Higher Rates and Clustering of Abnormal Lipids, Obesity, and Diabetes Mellitus in Psoriatic Arthritis Compared With Rheumatoid Arthritis

Abstract

Objective We compared the prevalence and the clustering of the Metabolic Syndrome (MetS) components: obese body mass index (BMI ≥ 30 kg/m2), hypertriglyceridemia, low high-density lipids, hypertension and diabetes, in patients with psoriatic arthritis (PsA) and rheumatoid arthritis (RA) in the Consortium of Rheumatology Researchers of North America (CORRONA) registry. Methods We included CORRONA participants with the rheumatologist-confirmed clinical diagnoses of PsA and RA with complete data. We used a modified definition of MetS that did not include insulin resistance, waist circumference or blood pressure measurements. Logistic regression models were adjusted for age, sex and race. Results In the overall CORRONA population, the rates of diabetes and obesity were significantly higher in PsA compared with RA. In 294 PsA and 1162 RA participants who had lipids measured, the overall prevalence of MetS in PsA vs. RA was 27% vs. 19%. The odds ratio (OR) of MetS in PsA vs. RA was 1.44 (95% confidence interval (CI) 1.05 to 1.96), p=0.02. The prevalence of hypertriglyceridemia was higher in PsA compared with RA, 38% vs. 28%, OR 1.51 (95% CI 1.15 to 1.98), p=0.003. The prevalence of type II diabetes was also higher in PsA compared with RA (15% vs. 11%), OR 1.56 (95% CI 1.07 to 2.28), p=0.02, in the adjusted model. Similarly, higher rates of hypertriglyceridemia and diabetes were observed in the subgroup of PsA and RA patients with obese BMI. Conclusion PsA is associated with the higher rates of obesity, diabetes, and hypertriglyceridemia, compared with RA.

Prevalence of metabolic syndrome and degree of cardiovascular disease risk in patients with Psoriatic Arthritis

“…In the literature, currently, there are only two studies in which MetS was identically compared in patients with PsA and those with RA, as in our current study (21,24). In the study by Mok et al (21) on 699 individuals with RA and 109 with PsA, they determined MetS prevalences to be 20% and 38%, respectively.…”

“…In another study published by Labitigan et al (24), a larger population was studied; results were obtained from 1,162 patients with RA and 294 patients with PsA. Patients with PsA were found to have a significantly higher MetS prevalence than those with RA (27% vs. 19%, respectively), in spite of the younger age of the patients with PsA in this study.…”

“…In most of these studies, MetS prevalence was found to be higher in patients with RA than in control groups (21,(24)(25)(26)(27)(28)(29)(30). Other, smaller studies have reported either higher MetS prevalence in the control group (31) or no difference between the RA and control groups (32).…”

“…In most of these studies, MetS prevalence was higher in patients with RA than in control groups (21,(24)(25)(26)(27) . The reason for the difference may be differences in patient selection.…”

“…Regardless of the applied criteria for MetS, significant between-group differences existed. A limited number of previous studies have indicated that the prevalence of MetS in patients with PsA is between 23.5% and 58.1% (21)(22)(23)(24). There is one study that investigated the prevalance of MetS in a small number of patients with PsA in Turkey (9).…”