Is psoriasis a pre-atherosclerotic disease? Increased insulin resistance and impaired endothelial function in patients with psoriasis.
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.
Karadag
Ayse Serap
AS
Department of Dermatology, Kecioren Teaching and Research Hospital, Ankara, Turkey.
Yavuz
Bunyamin
B
Ertugrul
Derun Taner
DT
Akin
Kadir Okhan
KO
Yalcin
Ahmet Arif
AA
Deveci
Onur Sinan
OS
Ata
Naim
N
Kucukazman
Metin
M
Dal
Kursad
K
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
D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D008055:Lipids