A study of the prevalence of diabetes, insulin resistance, lipid abnormalities, and cardiovascular risk factors in patients with chronic plaque psoriasis

Abstract

Background:The association between psoriasis, diabetes, and cardiovascular disease remains largely unelucidated in the Indian population.Aims:To study the prevalence of diabetes, insulin resistance, lipid abnormalities, and cardiovascular risk factors in patients with chronic plaque psoriasis.Materials and Methods:Seventy-seven patients of chronic plaque psoriasis and ninety two age- and sex-matched controls were enrolled in the study over a period of one year. Clinical and biometric data were noted and fasting venous blood samples were collected. Nondiabetic patients were subjected to an oral glucose tolerance test with 75 g glucose and postprandial venous blood samples collected at 120 mins. The fasting glucose, insulin, lipid levels, postprandial glucose and postprandial insulin levels were measured in samples from nondiabetic patients whereas fasting lipid levels only were measured in diabetic patients.Results:The prevalence of impaired fasting glucose, impaired glucose tolerance, and diabetes mellitus in psoriatics was 5.2%, 9.1%, and 32.5%, respectively, as compared to 6.5%, 3.3%, and 15.2%, respectively, in the controls. The difference was statistically significant. The odds ratio of having an abnormal glucose metabolism in psoriasis was 2.63. Smoking had a positive association with insulin resistance in psoriatic cases. The serum cholesterol levels were elevated in 29 (37.7%) cases with a mean of 186.27 ± 43.18 and 34 (37%) controls with a mean of 194.38 ± 57.20. The serum HDL-cholesterol levels were reduced in 50 (64.9%) cases with a mean of 53.29 ± 15.90 as compared to 71 (74.7%) in controls with a mean of 48.76 ± 12.85. The serum LDL-cholesterol levels were elevated in 38 (49.4%) cases with a mean of 102.56 ± 44.02 and 36 controls with a mean of 115.62 ± 54.37. The serum triglyceride levels were elevated in 25 (32.5%) cases with a mean of 129.99 ± 61.32 and 38 (41.3%) controls with a mean of 141.04 ± 80.10. The differences between the two groups were not statistically significant. The two groups did not differ with respect to other cardiovascular risk factors such as increased body mass index, increased waist size, increased waist-to-hip ratio, and hypertension.Conclusion:There is a positive association between insulin resistance and psoriasis. No association between psoriasis and dyslipidemia has been found in this study.

The role of lipids in psoriasis

“…Otyłość brzuszna i dyslipidemia to najbardziej istotne czynniki zwiększające częstość występowania MS u osób z tą dermatozą. Potwierdzono również częstsze pojawianie się składowych MS wraz ze wzrostem cięż-kości i czasu trwania łuszczycy [5,[67][68][69][70].…”

“…wspólnym podłożem genetycznym, w tym cząsteczkami mikro-RNA, czynnikami środowisko-wymi, przewlekłym procesem zapalnym i nadmierną syntezą adipokin i cytokin, m.in. osi IL-23/IL-17 oraz IL-18 [70,71].…”

“…In addition, diabetic patients are at an elevated risk of developing psoriasis. The associations between obesity and diabetes are attributed, among others, to the common genetic background including micro-RNA molecules, environmental factors, chronic inflammatory process and excessive synthesis of adipokines and cytokines including the IL-23/IL-17 and IL-18 axes [70,71].…”

“…Abdominal obesity and dyslipidaemia are the most significant factors leading to an increased incidence of MS in patients with this dermatosis. In addition, a link has been found between an increased frequency of metabolic syndrome components and the severity and duration of psoriasis [5,[67][68][69][70].…”

Metabolic syndrome in patients with chronic plaque psoriatic disease: a case-control study from western Uttar Pradesh, India

“…Bangalore, Kashmir and Mumbai, as they did not use the Asian modification for waist circumference. 10,16,17 In the present study, the mean for serum triglyceride level for psoriasis patients (159.42 mg/dL) was higher than controls (144.25 mg/dL). Forty six percent of cases fulfilled elevated triglycerides ≥150 mg/dl as a criterion of metabolic syndrome, compared to 40% of controls.…”