European Journal of Cardiovascular Medicine

Psoriasis is a chronic, immune-mediated inflammatory skin disease affecting approximately 2–3% of the global population [1]. Characterized by keratinocyte hyperproliferation, dysregulated immune responses, and systemic inflammation, psoriasis is increasingly recognized as a systemic condition with a range of extracutaneous manifestations [2]. Among the emerging areas of interest is the impact of psoriasis on serum electrolyte balance, which may be influenced by systemic inflammation, skin barrier dysfunction, and associated comorbidities.

Electrolytes such as sodium, potassium, calcium, magnesium, and phosphorus play essential roles in cellular function, neuromuscular activity, and fluid balance. Alterations in serum electrolyte levels have been observed in several inflammatory and autoimmune diseases, but data specific to psoriasis remain limited and inconsistent [3]. Some studies have reported hyponatremia, hypocalcemia, and hypomagnesemia in psoriatic patients, potentially related to increased transepidermal water loss, cytokine-mediated renal effects, or metabolic derangements [4,5].

Furthermore, electrolyte imbalances may contribute to complications such as muscle cramps, cardiac arrhythmias, or neuropsychiatric symptoms, thereby impacting the quality of life and management of patients with psoriasis [6]. Certain treatments used for psoriasis, including methotrexate, cyclosporine, and biologic agents, may also influence serum electrolyte levels [7].

Recent research has identified a possible link between psoriasis and altered purine metabolism, resulting in elevated serum uric acid levels [8]. Hyperuricemia, the biochemical precursor to gout, is increasingly being recognized not just as a comorbid condition, but also as a potential contributor to the inflammatory cascade observed in psoriatic disease [9]. Uric acid can activate the NLRP3 inflammasome, promoting the release of pro-inflammatory cytokines such as IL-1β, which are also implicated in psoriasis pathogenesis [10].

Gender may influence serum uric acid levels, with men generally exhibiting higher concentrations than women, possibly due to hormonal differences, lifestyle factors, and variations in body composition [11]. This gender-based disparity may be more pronounced in patients with psoriasis, who often have a higher inflammatory burden and are predisposed to metabolic abnormalities [12].This study demonstrates that psoriasis patients exhibit significant alterations in serum electrolytes, including sodium, potassium along with elevated uric acid levels compared to healthy individuals.

Aim

 To study the levels of electrolytes (sodium and potassium) and uric acid among the patients   diagnosed with psoriasis and controls and correlation of electrolytes with uric acid among psoriasis patients.

Objectives

1. To estimate serum electrolyte levels in psoriasis patients and controls.
2. To estimate serum uric acid levels in psoriasis patients and controls.
3. Correlation of Serum electrolytes with uric acid in psoriasis patients.

The study has been conducted in the department of biochemistry and dermatology, ACSR,GMC, Nellore after obtaining clearance from the institutional scientific and  ethical committee. A Total of 60 (30 Cases & 30 Controls ) subjects with age group 25-60yrs  and the psoriasis patients who have given written informed  consent and no other co-existing diseases/conditions were included in study and subjects with Chronic alcoholics and smokers, people with hypertension, diabetes, personal or family history of metabolic disease, patients who were on oral contraceptives and any other medication, pregnant women, and postmenopausal women  were excluded from the study .All subjects were investigated for Serum  Sodium , Potassium and  Uric acid. Sodium and potassium was done in ISE Electrolyte analyser and uric acid was done in semi auto analyser by using uricase  method  .

Statistical analysis of the data obtained was performed using Microsoft Excel, and  tables were generated. Statistical analysis (SPSS, Version 15.0) was done to calculate the Student's t-test (p value) to find the significance of the results. The results were presented as mean ± SD and p value.

Table 1 & graph 1 shows the mean and SD of Serum sodium levels were higher (146.8 ± 4.5) in cases compared to controls (138.6 ± 3.8) & p <0.0001 which is considered highly significant, and serum potassium levels were higher (5.2 ± 0.5) in cases compared to controls (4.1 ± 0.4) & p<0.0001 which is considered statistically significant.

Table 1: Comparison of serum electrolytes and uric acid levels in cases and controls

Graph 1: Comparison of serum electrolytes and uric acid levels in cases and controls

Table 2 shows gender based disparity in serum uric acid levels among cases and controls

Table 2 and graph 2 shows Mean and SD of serum uric acid levels in males (7.5± 1.1) were higher compared to controls (6.5 ± 0.8) and p <0.05 which is considered statistically significant. Mean and SD of serum uric acid levels in females (5.8± 0.51) were higher compared to controls (5.3 ± 0.43) and p <0.5 which is not statistically significant.

Graph 2 shows gender-based disparity in serum uric acid levels among cases and controls

Table 1 Correlation of Serum electrolytes and Uric acid levels among psoriasis patients

Table 1 and Graph 1 & 2 shows there is positive correlation between serum electrolytes and uric acid.

Graph 1: Correlation of Serum Sodium and Uric acid levels in psoriasis cases

Graph 2: Correlation of Serum Potassium and Uric acid levels in psoriasis cases

Given the potential clinical significance of electrolyte disturbances in psoriatic patients, this study aims to evaluate serum electrolyte profiles in individuals with psoriasis and to explore possible association with disease severity. In our study we found that serum sodium levels were higher in cases compared to controls and serum potassium levels were with in normal range but were higher in psoriasis patients compared to the controls. So, monitoring serum electrolytes in psoriasis patients, especially those with severe disease or comorbidities, might be important for overall management. Identifying and correcting imbalances can help prevent complications and improve patient well-being. Serum uric acid is significantly elevated in psoriasis patients, especially in males. Gender differences are evident and may be due to hormonal, metabolic, and lifestyle factors. Screening for hyperuricemia in psoriasis particularly in men should be considered in clinical practice. Further research with larger cohorts and longitudinal studies is needed to fully elucidate the role of electrolytes and uric acid in the pathogenesis and progression of psoriasis and to determine if electrolyte management and uric acid could be a potential therapeutic target.

In conclusion, the study of serum electrolytes in psoriasis patients reveals potential systemic involvement beyond the skin. While initial findings suggest alterations in sodium, potassium, and uric acid, further research is crucial to elucidate the underlying mechanisms, determine the clinical significance of these changes, and explore potential therapeutic implications.

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