Disease Activity Indices and Body Mass Index: Cross-Sectional Analysis of a Large Psoriatic Arthritis Cohort

Umut Kalyoncu¹, Ozun BayndÄ±r¹, Barış Yılmazer¹, Ediz Dalkilic², Kenan Aksu¹, Mustafa Ferhat Oksuz¹, E.Figen Tarhan¹, Meryem Can¹, Orhan Kucuksahin¹, Gezmis Kimyon¹, Lutfi Akyol¹, Ahmet Mesut Onat¹, Bunyamin Kisacik¹, Abdulsamet Erden¹, Ahmet Omma¹, Duygu Ersozlu Bakirli¹, Cem Ozisler¹, Emel Gonullu¹, Seval Pehlevan¹, Dilek Solmaz¹, Muhammet Cinar¹, Gozde Cetin¹, Abdurrahman Tufan¹, Muge Aydin Tufan¹, Levent Kilic¹, Sukran Erten¹, Timucin Kasifoglu¹, Senol Kobak¹, Soner Senel¹, Servet Akar¹, Metin Ozgen¹, Esen Kasapoglu-Gunal¹, Veli Yazisiz¹, Sedat Yılmaz¹, Salim Donmez¹, Ä°smail Dogan¹, Hamide Kart Koseoglu¹, Funda Erbasan¹, Fatih Yildiz¹, Cemal Bes¹, Ayse Balkarli¹, Ali Sahin¹, Rıdvan Mercan¹, Fatoş Arslan¹, Atalay Dogru¹, Salih Pay¹, Sule Yavuz¹, Necati Cakir¹, Yasemin Kabasakal¹ and Sibel Z. Aydin¹, ¹PsART study group, Ankara, Turkey, ²Department of Rhematology, Uludag University Faculty of Medicine, Bursa, Turkey

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: body mass and psoriatic arthritis, Disease Activity

Session Information

Date: Sunday, November 8, 2015

Title: Spondylarthropathies and Psoriatic Arthritis - Clinical Aspects and Treatment Poster I: Clinical Aspects and Assessments

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Well known comorbidities of Psoriatic arthritis (PsA) such as cardiovascular disease, metabolic syndrome and diabetes mellitus are closely related with body mass index (BMI). Obesity is a risk factor for development of arthritis in patients with psoriasis but at the same time can be a marker of disease severity. Our objective was to assess association of disease activity indicies with obesity in a multicenter large PsA cohort.

Methods: PsART (Psoriatic Arthritis Registry of Turkey) is a prospective, multicentre, web-based, nationwide study in Turkey on patients with PsA. Patients are consecutively recruited to this registry, if they are diagnosed as PsA. Until May 2015, 1060 PsA patients from 37 centers enrolled to PsART. BMI≥30 was defined as obesity. The demographics were recorded including tender/swollen joint counts, body surface area (BSA), ESR, health assessment questionnaire (HAQ), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), 100mm visual analog scale (VAS) for patient global assessment (PtGA), physician global assessment (PGA), fatigue, pain. Minimal disease activity (MDA) items (SJC≤1, TJC≤1, HAQ≤0.5, PtGA≤20, BSA≤3, pain≤15) and PGA, BASDAI, BASFI, fatigue, ESR used the following cut-offs to dichotomize groups: PGA≤20, BASDAI<20, BASFI<20, fatigue<20, ESR < ULN.

Results: Within PsA patients whose BMI data were available (n=1054), 64.5% was female. Mean (SD) age was 46.8 (12.9) years with a disease duration of 188 (135) months for psoriasis and 77 (89) months for psoriatic arthritis. Mean (SD) BMI was 27.9 (5.2) and 30.9% of patients had a BMI>30. Obese patients were older (50.5 (11.8) vs 45.1 (12.9), p<0.001), had a lower education level (7.0 (4.2) vs 9.2 (4.5) years, p<0.001) and more frequent comorbidities such as DM (25.2% vs 11,4%, p<0.001) and HT (36.2% vs 19.6%, p<0.001). These patients had more fatigue, higher BASDAI and BASFI scores, and moderate PGA, pain and ESR (Table). Minimal disease activity items (except PtGA) were similar according to BMI. Disease activity groups by BMI categories are shown in Table.

