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Psoriasis Hastalarında Metotreksat ve TNF Alfa İnhibitörleri Tedavisinin İnsülin Direncine Etkisi

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dc.contributor.authorEzgi Aktaş
dc.contributor.authorDamla Demir
dc.contributor.authorIlknur Kivanc Altunay
dc.contributor.authorFeyza Yener Öztürk
dc.contributor.institutionBAHÇEŞEHİR ÜNİVERSİTESİ
dc.contributor.institutionSAĞLIK BİLİMLERİ ÜNİVERSİTESİ
dc.contributor.institutionSAĞLIK BİLİMLERİ ÜNİVERSİTESİ
dc.contributor.institutionSAĞLIK BİLİMLERİ ÜNİVERSİTESİ
dc.date.accessioned2025-09-20T19:59:14Z
dc.date.issued2020
dc.date.submitted17.12.2020
dc.description.abstractAmaç: Psoriasis ve obezite, tip 2 Diyabet, insulin direnci, dislipidemi ve metabolik sendrom arasında güçlü bir ilişki olduğu bilinmektedir. Bu çalışmanın amacı geleneksel bir antipsoriatik ajan olan metotreksat (MTX) ile tümör nekroz faktörü alfa inhibitörlerinin (TNFi) psoriasis hastalarında insulin direnci üzerine etkilerini araştırmaktır. Gereç ve Yöntemler: MTX ve TNFi tedavisi alan 31 psoriasis hastası prospektif olarak incelendi. 17 hasta MTX tedavisi, 14 hasta ise TNFi tedavisi aldı. Tedavi başlangıcında ve tedavinin 12. haftasında serum C-reactif protein (CRP), HOMA-IR (Homeostasis Model Assessment of Insulin Resistance) ve lipid parametreleri değerlendirildi. Bulgular: Tedavi sonrası CRP değerlerindeki düşüş TNFi grubunda MTX grubuna göre anlamlı olarak daha fazlaydı (-1,76 vs. -0,1, p=0,005, sırasıyla). Serum glukoz değerleri her iki tedavi grubunda da artış gösterse de bu artış sadece TNFi grubunda istatistiksel olarak anlamlıydı (p=0,012). İstatistiksel olarak anlamlı olmasa da MTX ve TNFi tedavi gruplarında HOMAIR değerlerinde artış izlendi (0,26±1,77 vs. 0,59±1,81, p=0,558, p= 249, sırasıyla). Sonuç: Bu çalışmada serum açlık glukoz düzeylerinde TNFi grubunda istatistiksel olarak anlamlı bir artış ve iki tedavi grubunda da HOMA-IR düzeylerinde artış izlenmiştir. Bu bulgular varolan literatür bilgisi ile uyumlu değildir. Kısa takip süresi ve küçük hasta grubuna rağmen insulin direncinin eşlik ettiği bir durum olan psoriasiste MTX ve TNFi tedavilerinde dikkatli olunmalıdır.
dc.identifier.doi10.5336/dermato.2020-74503
dc.identifier.endpage43
dc.identifier.issn2146-9016
dc.identifier.issue2
dc.identifier.startpage35
dc.identifier.urihttps://hdl.handle.net/20.500.14719/5134
dc.identifier.volume30
dc.language.isoen
dc.relation.journalTürkiye Klinikleri Dermatoloji Dergisi
dc.subjectDermatoloji
dc.subjectEndokrinoloji ve Metabolizma
dc.subjectGenel ve Dahili Tıp
dc.titlePsoriasis Hastalarında Metotreksat ve TNF Alfa İnhibitörleri Tedavisinin İnsülin Direncine Etkisi
dc.typeResearch Article
dcterms.references1. Christophers E. Psoriasis-epidemiology and clinical spectrum. Clin Exp Dermatol. 2001,26(4):314-20. [Crossref] [PubMed],2. Raaby L, Ahlehoff O, de Thurah A. Psoriasis and cardiovascular events: updating the evidence. Arch Dermatol Res. 2017,309(3):225- 8. [Crossref] [PubMed],3. Robati RM, Partovi-Kia M, Haghighatkhah HR, Younespour S, Abdollahimajd F. Increased serum leptin and resistin levels and increased carotid intima-media wall thickness in patients with psoriasis: is psoriasis associated with atherosclerosis? J Am Acad Dermatol. 2014,71(4):642-8. [Crossref] [PubMed],4. Takeshita J, Grewal S, Langan SM, Mehta NN, Ogdie A, van Voorhees AS, et al. Psoriasis and comorbid diseases: epidemiology. J Am Acad Dermatol. 