Thappa Devinder M, Chandrashekar Laxmisha, Rajappa Medha, Usha R, Muthupandi K, Mohanraj Palani S, Munisamy Malathi, Singh Nidhi
Department of Dermatology, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
Department of Biochemistry, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India.
Indian Dermatol Online J. 2021 Mar 2;12(2):244-249. doi: 10.4103/idoj.IDOJ_491_20. eCollection 2021 Mar-Apr.
Periorbital melanosis (PM) is one of the most common dermatological condition seen in routine practice. Several cutaneous markers such as acanthosis nigricans have been associated with insulin resistance (IR). However, the association of PM with IR needs to be substantiated.
The objective of the study is to evaluate the association of circulating adipokines and IR with PM.
In this cross-sectional study, we recruited 100 patients with PM and 100 age- and gender-matched healthy controls. The serum levels of leptin, adiponectin, fasting glucose, fasting insulin, insulin-like growth factor-1 (IGF-1), homeostatic model assessment of insulin resistance (HOMA-IR), and leptin: adiponectin ratio (L/A ratio) were assayed.
The serum levels of leptin, fasting glucose, fasting insulin, HOMA-IR, L/A ratio were significantly higher in patients with PM as compared to controls. The serum levels of adiponectin were significantly lower in cases as compared to controls. On multivariate regression analysis, leptin, adiponectin, and HOMA-IR were found to be significant, even after adjusting for BMI, blood pressure and LDL and HDL cholesterol.
Our findings suggest that patients with PM have hyperinsulinemia, IR, and elevated L/A ratio. PM as a marker of IR in adults may help in identifying patients early and thus aid in the early prevention and management of the disease.
眶周色素沉着（PM）是日常临床实践中最常见的皮肤病之一。几种皮肤标志物如黑棘皮病已与胰岛素抵抗（IR）相关联。然而，PM与IR之间的关联需要得到证实。
本研究的目的是评估循环脂肪因子和IR与PM之间的关联。
在这项横断面研究中，我们招募了100例PM患者和100例年龄及性别匹配的健康对照者。检测血清瘦素、脂联素、空腹血糖、空腹胰岛素、胰岛素样生长因子-1（IGF-1）、胰岛素抵抗稳态模型评估（HOMA-IR）以及瘦素：脂联素比值（L/A比值）。
与对照组相比，PM患者的血清瘦素、空腹血糖、空腹胰岛素、HOMA-IR、L/A比值显著更高。与对照组相比，病例组的血清脂联素水平显著更低。多因素回归分析显示，即使在调整了BMI、血压以及低密度脂蛋白和高密度脂蛋白胆固醇后，瘦素、脂联素和HOMA-IR仍具有显著性。
我们的研究结果表明，PM患者存在高胰岛素血症、IR以及升高的L/A比值。PM作为成人IR的一个标志物可能有助于早期识别患者，从而有助于疾病的早期预防和管理。
