银屑病与胰岛素抵抗

Psoriasis and insulin resistance

银屑病是一种发病机制较为复杂的免疫介导的慢性、炎症性皮肤病。以往的研究认为,银屑病的发病机制涉及表皮角质形成细胞、T 淋巴细胞、白细胞和血管内皮之间的相互作用。然而,人们越来越多地认识到银屑病不仅仅停留于皮肤层面,而且还伴有重要的全身表现。银屑病也被称为免疫代谢性疾病,患者具有发展为心血管疾病和代谢性疾病的高风险。胰岛素不但在皮肤的稳态中具有重要地位,而且由于银屑病与代谢性疾病(肥胖症、糖尿病、代谢综合征等)之间的临床联系可以通过它们发病机制中的“慢性炎症”来强调,所以胰岛素抵抗可以作为二者的连接因素。本文针对银屑病与 IR的相关性、二者相互作用可能机制及胰岛素增敏剂在银屑病中的治疗作用做以下综述。

Psoriasis is an immune-mediated chronic,inflammatory skin disease with complex pathogenesis. Previous studies have suggested that the pathogenesis of psoriasis involves the interaction between epidermal keratinocytes,T lymphocytes,leukocytes and vascular endothelium. However,it is increasingly recognized that psoriasis not only stays on the derma,but also has important systemic manifestations. Psoriasis known as immune metabolic diseases,patients have a high risk of developing cardiovascular and metabolic diseases. Insulin plays an important role in the homeostasis of the skin,and since the clinical links between psoriasis and metabolic diseases ( obesity,diabetes,metabolic syndrome,etc.) is emphasized by “chronic inflammation”in that pathogenesis,then insulin resistance ( IR) can be used as a connection factor of the two diseases. This article reviewed the correlation and the possible mechanisms between insulin and psoriasis,and the therapeutic effects of insulin sensitizers in psoriasis.