Ab1243 obesity, Metabolic Syndrome and Other Comorbidities: Influence on Rheumatoid Arthritisand Psoriatic Arthritis Activity and Quality of Life

Abstract

BackgroundPatients with rheumatic inflammatory conditions have an increased risk of premature death due to cardiovascular causes. It can be explained by the unfavourable interaction between the inflammatory process and the traditional cardiovascular risk factors. In obesity, especially if visceral, and in rheumatic diseases, there is production of pro-inflammatory cytokines, which contributes to an increase in cardiovascular risk. The influence of body mass index (BMI) on the evolution, activity and quality of life in rheumatoid arthritis (RA) and in psoriatic arthritis (PsA) has been proven. However, studies evaluating the influence of the abdominal circumference (AC) and metabolic syndrome (MS) are meagre.ObjectivesTo assess the influence of BMI, AC and MS, on disease activity and quality of life in RA and PA, using parameters of inflammatory activity (sedimentation rate (SR) and C-reactive protein (CRP), Activity Score (DAS28), Visual Analogue Pain Scale (VAS) and Health Assessment Questionnaire (HAQ) and to compare patients with RA and PA.MethodsA cross-sectional study, including 150 patients with RA, diagnosed according to the ACR/EULAR criteria and 75 patients with PsA (CASPAR criteria). Assessment of weight, height, AC, SR and CRP of all patients, clinical and demographic data collection. The presence of MS was assessed according to WHO definition. Participants completed HAQ and disease activity was measured by DAS28. SPSS was used for the statistical analysis, significance level was 2-sided p<0.050.ResultsAge, duration of illness, schooling and professional class were similar in RA and PsA. In RA there was a predominance of females (78.7%), while in PsA a predominance of males (53.3%). There were no differences between the quality of life (by HAQ), or in the disease activity (by DAS28 or by inflammatory parameters). PsA patients had significantly higher BMI and AC. The number of comorbidities was higher in cases of PsA. Dyslipidaemia and hyperuricemia were significantly more frequent in this group of patients. Independently the underlying pathology (RA or PsA), the number of comorbidities correlated positively with DAS28, with HAQ, CRP and SR.In RA group, there was a positive correlation of both BMI and AC with HAQ, also MS associated the highest HAQ values. Overweight/obesity (BMI≥25kg/m2) were associated with at least one painful joint. Still, the risk of having at least one swollen joint was 3.4 times higher in patients with increased AC (95% CI: 1.08-10.39). There was an association between the BMI and AC and the CRP value. Patients with BMI≥25 kg/m2 and with increased AC had DAS28 values significantly higher. MS was associated with significantly higher SR.In PsA group Patients with MS had higher CRP values, more joint pain and higher disease activity according to DAS28. Patients with BMI≥25kg/m2 also had more painful joints and higher CRP values. None of the patients with normal BMI had swollen joints, however 20.4% of overweight patients had at least one swollen joint. There was no association betwee...

<p>Metabolic Score for Insulin Resistance Is Correlated to Adipokine Disorder and Inflammatory Activity in Female Knee Osteoarthritis Patients in a Chinese Population</p>

“…MetS leads to a state of chronic low-grade systemic inflammation, 5 and certain markers of inflammation are elevated in this condition. Previous studies have shown that MetS patients have higher CRP and ESR levels than nMetS patients, 35,36 and MetS-OA patients have higher expression levels of CRP and ESR than nMetS-OA patients. 21 These previous studies are in line with the present findings.…”

Comorbidities, pain and fatigue in psoriatic arthritis, psoriasis and healthy controls: a clinical cohort study

“…Comorbidities such as hypertension, obesity, and depression/anxiety have previously been identified as negative prognostic factors for clinically relevant treatment outcomes in PsA (4)(5)(6)(7)(8)(9)(10)(11)(12), and comorbidities significantly impact patients' quality of life (13). Moreover, the presence of comorbidities according to the Charlson Comorbidity Index (CCI) and other comorbidity scores have been associated with higher disease activity, shorter treatment persistence and/or reduced clinical treatment response rates (14)(15)(16)(17)(18). Thus, growing evidence indicates that comorbidities play an important role in PsA concerning disease activity and response to treatment.…”

Clinical Characteristics of Patients With Psoriatic Spondylitis Versus Those With Ankylosing Spondylitis: Features at Baseline Before Biologic Therapy

“…Recent studies showed that over half of the patients with PsA have more than one comorbidity, which has a significant impact on their quality of life. 22 23 24 In addition, some studies have revealed that similar to patients with RA, patients with PsA have a higher prevalence and incidence of cardiovascular diseases, such as ischemic heart disease and stroke, than the general population. 24 25 In our study, the comorbidities related to the risk of cardiovascular diseases in patients with PsA were hypertension (29.4%), diabetes mellitus (12.8%), and hyperlipidemia (35.8%).…”