الفهرس 
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IrisinOnly 14 pages are availabe for public view
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Abstract
Psoriasis is a common chronic inflammatory disease, affecting over 2% of the population worldwide. Patients with psoriasis are at higher risk of numerous comorbidities such as obesity, cardiovascular disease, metabolic syndrome or insulin resistance and diabetes mellitus. Therefore, currently this dermatosis has been considered as a systemic disorder with impact on psoriatics’ morbidity and mortality. There is a significantly higher prevalence of metabolic syndrome in psoriatic patients ranging from 40% to 65%. Interesting, but very complex, is association between psoriasis and obesity, as one of the pivotal components of MS. Irisin is a novel myokine, processed from the product of the fibronectin type III domain-containing protein 5 (FNDC5) gene prior to being released into the circulation and regulated by peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α). Irisin is synthesized generally in skeletal muscle, but is also distributed in cardiac muscle, adipose tissue, liver, brain, bones, sebaceous glands, pancreas, kidney and others. It was assumed that irisin could be an indicator of body fat mass as it was elevated in obese subjects. Irisin might be a marker for macrovascular disease in DM. Our study aimed to assess the serum irisin level in patients with psoriasis and its relation to the severity of the disease aiming at the understanding of etiopathogenesis of psoriasis. This is a case-control study, carried out at the Outpatient Clinic of Dermatology, Andrology and Sexual Transmitted Disease Department, Mansoura University Hospital. Patients divided into 2 groups: (group A); included 40 patients with chronic plaque psoriasis, (group B); included 40 healthy persons who match the patient group as regard age and sex, from January 2018 to January 2019. The main results of the study revealed that:Among psoriasis group, 13.3% were diabetics. CRP range in psoriasis group was 1.67 to 286.53 with median 118.53. The median score of PASI score among psoriasis group was 18.9 (ranged 6.8 - 40.8). 11.1 % of cases were mild, 40 % were moderate and 48.9 % were severe. There was statistically significant increase in serum cholesterol level in psoriasis group 206.33±37.49 as compared to 186.77±32.06 in control group. The same difference was observed with LDL. Mean LDL was 127.78±21.39 in psoriasis group as compared to 110.62±29.37 in control group. There was a statistically significant decrease in HDL level in psoriasis group (48.95±8.81) as compared to control group (59.73±12.23). No statistically significant differences were found between psoriasis and control groups regarding blood sugar and triglycerides (p value > 0.05). There was a statistically significant increase in serum Irisin level in psoriasis with median value of 2.19 (rang from o.25 - 14.77) as compared to 1.25 (rang from 0.01 - 7.81 in control group. There was a statistically significant highly positive correlation between serum irisin level and PASI score (p≤0.001).There was a statistically significant positive correlation between serum irisin level and CRP (r=0.454, p=0.002). No statistically significant correlation was observed between serum irisin level and age, BMI, blood Sugar, cholesterol, TG, HDL and LDL of psoriatic patients. There was a statistically significant negative correlation between serum irisin level and HDL (p=0.009). Regarding diagnostic accuracy of serum irisin level in prediction of psoriasis patients, AUC was 0.67 with 95% CI from 0.556 to 0.784.The optimal cut-off value was 1.18 (Sensitivity, Specificity, PPV, NPV & Accuracy) were (66.7%, 50%, 60%, 57.1% & 58.8%) respectively. Regarding diagnostic accuracy of serum irisin level in prediction of severe psoriasis, AUC was 0.83 with 95% CI from 0.71 to 0.951. The optimal cut-off value was 1.28 (Sensitivity, Specificity, PPV, NPV & Accuracy) were (77.3%, 78.3%, 77.3%, 78.3% & 77.8%) respectively. There were non-statistically significant differences between the studied groups as regard age, sex and BMI. Based on our results we recommend further studies on larger patients and longer period of follow up to emphasize our conclusion.