c-peptide and Psoriasis

Literature reports link psoriasis with insulin resistance characteristic for type 2 diabetes. However, this condition may also affect the clinical course of type 1 diabetes (T1D).. To investigate whether children with type 1 diabetes mellitus (T1D) and psoriasis have a different course of diabetes.. We evaluated patients diagnosed with T1D in the years 2002-2011 for the presence of psoriasis and matched them 1:10 with T1D-only patients by sex and duration of diabetes using propensity score. We collected T1D-onset parameters and metabolic control surrogates from six months after T1D diagnosis.. We identified 14 patients with psoriasis and matched 140 controls, of whom 129 (68 boys) were eligible for the analysis. At onset T1D+psoriasis patients showed higher concentration of C-peptide than controls (median: 0.38ng/ml vs 0.15ng/ml, p=0.02). Six months later, they had non-significantly lower HbA1c (6.0 vs 6.6%, p=0.11), TC (143mg/dl vs 159mg/dl, p=0.14) HDL (54.5mg/dl vs 59mg/dl, p=0.11).. Patients with T1D and psoriasis present higher endogenous insulin secretion at T1D onset and a tendency for better glycemic control during the first 6 months.. Wstęp. W doniesieniach literatury łuszczyca wiąże się z insulinoopornością, charakterystyczną dla cukrzycy typu 2. Potencjalnie stan ten może wpływać również na przebieg cukrzycy typu 1 (T1D). Cel pracy. Zbadanie, czy pacjenci pediatryczni z cukrzycą typu 1 i łuszczycą prezentują odmienny przebieg cukrzycy. Materiał i metody. Pacjenci z T1D zdiagnozowaną w latach 2002–2011 zostali retrospektywnie ocenieni w poszukiwaniu towarzyszącej łuszczycy. Do wyłonionej w ten sposób grupy dobrano kontrolę dzieci z samą T1D w stosunku 1:10 pod kątem płci i czasu trwania cukrzycy. Zebrano dane kliniczne z okresu rozpoznania cukrzycy oraz parametry wyrównania metabolicznego z wizyt kontrolnych po 6 miesiącach od rozpoznania cukrzycy. Wyniki. Zidentyfikowano 14 pacjentów z T1D i łuszczycą, dobrano 140 pacjentów z grupy kontrolnej, z których łącznie 129 (68 chłopców) włączono do analizy. W porównaniu do grupy kontrolnej pacjenci z T1D i łuszczycą charakteryzowali się wyższym stężeniem C-peptydu podczas rozpoznania T1D (mediana 0,38ng/ml vs 0,15ng/ml, p=0,02) oraz nieistotnie niższym stężeniem hemoglobiny glikowanej (6,0 vs 6,6%, p=0,11), całkowitego cholesterolu (143mg/dl vs 159mg/dl, p=0,14) i cholesterolu HDL (54,5mg/dl vs 59mg/dl, p=0,11) po 6 miesiącach od rozpoznania cukrzycy. Wnioski. Pacjenci z T1D i towarzyszącą łuszczycą wykazują wyższe stężenia endogennej insuliny w chwili rozpoznania cukrzycy oraz mają tendencję do lepszego wyrównania cukrzycy w trakcie pierwszych 6 miesięcy choroby.

Topics: Adolescent; C-Peptide; Child; Diabetes Mellitus, Type 1; Female; Humans; Male; Psoriasis

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.. We sought to investigate if normal glucose-tolerant patients with psoriasis exhibit impaired insulin sensitivity.. Three-hour hyperinsulinemic euglycemic clamps were performed in 16 patients with moderate to severe, untreated psoriasis and 16 matched control subjects.. 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.. The classic hyperinsulinemic euglycemic clamp technique does not allow assessment of endogenous glucose production.. Patients with psoriasis were more insulin resistant compared with healthy control subjects. This supports that psoriasis may be a prediabetic condition.

Topics: Adult; Anthropometry; Blood Glucose; C-Peptide; Case-Control Studies; Diabetes Mellitus, Type 2; Female; Glucagon; Gluconeogenesis; Glucose Clamp Technique; Glucose Intolerance; Humans; Hyperinsulinism; Inflammation; Insulin; Insulin Resistance; Male; Middle Aged; Prediabetic State; Psoriasis; Risk

Several studies have shown an association between psoriasis and atherosclerotic risk factors. In this study, we aimed to evaluate endothelial function by flow-mediated dilation (FMD) and insulin resistance by Homeostasis model assessment-insulin resistance (HOMA-IR).. We examined 75 consecutive psoriasis patients and 50 healthy controls. All subjects underwent transthoracic echocardiography and brachial artery imaging for detecting FMD. Fasting blood samples were drawn from all subjects for measuring insulin, C-peptide, fasting blood glucose. HOMA-IR was calculated.. Baseline characteristics of both groups were similar. Twenty-four psoriatic patients had arthritis. Insulin [9.3 (4.0-208.1) vs. 8.2 (2.3-16.5) mcIU/ml, P = 0.016] and C-peptide [2.5 (0.9-20.0) vs. 2.0 (0.9-3.7) ng/ml, P = 0.009] levels were significantly higher in patients with psoriasis than in controls. HOMA-IR [2.1 (0.8-68.9) vs. 1.8 (0.6-8.6), P = 0.036] was significantly higher in patients with psoriasis than in controls. FMD was reduced in patients with psoriasis compared with healthy controls (5.6 +/- 1.9% vs. 10.9 +/- 1.9%, P < 0.001).. This study demonstrated a significant impairment in endothelial function and increased insulin resistance in patients with psoriasis. This is a comprehensive study for identifying atherosclerotic risk factors in psoriasis. We suggest that psoriatic patients should be paid attention for atherosclerosis and its risk factors.

