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Patients with psoriasis are insulin resistant
Mette Gyldenløve1, Heidi Storgaard2, Jens J Holst3
1Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Journal of the American Academy of Dermatology
|February 6, 2015
Summary
Patients with psoriasis show reduced insulin sensitivity, suggesting psoriasis may be a prediabetic condition. This study used the gold standard hyperinsulinemic euglycemic clamp to assess insulin resistance.
Area of Science:
- Endocrinology
- Dermatology
- Metabolic Syndrome
Background:
- Psoriasis is linked to an increased risk of type 2 diabetes, potentially due to systemic inflammation causing insulin resistance.
- Previous investigations of insulin sensitivity in psoriasis patients used suboptimal methods.
- The hyperinsulinemic euglycemic clamp is the established gold standard for measuring whole-body insulin sensitivity.
Purpose of the Study:
- To investigate insulin sensitivity in patients with psoriasis who have normal glucose tolerance.
- To determine if psoriasis is associated with impaired insulin sensitivity.
Main Methods:
- Conducted a 3-hour hyperinsulinemic euglycemic clamp in 16 untreated psoriasis patients and 16 matched controls.
- Ensured groups were comparable in age, gender, BMI, body composition, physical activity, and baseline glucose/HbA1c levels.
Main Results:
- Psoriasis patients exhibited significantly lower insulin sensitivity (M-value) compared to controls (P=0.046).
- No significant differences were observed in plasma glucose, insulin, C-peptide, or glucagon levels during the clamp between groups.
- Psoriasis duration averaged 23 years, with an average Psoriasis Area and Severity Index score of 12.7.
Conclusions:
- Psoriasis patients demonstrate increased insulin resistance compared to healthy individuals.
- These findings suggest that psoriasis could be considered a prediabetic state.
- Limitations include the inability of the classic clamp to assess endogenous glucose production.
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