Adipokines in Subcutaneous Adipose Tissue are Associated with Metabolic Syndrome in Psoriasis Patients

Original Article
Background: Psoriasis is associated with metabolic syndrome (MetS), and both psoriasis and MetS are associated with abnormal adipokine secretion. Much is unknown regarding the association between adipokine gene expression in subcutaneous adipose tissue (SAT) and levels of circulating adipokines in psoriasis patients with or without MetS. We examined messenger ribonucleic acid (mRNA) expression levels in SAT and circulating levels of 4 major adipokines, namely, tumor necrosis factor α (TNF-α), adiponectin, leptin, and interleukin 6 (IL-6). Methods: Twenty-nine psoriasis patients and 25 control patients were studied; 27 of the psoriasis patients and controls did not undergo systemic therapy. One psoriasis patient was treated with TNF-α antagonist and another was treated with retinoids (etretinate). Among the 29 psoriasis patients, 24 were treated with topical therapies (topical steroids and vitamin D analogues) and 5 were not. The participants were subdivided into 4 groups based on the presence of psoriasis and MetS. Serum concentrations of adipokines were measured in all participants, and SAT samples were collected from 18 psoriasis patients and 9 controls. Topical therapies were avoided for at least 1 week before collecting biopsy specimens. Adipokine mRNA expression in SAT was measured using quantitative real-time reverse transcription polymerase chain reaction (real-time RT-PCR) amplification. Results: Psoriasis Area and Severity Index (PASI) score, serum leptin concentration, and leptin mRNA expression in SAT were significantly higher in psoriasis patients with MetS than in those without MetS. IL-6 mRNA expression in SAT was significantly higher in controls than in psoriasis patients. Conclusions: The association of psoriasis activity, adipokines, and MetS was confirmed. SAT from psoriasis patients was involved in increased leptin and decreased IL-6 mRNA expression. This is the first indication that SAT adipokines are involved in the pathophysiology of psoriasis.