Topics: Adult; Atherosclerosis; Blood Glucose; Brachial Artery; C-Peptide; Echocardiography; Endothelium, Vascular; Female; Homeostasis; Humans; Insulin; Insulin Resistance; Lipids; Male; Middle Aged; Psoriasis; Regional Blood Flow; Risk Factors

The aim of our study was to estimate the serum levels of glucose, insulin, C-peptide and uric acid in patients with psoriasis before and after treatment. The study included 12 males with active form of psoriasis and 15 control subjects carefully matched to the psoriatic patients for age and BMI. All measured parameters were in patients with psoriasis significantly increased and dependent on the BMI. Compared with pretreatment values of glucose and uric acid were significantly lower during therapy. The increase in the mean C-peptide and insulin levels after psoriasis therapy was constant and independent from clinical stage of disease. The results of the present study have provided evidence for the importance of impaired glucose and purine metabolism in patients with psoriasis in the increase risk of development of diabetes mellitus and hypertension.

Topics: Adult; Blood Glucose; Body Mass Index; C-Peptide; Case-Control Studies; Diabetes Mellitus; Humans; Hypertension; Insulin; Male; Middle Aged; Psoriasis; Risk; Treatment Outcome; Uric Acid

Although both kidney and pancreas transplantation can restore renal and pancreatic endocrine functions, the accompanying immunosuppression may cause diminished glucose tolerance in some individuals. Therefore, we determined to what extent pancreas transplantation itself and the triple immunosuppressive therapy used in pancreas transplant recipients have adverse effects on insulin secretory reserve. Beta-cell secretory reserve was assessed by the method of glucose potentiation of arginine-induced insulin secretion in 25 normoglycemic pancreas recipients, 12 nondiabetic kidney recipients using the same immunosuppressive therapy, 3 psoriasis patients treated long term with cyclosporine, 5 arthritis patients treated long term with prednisone, and their respective sex-, age-, and body mass index-matched control subjects. Levels of fasting glucose, HbA1c, and glucose disappearance rates were normal in all subjects. During the glucose potentiation study, pancreas recipients had significantly less insulin secretion than control subjects (maximal acute response [ARmax] = 1,083 +/- 93% vs. 3,938 +/- 355%, P < 0.001). Insulin responses were also decreased in kidney recipients (ARmax = 2,296 +/- 290%) vs. control subjects (4,691 +/- 554%, P = 0.001) and in psoriasis patients treated with cyclosporine (ARmax = 2,153 +/- 390%) vs. control subjects (3,962 +/- 88%, P = 0.011), but not as extreme as that seen in pancreas recipients. No abnormalities were observed in arthritis patients treated with steroids. We conclude that normoglycemic pancreas and kidney transplant recipients receiving triple immunosuppressive therapy have diminished beta-cell secretory reserve. Because this defect was present in psoriasis patients treated long term with cyclosporine, but not in arthritis patients treated long term with prednisone, this adverse effect was probably caused in part by cyclosporine.

Topics: Adult; Arginine; Arthritis; Blood Glucose; C-Peptide; Cyclosporine; Diabetes Mellitus, Type 1; Female; Glucose; Humans; Immunosuppressive Agents; Insulin; Insulin Secretion; Islets of Langerhans; Kidney Transplantation; Male; Pancreas Transplantation; Prednisone; Psoriasis; Transplantation, Homologous

The hormonal and immune status was investigated by a radioimmunoassay in 105 patients with dermatosis (55 female and 50 male patients aged 15 to 80): 51 suffered from eczema, 41--from psoriasis, and 13--from neurodermatitis. The results were compared with those of 32 controls. Serum concentrations of T3, T4, TSH, insulin, trypsin, C-peptide, cortisol, and IgE were investigated. Disorders of the hormonal and immune status were noted in the examinees with relation to sex, type of disease, season, time-period and extent of disease.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; C-Peptide; Eczema; Female; Humans; Hydrocortisone; Immunoglobulin E; Insulin; Male; Middle Aged; Neurodermatitis; Psoriasis; Radioimmunoassay; Thyrotropin; Thyroxine; Triiodothyronine; Trypsin

The discussion about a connection between diabetes and psoriasis is picked up again. Serum-values of glucose, insulin and C-peptide after intravenous glucose-load and of glucose and C-peptide after intravenous insulin-load were tested. The level of insulin and C-peptide after i. v. glucose-load was found higher in psoriasis-patients (hyperinsulinism). Considering earlier investigations and new results in diabetes-research (incretin concept), a connection between the two diseases must be denied. The carbohydratemetabolism-deviation in psoriasis could be declared by an enteropathy.

Topics: C-Peptide; Diabetes Mellitus; Glucose; Glucose Tolerance Test; Humans; Insulin; Insulin Secretion; Male; Psoriasis