Psoriasis and Diabetes, a Dangerous Association: Evaluation of Insulin Resistance, Lipid Abnormalities, and Cardiovascular Risk Biomarkers

Brazzelli, Valeria; Maffioli, Pamela; Bolcato, V.; Ciolfi, Christian; D’Angelo, Angela; Tinelli, Carmine; Derosa, Giuseppe

doi:10.3389/fmed.2021.605691

Cited by 29 publications

(30 citation statements)

References 42 publications

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“…25 The mean level of TG in the PsO group was slightly higher compared with the recommended level, which was consistent with findings from a recent study that explored the risk biomarkers of cardiovascular diseases in PsO with T2D. 26 Moreover, glucose metabolism related indices between two groups were explored. Analysis showed that the mean HOMA-β, glucose level, insulin concentration, and C-peptide were higher in PsO compared with the levels in the control group.…”

Section: Discussionsupporting

confidence: 85%

Psoriasis Exacerbates the State of Insulin Resistance in Patients with Type 2 Diabetes

Su¹,

Liu²,

Li³

et al. 2021

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Although psoriasis (PsO) is highly associated with insulin resistance (IR), the role of PsO on activity of insulin secretion or its action in diabetic patients has not been explored. Materials and Methods: In-patient data on type 2 diabetes (T2D) with or without PsO from 2016-2019 in our hospital were analyzed. Data for 42 diabetic patients with PsO were compared with that of the control group (T2D only). Blood examinations with reference to the levels of fasting blood glucose, C-peptide, insulin, HbA1c, plasma lipids, lipoproteins, and kidney function were explored. HOMA-IR and HOMA-β models were established to explore IR and pancreatic β-cell function. Results: HOMA-IR level was significantly higher (P=0.0003<0.05) in patients with PsO compared with the controls. Although the durations of diabetes in patients with PsO were significantly shorter compared with that of patients with diabetes only (P=0.012<0.05), analysis of mean BMI, eGFR, plasma lipids, and lipoprotein showed no significant differences. Analysis of the level of fasting glucose and HOMA-β showed no statistical differences between the two groups. On the other hand, the levels of C-peptide of PsO group were significantly high in both fasting state (P=0.0182<0.05) and after glucose challenge (P=0.0011<0.01). Conclusion:The findings of this study show that under the same fasting conditions, patients with PsO may have relatively preserved pancreatic β-cell function, and PsO significantly increases IR.

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Section: Discussionsupporting

confidence: 85%

Psoriasis Exacerbates the State of Insulin Resistance in Patients with Type 2 Diabetes

Su¹,

Liu²,

Li³

et al. 2021

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“…Insulin could promote wound healing ( Goren et al, 2006Goren et al, , 2009, so insulin resistance was not conducive to wound healing. The epidermal changes caused by psoriasis (such as dysdifferentiation and hyperplasia) were consistent with the process of wound healing (Boehncke et al, 2012), so insulin resistance seemed to be an important perspective for studying comorbidities of psoriasis (Brazzelli et al, 2021). IL-1β, a pro-inflammatory cytokine, could induce insulin resistance in psoriasis (Boehncke et al, 2012;Coban et al, 2016).…”

Section: Discussionmentioning

confidence: 98%

Identification of Potential Biomarkers for Psoriasis by DNA Methylation and Gene Expression Datasets

et al. 2021

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DNA methylation (DNAm) plays an important role in the pathogenesis of psoriasis through regulating mRNA expressions. This study aimed to identify hub genes regulated by DNAm as biomarkers of psoriasis. Psoriatic skin tissues gene expression and methylation datasets were downloaded from Gene Expression Omnibus (GEO) database. Subsequently, multiple computational approaches, including immune infiltration analysis, enrichment analysis, protein–protein interaction (PPI) network establishment, and machine learning algorithm analysis (lasso, random forest, and SVM-RFE), were performed to analyze the regulatory networks, to recognize hub genes, and to clarify the pathogenesis of psoriasis. Finally, the hypermethylated genes were used to immune cell infiltration analysis, which revealed that psoriasis skin tissues were mainly composed of activated dendritic cells, resting mast cells, T follicular helper cells (cTfh), etc. Differentially expressed-methylated genes (DEMGs) were identified and partitioned into four subgroups and the 97 significantly hypermethylated and downregulated (hyper-down) genes accounted for the highest proportion (47%). Hyper-down genes were mainly enriched in glucose homeostasis, AMP-activated protein kinase (AMPK) signaling pathway, lipid storage disease, partial lipodystrophy, and insulin resistance. Furthermore, insulin receptor substrate 1 (IRS1), Rho guanine nucleotide exchange factor 10 (ARHGEF10) and retinoic acid induced 14 (RAI14) were identified as potential targets. These findings provided new ideas for future studies of psoriasis on the occurrence and the molecular mechanisms.

