Insulin resistance in psoriasis: prevalence and prospects from a tertiary care centre

Ranajit Bari; Kuntolika Mani; Mrinmoy Adhikary; Shubhankar Chowdhury; Jyothi Chowdhury; Gobinda Chatterjee

doi:10.18203/2349-3933.ijam20221352

Authors

Ranajit Bari Department of Endocrinology, Institute of Post Graduate Medical Education and research, Kolkata, West Bengal, India
Kuntolika Mani Department of Physiology, Institute of Post Graduate Medical Education and research, Kolkata, West Bengal, India
Mrinmoy Adhikary Department of Community Medicine, Murshidabad Medical College, Berhampore, West Bengal, India
Shubhankar Chowdhury Department of Endocrinology, Institute of Post Graduate Medical Education and research, Kolkata, West Bengal, India
Jyothi Chowdhury Department of Pathology, Institute of Child Health, Kolkata, West Bengal, India
Gobinda Chatterjee Department of Dermatology, Institute of Post Graduate Medical Education and research, Kolkata, West Bengal, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20221352

Keywords:

Psoriasis, Hospital-based study, Cross-sectional, Insulin resistance, Inflammation

Abstract

Background: Psoriasis is a chronic autoimmune inflammatory disorder of skin. Though the exact etio-pathogenesis is not well-understood, several studies hypothesised it as a complex interaction between genetics, immunology, and environment. Hence, we aimed to assess the insulin resistance among psoriasis patients and to correlate the insulin resistance with the disease severity, and inflammation.

Methods: A tertiary hospital-based observational study was conducted for a year (2016-2017) at dermatology and endocrinology OPD, IPGMER and SSKM Hospital, Kolkata. The eligible participants were selected after applying the inclusion and exclusion criteria. After obtaining the written informed consent, basic demographic details were collected and examined for certain physical and biochemical parameters. Data was entered in Microsoft excel and analysed using SPSS software. Appropriate statistical analysis was carried out.

Results: A total of 48 cases and 40 controls participated in the study. The median fasting insulin (p<0.001), HOMA-IR (p<0.001), and hs CRP (p=0.047) in cases were significantly higher than controls. There were significant differences of HOMA-IR within three groups of psoriasis. There was a positive correlation and statistically significant between PASI and HOMA-IR (rho=0.469, p value=0.001) and between PASI and fasting insulin (rho-0.528, p value<0.001).

Conclusions: Chronic psoriasis patients were more insulin resistant and significantly correlated with the disease severity index.

Metrics

Metrics Loading ...

References

Griffiths CEM, Barker JNWN. Pathogenesis and clinical features of psoriasis. Lancet. 2007;370:263-71.

Parisi R, Iskandar IYK, Kontopantelis E, Augustin M, Griffiths CEM, Ashcroft DM. Global psoriasis atlas. national, regional, and worldwide epidemiology of psoriasis: systematic analysis and modelling study. BMJ. 2020;369:590.

Gladman DD, Anhorn KA, Schachter RK, Mervart H. HLA antigens in psoriatic arthritis. J Rheumatol. 1986;13(3):586.

Trembath RC, Clough RL, Rosbotham JL, Jones AB, Camp RD, Frodsham A, et al. Identification of a major susceptibility locus on chromosome 6p and evidence for further disease loci revealed by a two stage genome-wide search in psoriasis. Hum Mol Genet. 1997;6(5):813.

Mallon E, Bunce M, Wojnarowska F, Welsh K. HLA-CW*0602 is a susceptibility factor in type I psoriasis, and evidence Ala-73 is increased in male type I psoriatics. J Invest Dermatol. 1997;109(2):183.

Armstrong AW, Harskamp CT, Dhillon JS, Armstrong EJ Psoriasis and smoking: a systematic review and meta-analysis. Br J Dermatol. 2014;170(2):304-14.

Li W, Han J, Choi HK, Qureshi AA Smoking and risk of incident psoriasis among women and men in the UnitAm J Epidemiol. 2012;175(5):402-13.

Henseler T, Christophers E Disease concomitance in psoriasis. J Am Acad Dermatol. 1995;32(6):982.

Augustin M, Glaeske G, Radtke MA, Christophers E, Reich K, Schäfer I. Epidemiology and comorbidity of psoriasis in children Br J Dermatol. 2010;162(3):633-6.

Cullen G, Kroshinsky D, Cheifetz AS, Korzenik JR. Psoriasis associated with anti-tumour necrosis factor therapy in inflammatory bowel disease: a new series and a review of 120 cases from the literature Aliment Pharmacol Ther. 2011;34(11-12):1318-27.

Qureshi AA, Dominguez PL, Choi HK, Han J, Curhan G. Alcohol intake and risk of incident psoriasis in US women: a prospective study. Arch Dermatol. 2010;146(12):1364.

Poikolainen K, Karvonen J, Pukkala E. Excess mortality related to alcohol and smoking among hospital-treated patients with psoriasis Arch Dermatol. 1999;135(12):1490.

Boehncke WH, Boehncke S and Buerger C. Beyond immunopathogenesis. Insulin resistance and “epidermal dysfunction” Hautarzt. 2012; 63:178-83.

Claudia B. Interleukin-1b interferes with epidermal homeostasis through induction of insulin resistance: implications for psoriasis pathogenesis. J Investigat Dermatol. 2012;132:2206-14.

Warram JH, Martin BC, Krowelski AS, et al. Slow glucose removal rate and hyperinsulinemia precede the development of type II diabetes in the offspring of diabetic parents. Ann Intern Med. 1990;113:909-91.

DeFronzo RA, Tobin JD, Andres R: Glucose clamp technique: a method for quantifying insulin secretion and resistance. Am J Physiol. 1979;237:E214-23.

Boehncke S, Thaci D, Beschmann H, Ludwig RJ, Ackermann H, Badenhoop K and Boehncke WH. Psoriasis patients show signs of insulin resistance. Br J Dermatol. 2007;157:1249-51.

Yashpal S, Garg MK, Tandon N, Marwaha RK. A study of insulin resistance by homa-ir and its cut-off value to identify metabolic syndrome in urban Indian Adolescents. J Clin Res Pediatr Endocrinol. 2013;5(4):245-51.

Rhea F, Sadlier M, Connolly M, Marie A. Tobin Psoriasis and insulin resistance: a review. J Diab Res Clin Metab. 2014;2050-0866-3-3.

Uysal S, Yilmaz FM, Karatoprak K, Artüz F, Cumbul NU. The levels of serum pentraxin3, CRP, fetuin-A, and insulin in patients with psoriasis. Eur Rev Med Pharmacol Sci. 2014;18:3453-8.

Dhara S, Dasgupta A, Rout JK, Banerjee U, Dasgupta S. Clinico-biochemical correlation between psoriasis and IR. Indian J Clin Biochem. 2015;30:99-103.

Ucak S, Ekmekci T, Basat O, Koslu A, Altuntas Y. Comparison of various insulin sensivity indices in psoriatic patients and their relationship with type of psoriasis. JEADV. 2006;20:517-22.