Association of metabolic syndrome and insulin resistance in papulosquamous diseases

Abhineetha Hosthota, I. U., Anila Sara Thampi, S. R, Chaganam Kavya, Chandan B. C., Bhavana Venumbaka
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Abstract

Background: Metabolic syndrome (MetS), insulin resistance (IR) and papulosquamous diseases with shared pathophysiology leads to conglomeration of risk factors of non-communicable diseases like cardiovascular disease (CVD) and type 2 diabetes (T2D) causing high mortality worldwide. The objective is to study the association of MetS and IR in papulosquamous diseases. Methods: It is a hospital-based case-control study conducted on 200 age-sex matched cases and controls with consent. Subjects were administered a pre-validated questionnaire, diagnosis of papulosquamous diseases was based on clinical examination and skin biopsy. MetS was diagnosed based on national cholesterol education program's- adult treatment plan iii with Asian modification for abdominal circumference criteria. Fasting serum insulin levels (FI) was used as a surrogate marker of IR.  Results: Mean serum HDL- C level was low and statistically significant (p=0.017). Mean fasting plasma glucose level was significantly higher in patients (p=0.008). Mean FI level was significant between cases and controls (p=0.013). IR was found in 76% of cases which was significantly higher than in controls (p<0.05). IR was highest in psoriasis 29% followed by LP 22%, PRP 19%, and LS 6% which was statistically significant (p<0.05). MetS was mostly found in psoriasis (17%), LP (9%) and least in PRP, LS. Conclusions: This study intends clinicians to do periodic MetS and IR evaluation in papulosquamous diseases. Thus, subclinical cases of non-communicable diseases can be detected and potential co-morbidities can be prevented.
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丘疹鳞状病变代谢综合征与胰岛素抵抗的关系
背景:代谢综合征(MetS)、胰岛素抵抗(IR)和丘疹鳞状疾病具有共同的病理生理,导致心血管疾病(CVD)和2型糖尿病(T2D)等非传染性疾病危险因素的聚集,导致全球高死亡率。目的是研究在丘疹鳞状疾病中met和IR的关系。方法:以医院为基础的病例对照研究,对200例年龄性别匹配的病例和经同意的对照组进行研究。受试者接受预先验证的问卷调查,丘疹鳞状疾病的诊断基于临床检查和皮肤活检。MetS的诊断是基于国家胆固醇教育计划的成人治疗计划iii和亚洲修改的腹围标准。空腹血清胰岛素水平(FI)作为IR的替代指标。结果:两组患者血清HDL- C水平均较低,差异有统计学意义(p=0.017)。患者平均空腹血糖水平显著升高(p=0.008)。平均FI水平在病例和对照组之间有显著性差异(p=0.013)。IR发生率为76%,显著高于对照组(p<0.05)。银屑病患者IR最高,为29%,LP次之,为22%,PRP为19%,LS为6%,差异有统计学意义(p<0.05)。MetS主要见于银屑病(17%),LP (9%), PRP、LS最少。结论:本研究旨在临床医生对丘疹鳞状病变进行定期MetS和IR评估。因此,可以发现非传染性疾病的亚临床病例,并预防潜在的合并症。
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