Psoriasis and Diabetes, a Dangerous Association: Evaluation of Insulin Resistance, Lipid Abnormalities, and Cardiovascular Risk Biomarkers

Frontiers in Medicine

article

Valeria Brazzelli¹  Pamela Maffioli²  Vittorio Bolcato⁴  Christian Ciolfi¹  Angela D'Angelo²  Carmine Tinelli⁶  Giuseppe Derosa² 

[1] Institute of Dermatology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, University of Pavia;Department of Internal Medicine and Therapeutics, Centre of Diabetes and Metabolic Diseases, University of Pavia and Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo;Centre for Prevention, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo;Department of Public Health, Experimental and Forensic Medicine, Forensic Science Section, University of Pavia;Laboratory of Molecular Medicine, University of Pavia;Clinical Epidemiology and Biometric Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo

关键词: psoriasis;    type 2 diabetes mellitus;    insulin-resistance;    endothelial parameters;    obesity;   

DOI  :  10.3389/fmed.2021.605691

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Aims: Psoriasis is an immune-mediated dermatosis with cardio-metabolic comorbidities. The aim of this study was to assess insulin-resistance, lipid abnormalities, and cardiovascular risk biomarkers in psoriatic patients with or without type 2 diabetes mellitus (T2DM). Methods and materials: We enrolled 425 patients: 86 psoriatics, 69 psoriatics with T2DM, 120 T2DM patients, and 150 healthy subjects. We measured the Psoriasis Area and Severity Index (PASI), body mass index (BMI), insulin-resistance parameters [glycosylated hemoglobin (HbA 1c ), fasting plasma glucose (FPG), fasting plasma insulin (FPI), and with homeostasis model assessment index (HOMA index)], lipidic panel, plasminogen activator inhibitor-1 (PAI-1), homocysteine, soluble adhesion molecules, matrix metalloproteinase, and adipocytokines. Results: FPG, HbA 1c , and HOMA-IR were higher in diabetics with psoriasis ( p < 0.0001) than in psoriatics. FPI levels were higher in diabetics with psoriasis than in diabetics and psoriatics ( p < 0.0001), and higher in psoriatics than controls ( p < 0.0001). Psoriatics and diabetics with psoriasis showed higher triglyceride and LDL-C levels ( p < 0.0001) than diabetics. Homocysteine was higher in psoriatics and diabetics with psoriasis ( p < 0.0001) than in diabetics. PAI-1 was higher in diabetics with psoriasis than diabetics ( p < 0.01). sICAM-1 and sVCAM-1 were higher in diabetics with psoriasis than diabetics ( p < 0.001 and p < 0.01) and psoriatics ( p < 0.001 and p < 0.0001). Visfatin and resistin were lower in psoriatics ( p < 0.0001) and in diabetics with psoriasis ( p < 0.001 and p < 0.0001, respectively) than diabetics. Conclusions: A limitation of this study is that there is a significant difference in mean age between controls and other study groups: the lack of matching between case and control groups may interfere with the external validity of the study findings. Despite this, the study highlights a pathogenetic link between psoriasis, considered a pre-diabetic condition, and diabetes. Insulin-resistance seems to be the keystone of psoriasis comorbidities. Psoriasis reinforces diabetes, causing a greater cardiometabolic risk.

【 授权许可】

CC BY