银屑病合并2型糖尿病的研究进展

Research progress of psoriasis complicated with type 2 diabetes mellitus

摘要:

银屑病是一种常见的慢性炎症性皮肤病。糖尿病是一组由于胰岛素分泌绝对或相对缺陷，以及胰岛素抵抗所引起的以慢性高血糖为特征的代谢性疾病。目前流行病学研究认为，银屑病患者较一般人群发生糖尿病的风险显著增高。银屑病患者体内肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）水平明显增高，而TNF-α在胰岛素抵抗中发挥重要作用。目前发现CDKAL1、PSORS2、PSORS3和PSORS4这4个银屑病易感基因与2型糖尿病相关。既往研究提示，一些降糖药物如噻唑烷二酮类药物在治疗2型糖尿病的同时，可能通过改变皮下慢性炎症状态而改善银屑病皮损症状。本文总结相关研究进展，并分析与2种疾病相联系的可能病理生理学机制及相关治疗。

Abstract:

Psoriasis is a common chronic inflammatory skin disease. Diabetes is a group of metabolic diseases characterized by chronic hyperglycemia due to absolute or relative deficiencies in insulin secretion and insulin resistance. Current epidemiological studies indi－cate that patients with psoriasis have a significantly higher risk of developing diabetes than the general population. Patients with psoriasis have significantly higher levels of tumor necrosis factor-α（TNF-α） which plays an important role in insulin resistance. It has been found that four susceptible genes of psoriasis，CDKAL1，PSORS2，PSORS3 and PSORS4，are related to type 2 diabetes mellitus. In addition，our previous studies suggested that an hypoglycemicdrug，thiazolidinediones，can also improve the psoriasis skin lesion symptoms by changing the hypodermic chronic inflammatory state while treating the type 2 diabetes mellitus. Therefore，this paper summarizes the relevant research progress，analyzes the possible pathophysiological mechanisms，and related therapies for these two diseases.