Lipoprotein (a) levels are elevated in psoriasis: An updated systematic review and meta-analysis

Psoriasis is a chronic inflammatory condition related to an increased atherosclerotic cardiovascular disease (ASCVD) risk.

To investigate whether lipoprotein (a) [Lp(a)] levels are increased in patients with psoriasis.

A comprehensive literature search up to January 30, 2025 was conducted utilizing PubMed and Cochrane Library databases. A qualitative synthesis and a meta-analysis on Lp(a) mean differences (MD) between psoriasis cases and healthy controls (HC) was performed. The protocol of this meta-analysis has been registered to PROSPERO (No. CRD420250652465).

Eighteen studies with 1650 psoriasis patients and 1621 HC were eligible for qualitative synthesis. Pooled analysis from 16 studies (1401 psoriasis patients and 1320 HC) demonstrated that psoriasis patients had significantly higher Lp(a) levels compared with the HC group (MD: 6.72 mg/dL, 95%CI: 4.32-9.12, P < 0.00001, I ² = 71%). Sensitivity analyses according to the region of origin was also performed. The pooled analysis of the European sub-population showed a pronounced increase in Lp(a) levels in 189 patients with psoriasis vs 178 HC (MD: 15.86 mg/dL, 95%CI: 5.79-25.92, P < 0.002, I ² = 79%), while the pooled analysis on the Asian sub-population demonstrated a smaller but still significant difference in Lp(a) levels between 1177 psoriasis patients and 1127 HC (MD: 4.95 mg/dL, 95%CI: 2.99-6.92, P < 0.00001, I ² = 58%).

Our findings suggest that Lp(a) levels are significantly elevated in psoriasis patients, further adding to their ASCVD risk.