Comparação do perfil glicêmico de pacientes não diabéticos com psoríase, com e sem artrite psoriásica
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Tipo
TCC
Data de publicação
2023-11-27
Periódico
Citações (Scopus)
Autores
Lourenço, Eduardo Muhlfeit
Conte, Lucas Braga
Conte, Lucas Braga
Orientador
Skare, Thelma Larocca
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Introdução: A psoríase é uma dermatose comum, eritemato-escamosa causada pela hiperplasia de queratinócitos da epiderme. A causa específica da doença ainda não se encontra definida, porém é sabido que há base genética e multifatorial com possível relação a fatores ambientais. Na psoríase são comuns comorbidades como doença de Crohn, aterosclerose, hipertensão, dislipidemia, hiper-homocisteinemia, entre outras, que potencializam os riscos cardiovasculares e desordens metabólicas como a diabetes mellitus (DM) e síndrome metabólica. Pacientes com psoríase podem desenvolver Artrite Psoriásica (AP) que é uma doença articular sistêmica, polimórfica que afeta tanto o esqueleto periférico, quanto o axial. Semelhante a psoríase puramente cutânea, a AP apresenta relação a comorbidades como a DM2, hipertensão, obesidade, hiperlipidemia e síndrome metabólica. Todavia não se sabe se a associação com diabetes difere nos indivíduos com psoríase com e sem AP. Objetivos: Estudar comparativamente a prevalência de alterações de HbA1c em indivíduos não diabéticos com psoríase, com e sem artrite psoriásica. Metodologia: Estudo observacional transversal envolvendo 49 indivíduos com psoríase e/ou artrite psoriásica. Foram coletados dados epidemiológicos, clínicos, de tratamento e de atividade inflamatória da pele pelo PASI (Psoriasis Area Severity Index) e articular pelo DAPSA (Disease Activity index for Psoriatic Arthritis). A seguir os prontuários foram revisados para valores de HbA1c, VHS e Proteína C Reativa. Resultados:A amostra total avaliada foi de 49 paciente, sendo 23 do sexo feminino e o restante masculino. Dentre o número total de participantes foram descritos 36 caucasianos, 12 afrodescendentes e um de origem asiática, com idades variando de 19 a 77 anos e uma mediana de 53. A amostra apresentou uma média de cerca de 37 anos de idade para o início da doença e uma população majoritariamente apresentando sobrepeso ou obesidade. Na análise foi possível encontrar valores levemente elevados de HbA1c dentro da população que apresentava quadro de artrite associada (p=0.02), assim como, ela também foi encontrada elevada em pacientes que faziam uso do medicamento secuquinumabe (p=0.05) Foi possível encontrar correlação dos valores de HbA1c com as variáveis circunferência abdominal (p=0.02) idade (p=0.003) e idade ao início da doença (p=0.003).A variável VHS demonstrou p valor de 0,09. Conclusões: Pacientes não diabéticos com artrite psoriásica apresentam valores de HbA1c mais elevados dos que os com psoríase mas sem artrite. Além disso, foi observado um aumento nos níveis de HbaA1c nos pacientes que faziam uso do medicamento secuquinumabe. Além disso, neste estudo não foi possível demonstrar associação entre valores de HbA1c com índices de atividade de pele (PASI), nem com índices de atividade articular (DAPSA).
