title: Patients with psoriasis are insulin resistant.
abstract: BACKGROUND
  Patients with psoriasis have increased risk of type 2 diabetes. The pathophysiology is largely unknown, but it is hypothesized that systemic inflammation causes insulin resistance. Insulin sensitivity has only been sparsely investigated in patients with psoriasis, and previous studies have used suboptimal methodology. The hyperinsulinemic euglycemic clamp remains the gold standard for quantifying whole-body insulin sensitivity.
  
  
  OBJECTIVE
  We sought to investigate if normal glucose-tolerant patients with psoriasis exhibit impaired insulin sensitivity.
  
  
  METHODS
  Three-hour hyperinsulinemic euglycemic clamps were performed in 16 patients with moderate to severe, untreated psoriasis and 16 matched control subjects.
  
  
  RESULTS
  The 2 groups were similar with regard to age, gender, body mass index, body composition, physical activity, fasting plasma glucose, and glycosylated hemoglobin. Mean ± SEM psoriasis duration was 23 ± 3 years and Psoriasis Area and Severity Index score was 12.7 ± 1.4. Patients with psoriasis exhibited reduced insulin sensitivity compared with control subjects (median M-value 4.5 [range 1.6-14.0] vs 7.4 [range 2.1-10.8] mg/kg/min, P = .046). There were no differences between groups in plasma glucose, insulin, C-peptide, and glucagon during the clamp.
  
  
  CONCLUSIONS
  The classic hyperinsulinemic euglycemic clamp technique does not allow assessment of endogenous glucose production.
  
  
  CONCLUSIONS
  Patients with psoriasis were more insulin resistant compared with healthy control subjects. This supports that psoriasis may be a prediabetic condition.
authors: Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. Electronic address: mette.gyldenloeve@regionh.dk.
authors: Mette
authors: M
authors: Gyldenløve
authors: Center for Diabetes Research, Department of Medicine, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
authors: Heidi
authors: H
authors: Storgaard
authors: Novo Nordisk Foundation (NNF) Center for Basic Metabolic Research, Department of Biomedicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors: Jens J
authors: JJ
authors: Holst
authors: Center for Diabetes Research, Department of Medicine, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
authors: Tina
authors: T
authors: Vilsbøll
authors: Center for Diabetes Research, Department of Medicine, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Novo Nordisk Foundation (NNF) Center for Basic Metabolic Research, Department of Biomedicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors: Filip K
authors: FK
authors: Knop
authors: Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
authors: Lone
authors: L
authors: Skov
mesh_terms: D000328:Adult; D000886:Anthropometry; D001786:Blood Glucose / Q000032:analysis; D002096:C-Peptide / Q000032:analysis; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005260:Female; D005934:Glucagon / Q000097:blood; D005943:Gluconeogenesis; D015309:Glucose Clamp Technique; D018149:Glucose Intolerance; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood; D007249:Inflammation; D007328:Insulin; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000453:epidemiology / Q000378:metabolism; D011565:Psoriasis / Q000453:epidemiology / Q000378:metabolism*; D012306:Risk
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D007328:Insulin; D005934:Glucagon
keywords: M-value; hyperinsulinemic euglycemic clamp; insulin resistance/sensitivity; psoriasis; type 2 diabetes