{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T17:27:34Z","timestamp":1776360454842,"version":"3.51.2"},"reference-count":35,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,5,29]],"date-time":"2024-05-29T00:00:00Z","timestamp":1716940800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Psoriasis is a chronic inflammatory disease with specific cutaneous and nail lesions. Recent data has emphasized its systemic nature, highlighting metabolic conditions found in patients. Insulin resistance was identified in adult psoriasis, sometimes related to psoriasis severity. Data regarding this relationship in children are limited. Consequently, we tested the association between the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and Psoriasis Area and Severity Index (PASI) using a retrospective dataset of 43 children with various types of psoriasis. First, we attempted to replicate the relationship between the HOMA-IR and PASI. Second, we explored potential associations between these variables and others in the dataset. The results illustrated no association between HOMA-IR and PASI (p-value = 0.512). The exploratory findings hinted at a connection between nail pitting and insulin resistance (p-value = 0.038), yet Bonferroni adjustments suggested the risk of a false-positive finding. Noteworthy associations were found between the HOMA-IR and body mass index (BMI) (p-value = 0.001), the PASI and quality of life impairment (p-value = 0.005), and psoriasis severity and type (p-value = 0.001). The null hypothesis that insulin resistance in children is not positively associated with psoriasis severity cannot be rejected. Pilot estimates of variables and covariates of interest are provided for further confirmatory studies assessing this hypothesis.<\/jats:p>","DOI":"10.3390\/life14060700","type":"journal-article","created":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T10:06:01Z","timestamp":1717409161000},"page":"700","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["HOMA-IR Index and Pediatric Psoriasis Severity\u2014A Retrospective Observational Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2271-8382","authenticated-orcid":false,"given":"Adelina Maria","family":"Sendrea","sequence":"first","affiliation":[{"name":"Pediatric Dermatology Department, Carol Davila University of Medicine and Pharmacy, 8 Eroilor Sanitari Boulevard, 050474 Bucharest, Romania"},{"name":"Pediatric Dermatology Department, Colentina Clinical Hospital, 19-21 Stefan cel Mare Street, 020125 Bucharest, Romania"},{"name":"Dermatology Research Unit, Colentina Clinical Hospital, 19-21 Stefan cel Mare Street, 020125 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denis","family":"Iorga","sequence":"additional","affiliation":[{"name":"Computer Science & Engineering Department, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4815-9227","authenticated-orcid":false,"given":"Mihai","family":"Dascalu","sequence":"additional","affiliation":[{"name":"Computer Science & Engineering Department, National University of Science and Technology Politehnica Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania"},{"name":"Academy of Romanian Scientists, 3 Ilfov Street, 050044 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9747-9091","authenticated-orcid":false,"given":"Alina","family":"Suru","sequence":"additional","affiliation":[{"name":"Pediatric Dermatology Department, Carol Davila University of Medicine and Pharmacy, 8 Eroilor Sanitari Boulevard, 050474 Bucharest, Romania"},{"name":"Pediatric Dermatology Department, Colentina Clinical Hospital, 19-21 Stefan cel Mare Street, 020125 Bucharest, Romania"},{"name":"Dermatology Research Unit, Colentina Clinical Hospital, 19-21 Stefan cel Mare Street, 020125 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen Maria","family":"Salavastru","sequence":"additional","affiliation":[{"name":"Pediatric Dermatology Department, Carol Davila University of Medicine and Pharmacy, 8 Eroilor Sanitari Boulevard, 050474 Bucharest, Romania"},{"name":"Pediatric Dermatology Department, Colentina Clinical Hospital, 19-21 Stefan cel Mare Street, 020125 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1007\/s40272-015-0137-1","article-title":"Psoriasis in Children and Adolescents: Diagnosis, Management and Comorbidities","volume":"17","author":"Bronckers","year":"2015","journal-title":"Paediatr. Drugs"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1001\/jama.2020.4006","article-title":"Pathophysiology, Clinical Presentation, and Treatment of Psoriasis: A Review","volume":"323","author":"Armstrong","year":"2020","journal-title":"JAMA"},{"key":"ref_3","first-page":"900","article-title":"The first nation-wide study revealing epidemiologic data and life quality aspects of psoriasis in Romania","volume":"18","author":"Boca","year":"2019","journal-title":"Exp. Ther. Med."