2017,76(3):377-90. [Crossref] [PubMed] [PMC],5. Takahashi H, Lizuka H. Psoriasis and metabolic syndrome. J Dermatol. 2012,39(3):212- 8. [Crossref] [PubMed],6. Boehncke WH, Boehncke S, Tobin AM, Kirby B. The 'psoriatic march': a concept of how severe psoriasis may drive cardiovascular comorbidity. Exp Dermatol. 2011,20(4):303-7. [Crossref] [PubMed],7. Hugh J, Van Voorhees AS, Nijhawan RI, Bagel J, Lebwohl M, Blauvelt A, et al. From the medical board of the national psoriasis foundation: the risk of cardiovascular disease in individuals with psoriasis and the potential impact of current therapies. J Am Acad Dermatol. 2014,70(1):168-77. [Crossref] [PubMed],8. Nast A, Gisondi P, Ormerod AD, Saiag P, Smith C, Spuls PI, et al. European S3-Guidelines on the systemic treatment of psoriasis vulgaris--update 2015--Short version--EDF in cooperation with EADV and IPC. J Eur Acad Dermatol Venereol. 2015,29(12):2277-94. [Crossref] [PubMed],9. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985,28(7):412-9. [Crossref] [PubMed],10. Boehncke S, Thaci D, Beschmann H, Ludwig RJ, Ackermann H, Badenhoop K, et al. Psoriasis patients show signs of insulin resistance. Br J Dermatol. 2007,157(6):1249-51. [Crossref] [PubMed],11. Kyriakou A, Patsatsi A, Sotiriadis D, Goulis DG. Serum leptin, resistin, and adiponectin concentrations in psoriasis: a meta-analysis of observational studies. Dermatology. 2017,233(5):378-89. [Crossref] [PubMed],12. ucak S, Ekmekci TR, Basat O, Koslu A, Altuntas Y. Comparison of various insulin sensitivity indices in psoriatic patients and their relationship with type of psoriasis. J Eur Acad Dermatol Venereol. 2006,20(5):517-22. [Crossref] [PubMed],13. Karadag AS, Yavuz B, Ertugrul DT, Akin KO, Yalcin AA, Deveci OS, et al. Is psoriasis a preatherosclerotic disease? Increased insulin resistance and impaired endothelial function in patients with psoriasis. Int J Dermatol. 2010,49(6):642-6. [Crossref] [PubMed],14. Coimbra S, Oliveira H, Reis F, Belo L, Rocha S, Quintanilha A, et al. Circulating adipokine levels in Portuguese patients with psoriasis vulgaris according to body mass index, severity and therapy. J Eur Acad Dermatol Venereol. 2010,24(12):1386-94. [Crossref] [PubMed],15. Kawashima K, Torii K, Furuhashi T, Saito C, Nishio E, Nishida E, et al. Phototherapy reduces serum resistin levels in psoriasis patients. Photodermatol Photoimmunol Photomed. 2011,27(3):152-5. [Crossref] [PubMed],16. Takahashi H, Tsuji H, Ishida-Yamamoto A, Iizuka H. Serum level of adiponectin increases and those of leptin and resistin decrease following the treatment of psoriasis. J Dermatol. 2013,40(6):475-6. [Crossref] [PubMed],17. Boehncke S, Salgo R, Garbaraviciene J, Beschmann H, Hardt K, Diehl S, et al. Effective continuous systemic therapy of severe plaque-type psoriasis is accompanied by amelioration of biomarkers of cardiovascular risk: results of a prospective longitudinal observational study. J Eur Acad Dermatol Venereol. 2011,25(10):1187-93. [Crossref] [PubMed],18. Rajappa M, Rathika S, Munisamy M, Chandrashekar L, Thappa DM. Effect of treatment with methotrexate and coal tar on adipokine levels and indices of insulin resistance and sensitivity in patients with psoriasis vulgaris. J Eur Acad Dermatol Venereol. 