Higher bodily adiposity, fat intake, and cholesterol serum levels are associated with higher disease activity in psoriatic arthritis patients: is there a link among fat and skin and joint involvement?

Abstract

Introduction/ objectives: Assuming that there is a link between lipid and glucose metabolism and inflammation in patients with psoriatic arthritis (PsA), our aim was to evaluate the relationships among body composition measurements, food intake, and disease activity in patients with PsA. Methods: A total of 97 patients with PsA, according to the CASPAR criteria, were included in this cross-sectional study. Body composition measurements (whole-body DXA, GE-Lunar), food intake (3-day registry) and biochemical and inflammatory serum markers were evaluated. Skin and joint disease activity were assessed by using PASI, BSA, DAS28, and minimal disease activity (MDA). The level of significance was set as p < 0.05. Results: A higher prevalence of obesity, according to the fat mass index (FMI) (92.7%), and metabolic syndrome (MetS) (54%) were found, but no significant changes regarding lean or bone mass were found. Joint disease activity was positively correlated with total body fat (r = 0.4; p < 0.001), FMI (r = 0.33; p < 0.001), body mass index (r = 0.20; p < 0.049) and waist circumference (r = 0.27; p = 0.009). In addition, joint disease activity was negatively associated with muscle mass (r = − 0.38; p < 0.001). Skin disease activity was positively correlated with total cholesterol (r = 0.3; p = 0.003) and LDL-cholesterol (r = 0.28; p = 0.006). After multiple adjustments, patients with severe joint disease activity had higher body adiposity than patients in remission or with low disease activity. Skin disease activity was associated with higher trans-fat intake and lower omega-6 consumption. Conclusions: Our data suggest a possible harmful link among fat (body adiposity, saturated fat consumption, LDLcholesterol serum levels) and joint and skin disease activity in patients with PsA.

Discrepancy in Metabolic Syndrome between Psoriatic Arthritis and Rheumatoid Arthritis: a Direct Comparison of Two Cohorts in One Center

“…Leite et al. revealed a similar positive linear correlation between disease activity and total body fat in patients with PsA [ 41 ]. The weak correlation may be caused by not combining joint and skin lesion together when evaluating disease activity of PsA.…”

Methotrexate-Related Liver Cirrhosis in Psoriatic Arthritis: A Case Report and Review of the Literature

“… 50 – 53 For instance, strong epidemiological data from cross-sectional studies correlate total cholesterol levels and body mass index (BMI) with joint and skin disease activity, thus implying a negative impact of MetS in achieving low disease activity and good clinical response in PsA patients. 54 – 56 …”

How diet affects Alzheimer's disease and small vessel disease

“…The immune system is one important ‘target organ’ that we can try to treat by changing nutritional factors. For example, it has been shown in the case of psoriasis (an autoimmune disease) that large amounts of trans‐fats are associated with more severe skin problems 7 . Partially hydrogenated vegetable oils, which are found in a variety of processed foods (for instance, cakes, doughnuts, pastries, ice cream and several fast foods), are the largest source of these harmful fats.…”

“…For example, it has been shown in the case of psoriasis (an autoimmune disease) that large amounts of trans-fats are associated with more severe skin problems. 7 Partially hydrogenated vegetable oils, which are found in a variety of processed foods (for instance, cakes, doughnuts, pastries, ice cream and several fast foods), are the largest source of these harmful fats. Swedish researchers have also shown that changing the Western diet (containing meat, chicken, butter, cheese, dairy products and refined grains) to the Mediterranean diet (containing more vegetables, vegetable oils and fish) decreases the activity of rheumatoid arthritis (also an autoimmune disease).…”