title: Impaired incretin effect is an early sign of glucose dysmetabolism in nondiabetic patients with psoriasis.
abstract: BACKGROUND
  Patients with psoriasis have an increased risk of type 2 diabetes. The gastrointestinal system plays a major role in normal glucose metabolism, and in healthy individuals, postprandial insulin secretion is largely mediated by the gut incretin hormones. This potentiation is termed the incretin effect and is reduced in type 2 diabetes. The impact of psoriasis on gastrointestinal factors involved in glucose metabolism has not previously been examined.
  
  
  OBJECTIVE
  To investigate whether the incretin effect, gastrointestinal-mediated glucose disposal (GIGD) and/or secretion of glucagon and gut incretin hormones are impaired in normal glucose-tolerant patients with psoriasis.
  
  
  METHODS
  Oral glucose tolerance tests and intravenous isoglycaemic glucose infusions were performed in 12 patients with moderate-to-severe psoriasis and 12 healthy matched control subjects.
  
  
  RESULTS
  In patients with psoriasis, the incretin effect (39% vs. 57%, P = 0.02) and GIGD (53% vs. 61%, P = 0.04) were significantly reduced compared to control subjects. In addition, patients were glucose intolerant and showed exaggerated glucose-dependent insulinotropic polypeptide responses.
  
  
  CONCLUSIONS
  These novel findings support the notion that psoriasis is a prediabetic condition and suggest that gastrointestinal-related mechanisms are involved in the increased susceptibility to type 2 diabetes in patients with psoriasis.
authors.affiliation: Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Gyldenløve
authors.affiliation: Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
authors.forename: T
authors.initials: T
authors.lastname: Vilsbøll
authors.affiliation: Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Zachariae
authors.affiliation: NNF Centre for Basic Metabolic Research, Department of Biomedicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: J J
authors.initials: JJ
authors.lastname: Holst
authors.affiliation: Center for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.|NNF Centre for Basic Metabolic Research, Department of Biomedicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: F K
authors.initials: FK
authors.lastname: Knop
authors.affiliation: Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
authors.forename: L
authors.initials: L
authors.lastname: Skov
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D041981:Gastrointestinal Tract / Q000378:metabolism / Q000503:physiopathology; D005934:Glucagon / Q000378:metabolism*; D005947:Glucose / Q000378:metabolism*; D005951:Glucose Tolerance Test / Q000379:methods; D006801:Humans; D054795:Incretins / Q000378:metabolism*; D007328:Insulin / Q000378:metabolism*; D050417:Insulin-Secreting Cells / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology; D011565:Psoriasis / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology; D015203:Reproducibility of Results; D012720:Severity of Illness Index
chemical_list: D054795:Incretins; D007328:Insulin; D005934:Glucagon; D005947:Glucose
keywords: glucagon; incretin effect; incretin hormones; psoriasis; type 2 diabetes