Strelitz Diabetes Center, Endocrine & Metabolic Disorders, Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA.
Department of Dermatology, Eastern Virginia Medical School, Norfolk, Virginia, USA.
Metab Syndr Relat Disord. 2022 May;20(4):234-242. doi: 10.1089/met.2021.0112. Epub 2022 May 9.
Studies have shown that subjects with psoriasis (PsO) are associated with an increased risk of developing metabolic syndrome (MetS), diabetes, and cardiovascular disease. In addition, MetS and diabetes are associated with autonomic dysfunction (AD). The aim of this study was to investigate cardiac and sudomotor autonomic function in subjects with PsO and without diabetes. A cross-sectional study was performed in 20 subjects with PsO, compared with age- and sex-matched 21 healthy controls, and 20 subjects with MetS. Subjects underwent skin evaluation by dermatologist, glycated hemoglobin (HbA1c), insulin, glucose, and lipid levels, sudomotor function testing with Sudoscan device (Impeto Medical, Paris, France), and cardiac autonomic function testing with ANSAR device (ANX 3.0; ANSAR Group, Inc., Philadelphia, PA). Quality of Life (QOL) and peripheral neurologic function were also assessed. Participants with PsO were significantly more obese, had higher levels of fasting insulin and triglycerides, and were more insulin resistant when compared to controls. Subjects with PsO showed significantly worse cardiac autonomic function when compared to control and MetS groups. Sudomotor function and QOL scores were similar between the groups. Subgroup analysis of PsO subjects without MetS criteria ( = 15) showed persistent significantly deteriorated cardiac autonomic function when compared to the other two groups. This study suggests an association between PsO and cardiac AD, independent of the presence of overt dysglycemia and MetS. Additional larger studies are needed to clarify the significance of these findings and the relationship between PsO, AD, and metabolic disease.
研究表明，银屑病（PsO）患者发生代谢综合征（MetS）、糖尿病和心血管疾病的风险增加。此外，MetS 和糖尿病与自主神经功能障碍（AD）相关。本研究旨在探讨无糖尿病的银屑病患者的心脏和汗腺自主神经功能。在 20 名银屑病患者中进行了一项横断面研究，与年龄和性别匹配的 21 名健康对照者和 20 名 MetS 患者进行了比较。皮肤科医生对患者进行皮肤评估，检测糖化血红蛋白（HbA1c）、胰岛素、血糖和血脂水平，使用 Sudoscan 设备（Impeto Medical，法国巴黎）进行汗腺功能测试，使用 ANSAR 设备（ANX 3.0；ANSAR Group，Inc.，宾夕法尼亚州费城）进行心脏自主神经功能测试。还评估了生活质量（QOL）和周围神经功能。与对照组相比，银屑病患者明显更肥胖，空腹胰岛素和甘油三酯水平更高，胰岛素抵抗更严重。与对照组和 MetS 组相比，银屑病患者的心脏自主神经功能明显更差。汗腺功能和 QOL 评分在各组之间相似。无 MetS 标准的银屑病患者亚组分析（ = 15）显示，与其他两组相比，心脏自主神经功能持续显著恶化。本研究表明，银屑病与心脏 AD 之间存在关联，而与明显的糖代谢异常和 MetS 无关。需要更大规模的研究来阐明这些发现的意义以及银屑病、AD 和代谢性疾病之间的关系。
