title: Is psoriasis a pre-atherosclerotic disease? Increased insulin resistance and impaired endothelial function in patients with psoriasis.
abstract: BACKGROUND
  Several studies have shown an association between psoriasis and atherosclerotic risk factors. In this study, we aimed to evaluate endothelial function by flow-mediated dilation (FMD) and insulin resistance by Homeostasis model assessment-insulin resistance (HOMA-IR).
  
  
  METHODS
  We examined 75 consecutive psoriasis patients and 50 healthy controls. All subjects underwent transthoracic echocardiography and brachial artery imaging for detecting FMD. Fasting blood samples were drawn from all subjects for measuring insulin, C-peptide, fasting blood glucose. HOMA-IR was calculated.
  
  
  RESULTS
  Baseline characteristics of both groups were similar. Twenty-four psoriatic patients had arthritis. Insulin [9.3 (4.0-208.1) vs. 8.2 (2.3-16.5) mcIU/ml, P = 0.016] and C-peptide [2.5 (0.9-20.0) vs. 2.0 (0.9-3.7) ng/ml, P = 0.009] levels were significantly higher in patients with psoriasis than in controls. HOMA-IR [2.1 (0.8-68.9) vs. 1.8 (0.6-8.6), P = 0.036] was significantly higher in patients with psoriasis than in controls. FMD was reduced in patients with psoriasis compared with healthy controls (5.6 +/- 1.9% vs. 10.9 +/- 1.9%, P < 0.001).
  
  
  CONCLUSIONS
  This study demonstrated a significant impairment in endothelial function and increased insulin resistance in patients with psoriasis. This is a comprehensive study for identifying atherosclerotic risk factors in psoriasis. We suggest that psoriatic patients should be paid attention for atherosclerosis and its risk factors.
authors.affiliation: Department of Dermatology, Kecioren Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Ayse Serap
authors.initials: AS
authors.lastname: Karadag
authors.forename: Bunyamin
authors.initials: B
authors.lastname: Yavuz
authors.forename: Derun Taner
authors.initials: DT
authors.lastname: Ertugrul
authors.forename: Kadir Okhan
authors.initials: KO
authors.lastname: Akin
authors.forename: Ahmet Arif
authors.initials: AA
authors.lastname: Yalcin
authors.forename: Onur Sinan
authors.initials: OS
authors.lastname: Deveci
authors.forename: Naim
authors.initials: N
authors.lastname: Ata
authors.forename: Metin
authors.initials: M
authors.lastname: Kucukazman
authors.forename: Kursad
authors.initials: K
authors.lastname: Dal
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D001786:Blood Glucose / Q000378:metabolism; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000502:physiology; D002096:C-Peptide / Q000378:metabolism; D004452:Echocardiography; D004730:Endothelium, Vascular / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology; D012039:Regional Blood Flow / Q000502:physiology; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D008055:Lipids