■牛皮癣是一种慢性,免疫介导的皮肤炎症状态和炎症介质的失衡可导致胰岛素抵抗,代谢综合征和促进非酒精性脂肪性肝病(NAFLD)的发生和进展。
■主要目标:研究慢性斑块型银屑病和对照组患者NAFLD的发生频率研究慢性斑块型银屑病和对照组患者的白细胞介素水平。次要目标:研究BMI,血脂谱,腰围,FBS(空腹血糖),PPBS(餐后血糖)和血清胰岛素在病例和对照组中的相关性研究,牛皮癣的持续时间,PASI(银屑病面积严重程度指数),涉及BSA(体表面积),BMI(体重指数),血脂谱,肥胖,腰围,FBS(空腹血糖),慢性斑块型银屑病患者的PPBS(餐后血糖)和血清胰岛素水平与NAFLD相关,IL6和TNF-α与慢性斑块型银屑病患者NAFLD的关系.
■50例年龄≥18岁的慢性斑块状银屑病临床诊断病例,疾病持续时间≥6个月,纳入30名年龄和性别匹配的对照.PASI,计算病例的BSA和BMI,BP,测量所有受试者的WC。血脂谱,FBS,PPBS,胰岛素水平,IL1-β,IL6,TNF-α,高频B超,在所有受试者中进行LFT和纤维扫描。
■28例(56.0%)和2例(6.6%)对照组患有NAFLD,差异有统计学意义。WC显著升高,血清胰岛素,紊乱的脂质分布,脂肪肝,转胺炎,纤维扫描评分,肝纤维化,在病例与对照组中发现了NAFLD和白细胞介素。银屑病患者的NAFLD与银屑病持续时间增加有显著关联,BMI≥23Kg/m2,高WC,涉及的BSA增加,紊乱的脂质分布,总胆固醇水平升高,危险因素增多。在IL1-β高水平的病例中发现NAFLD无显著但呈正相关,IL-6,TNF-α,FBS和增加PASI。
■白细胞介素水平显着升高,与银屑病的严重程度呈微弱正相关(PASI,BSA)在慢性斑块型银屑病患者中解释了炎症在银屑病病因中的可能作用。筛查可考虑在银屑病患者与银屑病的持续时间增加,高WC,涉及高BSA,高BMI,肥胖,血脂异常和胰岛素抵抗。
■样本量小。
■无。
UNASSIGNED: Psoriasis is a chronic, immune mediated inflammatory condition of the skin and imbalance in inflammatory mediators could result in insulin resistance, metabolic syndrome and facilitate the occurrence and progression of Non-alcoholic fatty liver disease (NAFLD).
UNASSIGNED: Primary objectives: To study the frequency of NAFLD in cases of chronic plaque psoriasis and controlsTo study the interleukin levels in cases of chronic plaque psoriasis and controls. Secondary objectives: To study the BMI, lipid profile, waist circumference, FBS (fasting blood sugar), PPBS (post prandial blood sugar) and serum insulin in cases and controlsTo study the association of age, duration of psoriasis, PASI (psoriasis area severity index), BSA (body surface area) involved, BMI (body mass index), lipid profile, obesity, waist circumference, FBS (fasting blood sugar), PPBS (post prandial blood sugar) and serum insulin levels with NAFLD in patients of chronic plaque psoriasisTo correlate serum levels of IL1-β, IL6 and TNF-α with NAFLD in patients of chronic plaque psoriasis.
UNASSIGNED: 50 clinically diagnosed cases of chronic plaque psoriasis with age ≥ 18years, diseases duration ≥ 6 months and 30 age and sex matched controls were recruited. PASI, BSA of cases was calculated and BMI, BP, WC of all subjects was measured. Serum lipid profile, FBS, PPBS, insulin level, IL1- β , IL6, TNF- α , high frequency B-mode ultrasound, LFT and fibroscan were done in all subjects.
UNASSIGNED: 28(56.0%) cases and 2(6.6%) controls had NAFLD with statistically significant difference. Significantly elevated WC, serum insulin, deranged lipid profile, fatty liver, transaminitis, fibroscan score, liver fibrosis, NAFLD and interleukins were found in cases vs controls. There was a significant association of NAFLD in psoriatic patients with increasing duration of psoriasis, BMI ≥23 Kg/m2, high WC, increasing BSA involved, deranged lipid profile, raised total cholesterol levels and increasing number of risk factors. Nonsignificant but positive association of NAFLD in cases was found with high levels of IL1 - β, IL - 6, TNF-α, FBS and increasing PASI.
UNASSIGNED: Significantly increased interleukin levels and their weak positive correlation with the severity of psoriasis (PASI, BSA) in patients of chronic plaque psoriasis explains the possible role of inflammation in the causation of psoriasis. Screening may be considered in psoriatic patients with increasing duration of psoriasis, high WC, high BSA involved, high BMI, obesity, dyslipidemia and insulin resistance.
UNASSIGNED: Small sample size.
UNASSIGNED: NONE.