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Psoriasis Severity-A Risk Factor of Insulin Resistance Independent of Metabolic Syndrome.

Abstract

BACKGROUND

It is still debatable whether psoriasis increases cardiovascular risk indirectly since it is associated with metabolic syndrome or is an independent cardiovascular risk factor. The aim of this study was to evaluate psoriasis severity as an independent predictor of insulin resistance (IR) irrespective of the presence of metabolic syndrome (MetS).

METHODS

This was a case control study including 128 patients stratified into two groups: patients with psoriasis and metabolic syndrome vs. patients with psoriasis and no metabolic syndrome. MetS was diagnosed according to ATP III criteria with homeostatic model assessment of insulin resistance (HOMA-IR), as well as a homeostatic model assessment of beta cell function (HOMA-β) were calculated.

RESULTS

Compared to subjects without metabolic syndrome, patients with metabolic syndrome had a significantly higher Psoriasis Area Severity Index (PASI) values (p < 0.001). The strongest correlation was established for HOMA-IR and the PASI index (p < 0.001), even after adjustment for body mass index (BMI) in regression analysis model. In patients without MetS and severe forms of disease, the HOMA-IR and HOMA-β values were significantly higher compared to mild forms of disease (p < 0.001 for all) while in subjects with MetS no difference was established for HOMA-IR or HOMA-β based on disease severity.

CONCLUSIONS

Psoriasis severity is an independent risk factor of HOMA-IR, the strongest association being present in the non-MetS group, who still had preserved beta cell function suggesting direct promotion of atherosclerosis via insulin resistance depending on the disease severity, but irrespective of the presence of metabolic syndrome.

Authors+Show Affiliations

Department of Dermatology, University Hospital Center Osijek, 31000 Osijek, Croatia. melyderma@gmail.com. Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia. melyderma@gmail.com.Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia. miskulin.maja@gmail.com.Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia. martina.smolic@mefos.hr. Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia. martina.smolic@mefos.hr.Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia. kristina.kralik@gmail.com.Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia. ivan.miskulin@mefos.hr.Department of Endocrinology, Diabetes and Metabolism, University Hospital Centre Sestre Milosrdnice, 10000 Zagreb, Croatia. maja.cigrovskiberkovic@gmail.com.Department of Dermatology, University Hospital Center Osijek, 31000 Osijek, Croatia. ibcurcic@mefos.hr. Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia. ibcurcic@mefos.hr.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30011841

Citation

Polic, Melita Vuksic, et al. "Psoriasis Severity-A Risk Factor of Insulin Resistance Independent of Metabolic Syndrome." International Journal of Environmental Research and Public Health, vol. 15, no. 7, 2018.
Polic MV, Miskulin M, Smolic M, et al. Psoriasis Severity-A Risk Factor of Insulin Resistance Independent of Metabolic Syndrome. Int J Environ Res Public Health. 2018;15(7).
Polic, M. V., Miskulin, M., Smolic, M., Kralik, K., Miskulin, I., Berkovic, M. C., & Curcic, I. B. (2018). Psoriasis Severity-A Risk Factor of Insulin Resistance Independent of Metabolic Syndrome. International Journal of Environmental Research and Public Health, 15(7), doi:10.3390/ijerph15071486.
Polic MV, et al. Psoriasis Severity-A Risk Factor of Insulin Resistance Independent of Metabolic Syndrome. Int J Environ Res Public Health. 2018 07 13;15(7) PubMed PMID: 30011841.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psoriasis Severity-A Risk Factor of Insulin Resistance Independent of Metabolic Syndrome. AU - Polic,Melita Vuksic, AU - Miskulin,Maja, AU - Smolic,Martina, AU - Kralik,Kristina, AU - Miskulin,Ivan, AU - Berkovic,Maja Cigrovski, AU - Curcic,Ines Bilic, Y1 - 2018/07/13/ PY - 2018/06/03/received PY - 2018/07/04/revised PY - 2018/07/11/accepted PY - 2018/7/18/entrez PY - 2018/7/18/pubmed PY - 2019/1/17/medline KW - cardiovascular risk factor KW - chronic inflammation KW - insulin resistance KW - psoriasis severity JF - International journal of environmental research and public health JO - Int J Environ Res Public Health VL - 15 IS - 7 N2 - BACKGROUND: It is still debatable whether psoriasis increases cardiovascular risk indirectly since it is associated with metabolic syndrome or is an independent cardiovascular risk factor. The aim of this study was to evaluate psoriasis severity as an independent predictor of insulin resistance (IR) irrespective of the presence of metabolic syndrome (MetS). METHODS: This was a case control study including 128 patients stratified into two groups: patients with psoriasis and metabolic syndrome vs. patients with psoriasis and no metabolic syndrome. MetS was diagnosed according to ATP III criteria with homeostatic model assessment of insulin resistance (HOMA-IR), as well as a homeostatic model assessment of beta cell function (HOMA-β) were calculated. RESULTS: Compared to subjects without metabolic syndrome, patients with metabolic syndrome had a significantly higher Psoriasis Area Severity Index (PASI) values (p < 0.001). The strongest correlation was established for HOMA-IR and the PASI index (p < 0.001), even after adjustment for body mass index (BMI) in regression analysis model. In patients without MetS and severe forms of disease, the HOMA-IR and HOMA-β values were significantly higher compared to mild forms of disease (p < 0.001 for all) while in subjects with MetS no difference was established for HOMA-IR or HOMA-β based on disease severity. CONCLUSIONS: Psoriasis severity is an independent risk factor of HOMA-IR, the strongest association being present in the non-MetS group, who still had preserved beta cell function suggesting direct promotion of atherosclerosis via insulin resistance depending on the disease severity, but irrespective of the presence of metabolic syndrome. SN - 1660-4601 UR - https://www.unboundmedicine.com/medline/citation/30011841/Psoriasis_Severity_A_Risk_Factor_of_Insulin_Resistance_Independent_of_Metabolic_Syndrome_ L2 - http://www.mdpi.com/resolver?pii=ijerph15071486 DB - PRIME DP - Unbound Medicine ER -