Impact of metabolic syndrome in patients with psoriatic arthritis in a cohort from the province of Córdoba

Abstract

Psoriatic arthritis (PsA) is associated with higher cardiovascular morbidity and mortality than the general population. Metabolic syndrome (MetS) induces a proinflammatory state that could affect the activity of the disease and the treatment response. Our objective was to describe and compare the presence of MetS in patients with Psoriatic Arthritis (PsA) and its relationship with disease activity, quality of life, and treatment.

A prospective cross-sectional study was performed at Cordoba Hospital between 07/2019 to 03/2022. Patients older than 18 years old with a diagnosis of PsA according to (CASPAR criteria) were included. Sociodemographic and clinical features were analyzed and disease activity was evaluated by PASI (psoriasis area severity index), DAPSA (disease activity for psoriatic arthritis), MDA and VLDA (minimal and very low disease activity). Quality of life was assessed by self-administered questionnaires: DLQI (Dermatology life quality index), PASQoL (Psoriatic Arthritis Quality of Life) and HAQ (Health assessment questionnaire). MetS was defined by WHO, ATPIII, and IDF criteria. p<0.05 significant. The study was approved by ethical committee of Cordoba Hospital. 

69 patients with PsA, were included with a median age of 55.92±9.88 years. 60%were female. 39% of patients fulfilled MetS criteria by WHO, 70% by IDF and 37% by ATPIII.  >80% of patients of both groups had polyarticular involvement. Patients with MetS had a higher frequency of hypertension, diabetes, dyslipidemia, and ischemic heart disease (p<0.05). Remission was achieved by DAPSA in 4% of those with MetS versus 14% without MetS; MDA 28% versus 40% and VLDA 4% and 12% respectively (p=NS), DLQI in MetS and without MetS was (7.65±6.18 vs 9.72±7.83: p>0.05) and PASQUoL (10.04±4.49 vs 8.3±5.32; p>0 .05). Patients with MetS had a higher HAQ (1.08±0.61 vs 0.73±0.66; p<0.05).  Treatment was not different between the two groups.

The presence of MetS in PsA was associated with cardio metabolic comorbidities and worse quality of life. A multidisciplinary approach is essential in this group of patients in order to reduce cardiovascular morbidity and mortality.