title: The effect of acitretin treatment on insulin resistance, retinol-binding protein-4, leptin, and adiponectin in psoriasis vulgaris: a noncontrolled study.
abstract: OBJECTIVE
  To investigate the effects of acitretin treatment on insulin resistance (IR) and adipokines, particularly retinol-binding protein (RBP)-4.
  
  
  METHODS
  Thirty-four patients with chronic plaque psoriasis and a control group of 34 healthy volunteers were recruited in the study. Screening for the parameters was performed before starting and after 3 months of acitretin treatment in the psoriasis group. The control group was only evaluated at the beginning of the study and did not receive placebo. We could not compare our results with a placebo control group because of ethical reasons.
  
  
  RESULTS
  Basal adiponectin (p = 0.01), insulin (p < 0.0001) levels and homeostasis model assessment (HOMA) IR (p < 0.0001) were significantly higher in psoriasis patients. After the treatment, insulin (p = 0.014), C peptide (p = 0.011), RBP-4 (p < 0.0001) levels and HOMA-IR (p = 0.008) decreased significantly. Posttreatment leptin (p = 0.036) levels were significantly lower than those of the controls. Posttreatment adiponectin (p = 0.005) and insulin (p = 0.048) levels were higher than those of the controls.
  
  
  CONCLUSIONS
  This study showed for the first time that RBP-4 levels and IR are decreased significantly with acitretin treatment. This finding is very important in psoriasis patients because psoriasis may cause insulin resistance and diabetes. Further experimental and clinical studies are needed to clarify the effect of acitretin on adipocyte structure and behavior.
authors.affiliation: Department of Dermatology, Istanbul Medeniyet University Faculty of Medicine, Göztepe Research and Training Hospital, Istanbul, Turkey.
authors.forename: Ayse Serap
authors.initials: AS
authors.lastname: Karadag
authors.forename: Derun Taner
authors.initials: DT
authors.lastname: Ertugrul
authors.forename: Goknur
authors.initials: G
authors.lastname: Kalkan
authors.forename: Serap Gunes
authors.initials: SG
authors.lastname: Bilgili
authors.forename: Huseyin Tugrul
authors.initials: HT
authors.lastname: Celik
authors.forename: Zennure
authors.initials: Z
authors.lastname: Takci
authors.forename: Ragıp
authors.initials: R
authors.lastname: Balahoroglu
authors.forename: Omer
authors.initials: O
authors.lastname: Calka
mesh_terms: D017255:Acitretin / Q000008:administration & dosage / Q000627:therapeutic use*; D052242:Adiponectin / Q000378:metabolism*; D000328:Adult; D004305:Dose-Response Relationship, Drug; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D020738:Leptin / Q000378:metabolism*; D008297:Male; D011565:Psoriasis / Q000188:drug therapy* / Q000378:metabolism; D054839:Retinol-Binding Proteins, Plasma / Q000187:drug effects* / Q000378:metabolism
chemical_list: D052242:Adiponectin; D007328:Insulin; D020738:Leptin; C101326:RBP4 protein, human; D054839:Retinol-Binding Proteins, Plasma; D017255:Acitretin