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“…Adipose tissue is considered to be a true endocrine organ that secretes a multitude of soluble mediators involved in immunity, inflammation, and metabolic and appetite regulation ( 2 , 22 ). Adipokines (mediators secreted by adipose tissue) include classic cytokines, such as IL-6, TNF-α and leptin-specific molecules, adiponectin, resistin and visfatin, which exert proinflammatory effects that may contribute to the inflammatory status in psoriasis, which may explain the increased risk of psoriasis in obese patients ( 2 , 20 , 22 , 23 ). Thus, weight loss in these patients may reduce the risk and severity of psoriasis by lowering the levels of leptin and proinflammatory cytokines ( 20 , 23 ).…”

Section: Metabolic Comorbidities Of Psoriasismentioning

confidence: 99%

“…Adipokines (mediators secreted by adipose tissue) include classic cytokines, such as IL-6, TNF-α and leptin-specific molecules, adiponectin, resistin and visfatin, which exert proinflammatory effects that may contribute to the inflammatory status in psoriasis, which may explain the increased risk of psoriasis in obese patients ( 2 , 20 , 22 , 23 ). Thus, weight loss in these patients may reduce the risk and severity of psoriasis by lowering the levels of leptin and proinflammatory cytokines ( 20 , 23 ). Another feature that supports the coexistence of obesity with psoriasis is the presence of the HLA-Cw6 gene; this is a major psoriasis sensitivity gene, which is also associated with obesity and has been shown to increase the risk of patients developing psoriasis ( 2 ).…”

Section: Metabolic Comorbidities Of Psoriasismentioning

confidence: 99%

“…As diabetes itself is a cardiovascular risk factor, when associated with psoriasis it carries a significant risk of metabolic syndrome or cardiovascular events ( 16 , 25 , 26 ). Several studies have evaluated and reported the association between psoriasis and diabetes, suggesting a probable pathophysiological link between the two diseases ( 22 , 23 , 27 ). The increase in the levels of TNF-α, a proinflammatory cytokine that plays an important role in the pathogenesis of insulin resistance by reducing the tyrosine kinase activity of the insulin receptor, is a pathogenetic link between psoriasis and type 2 diabetes ( 23 ).…”

Section: Metabolic Comorbidities Of Psoriasismentioning

confidence: 99%

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Metabolic comorbidities of psoriasis (Review)

et al. 2021

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Psoriasis is a chronic inf lammatory and immune-mediated condition, which is no longer considered as being limited to the skin, but may affect the entire body. Epidemiological studies have shown that certain disorders, including obesity, diabetes, liver abnormalities, elevated lipid levels in the blood and metabolic syndrome, may occur more frequently in patients with psoriasis compared with the general population. As psoriasis is a chronic disease, the frequently associated comorbidities must be identified early to ensure timely treatment and, possibly, their prevention. Comorbidities often manifest clinically 1-2 years after the onset of psoriasis and are commonly seen in patients with severe forms of the disease. The association between psoriasis and its comorbidities is not coincidental, but rather based on common pathophysiological mechanisms and risk factors that underlie the increased frequency of comorbidities in patients with psoriasis. The aim of the present review was to emphasize the important role of dermatologists in the early recognition of comorbidities in patients with psoriasis, with a focus on metabolic comorbidities, precisely because the dermatologists are usually the first medical contact due to the predominance of skin lesions. Therefore, these specialists have the responsibility to inform patients on the association between psoriasis and possible multiple comorbidities, devise prevention and treatment plans, or even redirect patients to other specialists. Contents 1. Introduction 2. Metabolic comorbidities of psoriasis 3. Management of metabolic comorbidities in psoriasis 4. Conclusions

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Psoriasis and Diabetes, a Dangerous Association: Evaluation of Insulin Resistance, Lipid Abnormalities, and Cardiovascular Risk Biomarkers

Cited by 29 publications

References 42 publications

Psoriasis Exacerbates the State of Insulin Resistance in Patients with Type 2 Diabetes

Psoriasis Exacerbates the State of Insulin Resistance in Patients with Type 2 Diabetes

Identification of Potential Biomarkers for Psoriasis by DNA Methylation and Gene Expression Datasets

Metabolic comorbidities of psoriasis (Review)

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