Cardiovascular risk factors may dictate psoriatic arthritis severity

A provider listens to a patient's heart.
A provider listens to a patient's heart.

Severity of psoriatic arthritis is independently associated with metabolic syndrome and insulin resistance, according to findings published in the Journal of Rheumatology.

Muhammad Haroon, MB, MMedSc, MRCPI, from the Department of Rheumatology and Department of Diagnostic Imaging at St. Vincent's University Hospital in Dublin, Ireland, and colleagues studied 283 patients with psoriatic arthritis (mean age 55 years ) to determine prevalence of metabolic syndrome and insulin resistance. They then went on to identify clinical associations between these factors and cardiovascular risk factors.

More than half of patients in the study were women, and reported receiving a psoriatic arthritis diagnosis nearly 20 years prior. Insulin resistance was defined as an elevated homeostasis model assessment value of greater than 2.5.

Severe psoriatic arthritis was defined as presence of one or more radiographic symptoms severe enough for treatment with tumor necrosis factor inhibitors. Symptoms included peripheral joint erosions, thinning and weakening of bones, and inflammation of one or both sacroiliac joints of the pelvis.

There were significantly high rates of symptoms associated with metabolic syndrome in the study patients, including hypertension (74%), elevated waist circumference (56%), and high triglycerides (44%), the researchers found.

Similar to metabolic syndrome symptoms, insulin resistance appeared to be linked with more severe psoriatic arthritis (OR 3.49, P = 0.03), in addition to later psoriasis age of onset (OR 1.07, P = 0.001), and higher BMI (OR 1.22, P<0.001).

Providers should routinely screen for metabolic syndrome and insulin resistance among patients with psoriasis and PsA, the researchers suggested.

References

  1. Haroon M. J Rheumatol. 2014; 41(7): 1357-1365.
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