2015,29(1):69- 76. [Crossref] [PubMed],19. Ahlehoff O, Skov L, Gislason G, Lindhardsen J, Kristensen SL, Iversen L, et al. Cardiovascular disease event rates in patients with severe psoriasis treated with systemic anti-inflammatory drugs: a Danish real-world cohort study. J Intern Med. 2013,273(2):197- 204. [Crossref] [PubMed],20. Prodanovich S, Ma F, Taylor JR, Pezon C, Fasihi T, Kirsner RS, et al. Methotrexate reduces incidence of vascular diseases in veterans withpsoriasis or rheumatoid arthritis. J Am Acad Dermatol. 2005,52(2):262-7. [Crossref] [PubMed],21. Costa L, Caso F, Atteno M, Del Puente A, Darda MA, Caso P, et al. Impact of 24-month treatment with etanercept, adalimumab, or methotrexate on metabolic syndrome components in a cohort of 210 psoriatic arthritis patients. Clin Rheumatol. 2014,33(6):833-9. [Crossref] [PubMed],22. Hassan S, Milman u, Feld J, Eder L, Lavi I, Cohen S, et al. Effects of anti-TNF- α treatment on lipid profile in rheumatic diseases: an analytical cohort study. Arthritis Res Ther. 2016,10,18(1):261. [Crossref] [PubMed] [PMC],23. Danesh MJ, Koo EB, Kimball AB. Effects of TNF-alpha antagonism in patients with metabolic syndrome and psoriasis. J Eur Acad Dermatol Venereol. 2016,30(11):e152-e4. [PubMed],24. Qasim A, Mehta NN, Tadesse MG, Wolfe ML, Rhodes T, Girman C, et al. Adipokines, insulin resistance and coronary artery calcification. J Am Coll Cardiol. 2008,15,52(3):231-6. [Crossref] [PubMed] [PMC],25. Strober B, Teller C, Yamauchi P, Miller JL, Hooper M, Yang YC, et al. Effects of etanercept on C-reactive protein levels in psoriasis and psoriatic arthritis. Br J Dermatol. 2008,159(2):322-30. [Crossref] [PubMed],26. Kanelleas A, Liapi C, Katoulis A, Stavropoulos P, Avgerinou G, Georgala S, et al. The role of inflammatory markers in assessing disease severity and response to treatment in patients with psoriasis treated with etanercept. Clin Exp Dermatol. 2011,36(8):845-50. [Crossref] [PubMed],27. Bacchetti T, Campanati A, Ferretti G, Simonetti O, Liberati G, Offidani AM, et al. Oxidative stress and psoriasis: the effect of antitumour necrosis factor-α inhibitor treatment. Br J Dermatol. 2013,168(5):984-9. [Crossref] [PubMed],28. Scrivo R, Vasile M, Bartosiewicz I, Valesini G. Inflammation as \"common soil\" of the multifactorial diseases. Autoimmun Rev. 2011,10(7):369-74. [Crossref] [PubMed],29. Wu JJ, Tsai TF. Recurrent hyperglycemia during adalimumab treatment an a patient with psoriasis. Arch Dermatol. 2008,144(10):1403- 4. [Crossref] [PubMed],30. Richez C, Blanco P, Gin H, Schaeverbeke T. Development of type 1 diabetes mellitus in a patient with rheumatoid arthritis receiving antitumor necrosis factor alpha. Clin Exp Rheumatol. 2006,24(5):607. [PubMed],31. Jansson PA. Endothelial dysfunction in insulin resistance and type 2 diabetes. J Int Med. 2007,262(2):173-83. [Crossref] [PubMed],32. Kearney MT, Duncan ER, Kahn M, Wheatcroft SB. Insulin resistance and endothelial cell dysfunction: studies in mammalian models. Exp Physiol. 2008,93(1):158-63. [Crossref] [PubMed],33. Kayali R, Aydin S, Cakatay u. Effect of gender on main clinical chemistry parameters in aged rats. Curr Aging Sci. 2009,2(1):67-71. [Crossref] [PubMed],34. Mauvais-Jarvis F. Gender differences in glucose homeostasis and diabetes. Physiol Behav. 2018,1,187:20-3. [Crossref] [PubMed] [PMC]
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