysteine blood levels in psoriatic patients to identify those at risk of cardiovascular disease. Further studies are recommended, particularly to investigate whether giving folic acid or vitamin B12 reduces the risk of these complications.
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