Frequency of metabolic syndrome and correlation with metabolic syndrome in patients with psoriatic arthritis / 中华风湿病学杂志

ABSTRACT

Objective:To investigate the frequency of metabolic syndrome (MS) in patients with psoriatic arthritis (PsA) and further analyze the correlation of MS and its components with clinical features of PsA.Methods:Data including demographics, clinical manifestations, laboratory tests, MS-associated features (height, weight, waist circumference, blood pressure, serum lipid spectrum, and so on) and history of complications (hypertension, diabetes mellitus, atherosclerosis, coronary heart disease, and cerebral vascular disease) were collected from PsA patients in our hospital from Jan 2017 to Sep 2019. The frequency of MS in PsA patients was calculated and the association between PsA clinical manifestations and MS as well as its components was investigated.Results:One hundred and sixty-two PsA patients who fulfilled the Classification Criteria for Psoriatic Arthritis (CASPAR) were recruited. Hypertension was identified in 36 (22.2%) patients, diabetes mellitus in 28(17.2%) patients, coronary heart disease in 11(6.7%) patients, and cerebral vascular disease in 7 (4.3%) patients. Based on the criteria of the International Diabetes Federation (IDF), 58(35.8%) patients were diagnosed as MS. Compared with MS-free patients, patients with MS, hypertension or diabetes mellitus were older [(54±10 vs 44±13; 56±11 vs 45±12; 54±11 vs 44±13, respectively, t=5.058 , 4.450, 5.150, P<0.01 for all], with higher disease activity [DAPSA scores 16.75(11.25, 26.7) vs 8.8(4.8, 16.4), 16.3(9.6, 27.8) vs 10.0 (5.1, 18.0), 14.4 (9, 25.7) vs 9.5 (5, 17.7), Z=4.539 , 3.046, 3.063, P<0.01]. There was a positive correlation between the sum of components of MS and DAPSA score ( r=0.27 , P<0.01), but multiple linear regression showed no correlation between each component with DAPSA score ( P>0.05) except for hypertension ( P<0.01, standard coefficient=0.334) and elevated fasting blood glucose ( P=0.023, standard coefficient=0.247). PsA patients with hypertension had higher ESR [16.5 (9.5, 34.25) mm/1 h vs 10 (5, 24.5) mm/1 h, Z=2.127, P=0.012]. CRP level was higher in patients with dyslipidemia [5.6(2.1, 17.8) mg/L vs 3.7(1.5, 6.5) mg/L, Z=2.543, P<0.01]. Prevalence of inflammatory back pain was also higher in dyslipidemia patients (41.3% vs 22.4%, χ2=5.901, P=0.016). DAPSA score was higher in dyslipidemia patients (14.1 vs9.9, P=0.031). Conclusion:MS and its components are not rare comorbidities in PsA patients. PsA patients with MS tend to be older with higher disease activity, which calls for more attention.