Association of metabolic syndrome and insulin resistance in papulosquamous diseases
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20231826Keywords:
MetS, Skin diseases, Papulosquamous, Psoriasis, Lichen planusAbstract
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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References
Fox BJ, Odom RB. Papulosquamous diseases: a review. J Am Acad Dermatol. 1985;12:597-624.
Wilson PW, D’Agostino RB, Parise H. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation. 2005;112:3066-72.
Nelson RA, Bremer AA. Insulin resistance and metabolic syndrome in the pediatric population. Metabolic Syndrome Related Disorders. 2010;8:1-14,
Deepa M, Farooq S, Datta M. Prevalence of metabolic syndrome using WHO, ATPIII and IDF definitions in Asian Indians: The Chennai urban rural epidemiology Study (CURES-34). Diabetes Metab Res Rev. 2007;23:127-34.
Chiarelli F, Marcovecchio ML. Insulin resistance and obesity in childhood. Eur J Endocrinol. 2008;159:S67-74.
Napolitano M, Megna M, Monfrecola G. Insulin Resistance and Skin Diseases. Scientific World J. 2015;2015:479354.
Lim JU, Lee JH, Kim JS. Comparison of World Health Organization and Asia-Pacific body mass index classifications in COPD patients. Int J Chron Obstruct Pulmon Dis. 2017;12:2465-75
Stefanadi EC, Dimitrakakis G, Antoniou CK. Metabolic syndrome and the skin: a more than superficial association. Reviewing the association between skin diseases and metabolic syndrome and a clinical decision algorithm for high risk patients. Diabetol Metab Syndr. 2018;10:9.
Hashba H, Bifi J, Thyvalappil A. Prevalence of metabolic syndrome in patients with lichen planus: A cross-sectional study from a tertiary care center. Indian Dermatol Online J. 2018;9:304-8.
Expert Panel on Detection. Evaluation, and treatment of high blood cholesterol in adults. Executive summary of the third report of The National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). JAMA. 2001;285:2486-97.
Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab. 2008;93:9 30.
Wilson PWF, D’Agostino RB, Parise H. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation. 2005;112:3066-72.
Roshni M, Chandni R, Bhagyanathan PV. Metabolic syndrome and the frequency of occurrence of its components in urban south Indian population. Br J Med Med Res. 2014;4:4855 67.
Kokpol C, Aekplakorn W, Rajatanavin N. Prevalence and characteristics of metabolic syndrome in South East Asian psoriatic patients: a case-control study. J Dermatol. 2014;41:898-902.
Owczarczyk Saczonek AB, Nowicki R. The association between smoking and the prevalence of metabolic syndrome and its components in patients with psoriasis aged 30 to 49 years. Postepy Dermatol Alergol. 2015;32:331-6.
Rao SNG, Prema G, Priya G. Comparison between serum insulin levels and its resistance with biochemical, clinical and anthropometric parameters in South Indian children and adolescents. Indian J Clin Biochem. 2011;26:22-7.
Chen YH, Lee YC, Tsao YC. Association between high-fasting insulin levels and metabolic syndrome in non-diabetic middle-aged and elderly populations: a community-based study in Taiwan. BMJ Open. 2018;8:e016554.
Barbato MT, Criado PR, Silva AK. Association of acanthosis nigricans and skin tags with insulin resistance. An Bras Dermatol. 2012;87:97-104.
Cho J, Hong H, Park S. Insulin Resistance and Its Association with Metabolic Syndrome in Korean Children. Biomed Res Int. 2017;2017:8728017.
Sung KC, Seo MH, Rhee EJ. Elevated fasting insulin predicts the future incidence of metabolic syndrome: a 5-year follow-up study. Cardiovasc Diabetol. 2011;10:108.
Praveenkumar U, Ganguly S, Ray L. Prevalence of Metabolic Syndrome in Psoriasis Patients and its Relation to Disease Duration: A Hospital Based Case-Control Study. J Clin Diagn Res. 2016;10:WC01-5.
Gottlieb AB, Chao C, Dann F. Psoriasis comorbidities. J Dermatolog Treat. 2008;19:5-21.
Gisondi P, Tessari G, Conti A. Prevalence of metabolic syndrome in patients with psoriasis: a hospital based case–control study. Br J Dermatol. 2007;157:68-73.
Cohen AD, Sherf M, Vidavsky L. Association between psoriasis and the metabolic syndrome. A cross sectional study. Dermatol Basel Switz. 2008;216:152-5.
Arias-Santiago S, Buendía-Eisman A, Aneiros-Fernández J. Cardiovascular risk factors in patients with lichen planus. Am J Med. 2011;124:543-8.
Kuntoji V, Kudligi C, Bhagwat PV. Dyslipidemia and metabolic syndrome in patients with lichen planus: A case-control study. J of Pak Assoc Dermatol. 2016;26:290-97.
Baykal L, Arica DA, Yayli S. Prevalence of Metabolic syndrome in patients with mucosal lichen planus: A case control Study. Am J Clin Dermatol. 2015;16:439 45.
Kar BR, Panda M, Patro N. Metabolic derangements in lichen planus A case control study. J Clin Diagn Res. 2016;10:1 3.
Lowe NJ, Cudworth AG, Clough SA. Carbohydrate metabolism in lichen planus. Br J Dermatol. 1976;95:9-12.
Seyhan M, Ozcan H, Sahin I. High prevalence of glucose metabolism disturbance in patients with lichen planus. Diab Res Clin Prac. 2007;77:198-202.
Atefi N, Majedi M, Peyghambari S. Prevalence of diabetes mellitus and impaired fasting blood glucose in patients with lichen planus. Medical J Islamic Repub Iran. 2012;26:22-6.
Leroith D. Pathophysiology of the metabolic syndrome: implications for the cardiometabolic risks associated with type 2 diabetes. Am J Med Sci. 2012;343:13-6.