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Changes in the sex hormone profile of male patients with moderate-to-severe plaque-type psoriasis under systemic therapy: results of a prospective longitudinal pilot study

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Abstract

Patients with moderate-to-severe plaque-type psoriasis exhibit increased cardiovascular mortality. Recent publications point towards psoriasis-induced insulin resistance as an important pathomechanism driving cardiovascular comorbidity in these patients. As the hormonal status in general and sex hormone-binding globulin (SHBG) in particular serve as sensitive indicators for insulin resistance, we analysed these parameters in the context of a set of multiple additional clinical and laboratory measurements in a cohort of male patients. Of 33 consecutively enrolled male patients receiving continuous systemic therapy for their moderate-to-severe plaque-type psoriasis, 23 male patients for whom all parameters could be collected over a 24-week treatment period were included in this analysis. At baseline, testosterone levels varied between 212 and 660 ng/ml (median: 377.0), and SHBG between 11.9 and 46.0 nmol/l (median: 29.2), thus documenting lack of hypogonadism among these patients. Clinically, 19/23 patients experienced at least a 50% reduction in their PASI under therapy. Using a multivariate regression model to further analyse the sub-group of patients responding to treatment, hs-CRP, PASI, leptin and resistin all improved under effective systemic anti-inflammatory therapy, thus losing their significant influence on SHBG. SHBG performed well as a sensitive biomarker for insulin resistance and systemic inflammation in these patients. Its improvement, as well as the reduction of resistin serum levels, most likely reflects a state of reduced cardiovascular risk in patients undergoing effective continuous systemic therapy. Long-term safety data, generated e.g. from psoriasis registries, are needed to assess whether this effect translates into reduced cardiovascular mortality.

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Acknowledgments

This study was supported by research grants from Abbott, Biogen Idec, and Wyeth to WHB. JG was supported through a Centocor fellowship.

Conflict of interest

WHB received honoraria as a speaker on sponsored symposia and as participants in advisory board meetings of the above-mentioned companies. The authors have no additional interests to disclose.

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Authors and Affiliations

  1. Department of Internal Medicine, Clinic of the Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany

    Sandra Boehncke

  2. Department of Dermatology, Clinic of the Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany

    Rebekka Salgo, Jurate Garbaraviciene, Heike Beschmann, Wolf-Henning Boehncke & Falk Rüdiger Ochsendorf

  3. Department of Biostatistics, J.W. Goethe-University Frankfurt/M, Frankfurt am Main, Germany

    Hanns Ackermann

Authors
  1. Sandra Boehncke
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  2. Rebekka Salgo
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  3. Jurate Garbaraviciene
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  4. Heike Beschmann
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  5. Hanns Ackermann
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  6. Wolf-Henning Boehncke
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  7. Falk Rüdiger Ochsendorf
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Correspondence to Sandra Boehncke.

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Boehncke, S., Salgo, R., Garbaraviciene, J. et al. Changes in the sex hormone profile of male patients with moderate-to-severe plaque-type psoriasis under systemic therapy: results of a prospective longitudinal pilot study. Arch Dermatol Res 303, 417–424 (2011). https://doi.org/10.1007/s00403-011-1157-5

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  • DOI: https://doi.org/10.1007/s00403-011-1157-5

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