Introduction: Psoriasis is a common erythematous-scaly dermatosis caused by epidermal keratinocyte hyperplasia. The specific cause of the disease remains undefined, but it is known to have a genetic and multifactorial basis with a possible relation to environmental factors. Comorbidities such as Crohn's disease, atherosclerosis, hypertension, dyslipidemia, hyperhomocysteinemia, among others, are common in psoriasis, which increases cardiovascular risks and metabolic disorders such as diabetes mellitus (DM) and metabolic syndrome. Psoriasis patients can develop Psoriatic Arthritis (PA), a systemic, polymorphic joint disease that affects both the peripheral and axial skeleton. Similar to purely cutaneous psoriasis, PA is associated with comorbidities like DM2, hypertension, obesity, hyperlipidemia, and metabolic syndrome. However, it is unknown whether the association with diabetes differs in individuals with psoriasis with and without PA. Objectives: To comparatively study the prevalence of HbA1c alterations in non-diabetic individuals with psoriasis, with and without psoriatic arthritis. Methodology: A cross-sectional observational study involving 49 individuals with psoriasis and/or psoriatic arthritis. Epidemiological, clinical, treatment, and skin inflammatory activity data were collected using the Psoriasis Area Severity Index (PASI) and joint activity using the Disease Activity Index for Psoriatic Arthritis (DAPSA). Subsequently, medical records were reviewed for HbA1c, ESR, and C-reactive protein values. Results: The total sample evaluated consisted of 49 patients, with 23 being female and the rest male. Among the total number of participants, 36 were Caucasians, 12 were of African descent, and one was of Asian origin, with ages ranging from 19 to 77 years and a median of 53. The sample had a mean age of approximately 37 years at the onset of the disease, and the majority of the population was overweight or had varying degrees of obesity. The analysis revealed slightly elevated HbA1c values within the population with associated arthritis, (p=002) as well as in patients using the drug secukinumab (0.05). A correlation was found between HbA1c values and the variables abdominal circumference (p=0.02), age (p=0;003), and age at the onset of the disease (p=0.05). The ESR variable showed a p-value of 0.09. Conclusions: Non-diabetic patients with psoriatic arthritis have higher HbA1c values than those with psoriasis but without arthritis. Furthermore, an increase in HbA1c levels was observed in patients using secukinumab medication. Additionally, this study did not demonstrate an association between HbA1c values and skin activity scores (PASI) or joint activity scores (DAPSA).
Introduction: Psoriasis is a common erythematous-scaly dermatosis caused by epidermal keratinocyte hyperplasia. The specific cause of the disease remains undefined, but it is known to have a genetic and multifactorial basis with a possible relation to environmental factors. Comorbidities such as Crohn's disease, atherosclerosis, hypertension, dyslipidemia, hyperhomocysteinemia, among others, are common in psoriasis, which increases cardiovascular risks and metabolic disorders such as diabetes mellitus (DM) and metabolic syndrome. Psoriasis patients can develop Psoriatic Arthritis (PA), a systemic, polymorphic joint disease that affects both the peripheral and axial skeleton. Similar to purely cutaneous psoriasis, PA is associated with comorbidities like DM2, hypertension, obesity, hyperlipidemia, and metabolic syndrome. However, it is unknown whether the association with diabetes differs in individuals with psoriasis with and without PA. Objectives: To comparatively study the prevalence of HbA1c alterations in non-diabetic individuals with psoriasis, with and without psoriatic arthritis. Methodology: A cross-sectional observational study involving 49 individuals with psoriasis and/or psoriatic arthritis. Epidemiological, clinical, treatment, and skin inflammatory activity data were collected using the Psoriasis Area Severity Index (PASI) and joint activity using the Disease Activity Index for Psoriatic Arthritis (DAPSA). Subsequently, medical records were reviewed for HbA1c, ESR, and C-reactive protein values. Results: The total sample evaluated consisted of 49 patients, with 23 being female and the rest male. Among the total number of participants, 36 were Caucasians, 12 were of African descent, and one was of Asian origin, with ages ranging from 19 to 77 years and a median of 53. The sample had a mean age of approximately 37 years at the onset of the disease, and the majority of the population was overweight or had varying degrees of obesity. The analysis revealed slightly elevated HbA1c values within the population with associated arthritis, (p=002) as well as in patients using the drug secukinumab (0.05). A correlation was found between HbA1c values and the variables abdominal circumference (p=0.02), age (p=0;003), and age at the onset of the disease (p=0.05). The ESR variable showed a p-value of 0.09. Conclusions: Non-diabetic patients with psoriatic arthritis have higher HbA1c values than those with psoriasis but without arthritis. Furthermore, an increase in HbA1c levels was observed in patients using secukinumab medication. Additionally, this study did not demonstrate an association between HbA1c values and skin activity scores (PASI) or joint activity scores (DAPSA).
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Palavras-chave
psoríase , artrite psoriásica , diabetes mellitus , glicemia , psoriasis , psoriatic arthritis , diabetes mellitus , blood glucose