Hyperglycemia Is a Potential Prognostic Factor for Exacerbation in Severe Psoriasis with Diabetes or Prediabetes
Tanat Yongpisarn,1 Kunlawat Thadanipon,1,2 Poonkiat Suchonwanit,1 Ploysyne Rattanakaemakorn1 1Division of Dermatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2025-02-01
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| Series: | Clinical, Cosmetic and Investigational Dermatology |
| Subjects: | |
| Online Access: | https://www.dovepress.com/hyperglycemia-is-a-potential-prognostic-factor-for-exacerbation-in-sev-peer-reviewed-fulltext-article-CCID |
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| Summary: | Tanat Yongpisarn,1 Kunlawat Thadanipon,1,2 Poonkiat Suchonwanit,1 Ploysyne Rattanakaemakorn1 1Division of Dermatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Ploysyne Rattanakaemakorn, Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchathewi, Bangkok, 10400, Thailand, Tel +662-201-1141, Fax +662-201-1211, Email ploysyne@gmail.comBackground: Psoriasis is an immune-mediated skin disease with a chronic relapsing-remitting course. Hyperglycemia has been shown to correlate with psoriasis severity. However, whether it could trigger psoriasis flares is not known.Objective: To investigate the association between hyperglycemia and psoriasis exacerbation.Methods: We conducted a retrospective cohort study at a university-affiliated hospital in Bangkok, Thailand, between 2008 and 2022 to examine the effects of elevated HbA1c on psoriasis flares. Patients with psoriasis vulgaris and either type 2 diabetes mellitus (T2DM) or impaired fasting glucose (IFG) who had at least 2 HbA1c values were identified. Statistical analyses were performed using mixed-effects logistic regression.Results: A total of 201 psoriasis patients (95 with severe psoriasis and 106 with mild psoriasis) with 1,717 follow-up visits were included in the analysis. In patients with severe psoriasis, HbA1c ≥ 7% (adjusted odds ratio (OR): 1.905 (95% confidence interval: 1.328– 2.731)) and alcohol consumption status (adjusted OR: 3.328 (1.235– 8.965)) were identified as independent prognostic factors for psoriasis flares. Meanwhile, in mild psoriasis patients, none of the variables were independently associated with psoriasis flares.Conclusion: Hyperglycemia and alcohol consumption were associated with exacerbation in patients with severe psoriasis who had T2DM/IFG.Plain Language Summary: Certain environmental factors, such as infections and medications, can cause psoriasis flare-ups. Research suggests that psoriasis-induced inflammation can trigger insulin resistance and high blood sugar (hyperglycemia), which in turn triggers abnormal functioning of the blood vessel’s inner lining, ultimately leading to atherosclerosis and cardiovascular disease. Interestingly, insulin resistance may also worsen psoriatic skin lesions. Multiple studies have found a correlation between psoriasis severity and hemoglobin A1C (HbA1c, average blood sugar levels for the last 3 months); however, it is unknown whether hyperglycemia can also cause psoriasis exacerbation. We aimed to explore the potential of hyperglycemia as a predictor of psoriasis flare-ups. Our study highlights the importance of managing diabetes and psoriasis concurrently to improve the health outcomes of psoriasis patients. Patients with severe psoriasis and diabetes or prediabetes with high blood sugar (HbA1c ≥ 7%) or a history of alcohol consumption are at higher risk of exacerbation. Diabetes monitoring is required for all psoriasis patients, and strict glycemic control may aid in the management of psoriasis.Keywords: psoriasis, diabetes mellitus type 2, impaired fasting glucose, prognosis, exacerbation |
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| ISSN: | 1178-7015 |