},{"key":"ref_4","first-page":"s5","article-title":"Psoriasis and its comorbidities","volume":"11","author":"Onumah","year":"2012","journal-title":"J. Drugs Dermatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.jaad.2019.08.049","article-title":"Joint American Academy of Dermatology-National Psoriasis Foundation guidelines of care for the management and treatment of psoriasis in pediatric patients","volume":"82","author":"Menter","year":"2020","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Polic, M.V., Miskulin, M., Smolic, M., Kralik, K., Miskulin, I., Berkovic, M.C., and Curcic, I.B. (2018). Psoriasis Severity-A Risk Factor of Insulin Resistance Independent of Metabolic Syndrome. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15071486"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1097\/MOP.0000000000000790","article-title":"Metabolic syndrome and inflammatory skin conditions","volume":"31","author":"Steele","year":"2019","journal-title":"Curr. Opin. Pediatr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"605691","DOI":"10.3389\/fmed.2021.605691","article-title":"Psoriasis and Diabetes, a Dangerous Association: Evaluation of Insulin Resistance, Lipid Abnormalities, and Cardiovascular Risk Biomarkers","volume":"8","author":"Brazzelli","year":"2021","journal-title":"Front. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1097\/MOP.0000000000001151","article-title":"Insulin resistance in children","volume":"34","author":"Mainieri","year":"2022","journal-title":"Curr. Opin. Pediatr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1149239","DOI":"10.3389\/fendo.2023.1149239","article-title":"The crucial role and mechanism of insulin resistance in metabolic disease","volume":"14","author":"Zhao","year":"2023","journal-title":"Front. Endocrinol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"160","DOI":"10.4103\/2230-8210.146874","article-title":"Assessment of insulin sensitivity\/resistance","volume":"19","author":"Gutch","year":"2015","journal-title":"Indian J. Endocrinol. Metab."},{"key":"ref_12","first-page":"689","article-title":"Inappropriate Use of Homeostasis Model Assessment Cutoff Values for Diagnosing Insulin Resistance in Pediatric Studies","volume":"117","author":"Fox","year":"2017","journal-title":"J. Am. Osteopath. Assoc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1007\/s00431-020-03924-w","article-title":"Metabolic syndrome and insulin resistance in pre-pubertal children with psoriasis","volume":"180","author":"Caroppo","year":"2021","journal-title":"Eur. J. Pediatr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1038\/JID.2015.385","article-title":"Characterization of Lipoprotein Composition and Function in Pediatric Psoriasis Reveals a More Atherogenic Profile","volume":"136","author":"Tom","year":"2016","journal-title":"J. Investig. Dermatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"10969","DOI":"10.1007\/s11229-021-03276-4","article-title":"When to adjust alpha during multiple testing: A consideration of disjunction, conjunction, and individual testing","volume":"199","author":"Rubin","year":"2021","journal-title":"Synthese"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"187","DOI":"10.5507\/bp.2019.021","article-title":"Indirect insulin resistance detection: Current clinical trends and laboratory limitations","volume":"163","author":"Placzkowska","year":"2019","journal-title":"Biomed. Pap."},{"key":"ref_17","unstructured":"Prevention CfDCa (2024, April 02). BMI Percentile Calculator for Child and Teen: CDC, Available online: https:\/\/www.cdc.gov\/healthyweight\/bmi\/calculator.html."},{"key":"ref_18","unstructured":"(2024, April 02). Ped(z) Pediatric Calculator. Available online: https:\/\/pedz.de\/de\/pedz\/bmi.html."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1111\/j.1365-2230.1994.tb01167.x","article-title":"Dermatology Life Quality Index (DLQI)\u2014Asimple practical measure for routine clinical use","volume":"19","author":"Finlay","year":"1994","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1684\/ejd.2014.2291","article-title":"Cardiovascular comorbidities in childhood psoriasis","volume":"24","author":"Torres","year":"2014","journal-title":"Eur. J. Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/s12291-013-0413-1","article-title":"Clinico-biochemical correlation between psoriasis and insulin resistance","volume":"30","author":"Dhara","year":"2015","journal-title":"Indian J. Clin. Biochem."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1111\/j.1365-2133.2009.09593.x","article-title":"Epidemiology and comorbidity of psoriasis in children","volume":"162","author":"Augustin","year":"2010","journal-title":"Br. J. Dermatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1159\/000381913","article-title":"Epidemiology and Comorbidity in Children with Psoriasis and Atopic Eczema","volume":"231","author":"Augustin","year":"2015","journal-title":"Dermatology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"203","DOI":"10.5021\/ad.2021.33.3.203","article-title":"Association of Metabolic Comorbidities with Pediatric Psoriasis: A Systematic Review and Meta-Analysis","volume":"33","author":"Cho","year":"2021","journal-title":"Ann. Dermatol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"17","DOI":"10.15562\/bdv.v2i1.18","article-title":"Positive correlation of psoriasis vulgaris severity and HOMA-IR","volume":"2","author":"Wardhana","year":"2019","journal-title":"Bali Dermatol. Venereol. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"689","DOI":"10.18203\/2349-3933.ijam20221352","article-title":"Insulin resistance in psoriasis: Prevalence and prospects from a tertiary care centre","volume":"9","author":"Bari","year":"2022","journal-title":"Int. J. Adv. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1111\/j.1365-2133.2007.08190.x","article-title":"Psoriasis patients show signs of insulin resistance","volume":"157","author":"Boehncke","year":"2007","journal-title":"Br. J. Dermatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"29","DOI":"10.4103\/ejdv.ejdv_20_19","article-title":"Relation between insulin resistance and severity of psoriasis in Egyptian patients","volume":"40","year":"2020","journal-title":"Egypt. J. Dermatol. Venereol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1111\/ijd.12811","article-title":"High prevalence of metabolic syndrome in patients with psoriasis in Lebanon: A prospective study","volume":"55","author":"Itani","year":"2016","journal-title":"Int. J. Dermatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"40","DOI":"10.18231\/j.ijced.2021.008","article-title":"Toe nail changes in diabetes mellitus","volume":"7","author":"Vidyasagar","year":"2021","journal-title":"IP Indian J. Clin. Exp. Dermatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1111\/j.1365-2230.2011.04131.x","article-title":"The role of inflammatory markers in assessing disease severity and response to treatment in patients with psoriasis treated with etanercept","volume":"36","author":"Kanelleas","year":"2011","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1111\/j.1365-2133.2004.05984.x","article-title":"The inflammatory response in mild and in severe psoriasis","volume":"150","author":"Rebelo","year":"2004","journal-title":"Br. J. Dermatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2362","DOI":"10.2337\/dc07-0637","article-title":"Serum C3 Is a Stronger Inflammatory Marker of Insulin Resistance Than CReactive Protein, Leukocyte Count, and Erythrocyte Sedimentation Rate","volume":"30","author":"Muscari","year":"2007","journal-title":"Diabetes Care"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Ahmed, B., Sultana, R., and Greene, M.W. (2021). Adipose tissue and insulin resistance in obese. Biomed. Pharmacother., 137.","DOI":"10.1016\/j.biopha.2021.111315"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.clindermatol.2014.12.006","article-title":"Obesity and the metabolic syndrome in pediatric psoriasis","volume":"33","author":"Shah","year":"2015","journal-title":"Clin. Dermatol."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/14\/6\/700\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:50:14Z","timestamp":1760107814000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/14\/6\/700"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,29]]},"references-count":35,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["life14060700"],"URL":"https:\/\/doi.org\/10.3390\/life14060700","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,29]]}}}