Conclusion: Obesity was foud to be associated with a lower probability of achieving sustained MDA state in a longitudinal PsA cohort (1). On the other hand, our results did not support to association of obesity and achieving low disease activity. . Interstingly, other than MDA items especially fatigue was significantly higher at obese patients. Fatigue has multidimensional affect on impact of patients’ health, and may be linked to body weight in inflammatory diseases.

Table. Disease activity and patient reported measures by BMI categories

	BMI > 30	BMI<30	p-value
SJC ≤ 1 n (%)	204/304 (67.1)	466/693 (67.3)	0.96
TJC ≤ 1 n (%)	134/311 (43.1)	318/688 (46.2)	0.36
BSA ≤ 3 n (%)	67/123 (54.5)	150/243 (61.7)	0.18
PtGA ≤ 20 n (%)	33/240 (13.7)	103/486 (21.2)	0.016
PGA ≤ 20 n (%)	42/218 (19.3)	129/454 (28.4)	0.011
PGA mean (SD)	35.3 (20.5)	31.5 (22.9)	0.037
Pain ≤ 15 n (%)	47/250 (18.8)	116/497 (23.3)	0.16
Pain mean (SD)	45.3 (27.3)	40.0 (27.9)	0.015
HAQ ≤ 0.5 n (%)	98/247 (39.7)	273/580 (47.1)	0.050
Fatigue ≤ 20 n (%)	36/248 (14.5)	117/492 (23.8)	0.003
Fatigue mean (SD)	48.2 (26.2)	40.4 (27.6)	<0.001
BASDAI ≤ 20 n (%)	45/196 (22.9)	135/404 (33.4)	0.009
BASDAI mean (SD)	40.6 (25.1)	33.8 (25.8)	0.003
BASFI ≤ 20 n (%)	68/200 (34.0)	202/397 (50.9)	<0.001
BASFI mean (SD)	32.1 (24.3)	24.5 (23.6)	<0.001
ESR < UL n (%)	128/306 (41.8)	324/638 (50.9)	0.010
ESR mean (SD)	26.2 (18.6)	23.0 (20.3)	0.019
Available data includes; SJC 997, TJC 999, BSA 366, PtGA 726, PGA 672, Pain 747, HAQ 827, Fatigue 740, BASDAI 600, BASFI 597 and ESR 944.

Eder L, et al. Ann Rheum Dis 2015;74:813–817

Disclosure: U. Kalyoncu, None; O. BayndÄ±r, None; B. Yılmazer, None; E. Dalkilic, None; K. Aksu, None; M. F. Oksuz, None; E. F. Tarhan, None; M. Can, None; O. Kucuksahin, None; G. Kimyon, None; L. Akyol, None; A. M. Onat, None; B. Kisacik, None; A. Erden, None; A. Omma, None; D. Ersozlu Bakirli, None; C. Ozisler, None; E. Gonullu, None; S. Pehlevan, None; D. Solmaz, None; M. Cinar, None; G. Cetin, None; A. Tufan, None; M. Aydin Tufan, None; L. Kilic, None; S. Erten, None; T. Kasifoglu, None; S. Kobak, None; S. Senel, None; S. Akar, None; M. Ozgen, None; E. Kasapoglu-Gunal, None; V. Yazisiz, None; S. Yılmaz, None; S. Donmez, None; Dogan, None; H. Kart Koseoglu, None; F. Erbasan, None; F. Yildiz, None; C. Bes, None; A. Balkarli, None; A. Sahin, None; R. Mercan, None; F. Arslan, None; A. Dogru, None; S. Pay, None; S. Yavuz, None; N. Cakir, None; Y. Kabasakal, None; S. Z. Aydin, None.

To cite this abstract in AMA style:

Kalyoncu U, BayndÄ±r O, Yılmazer B, Dalkilic E, Aksu K, Oksuz MF, Tarhan EF, Can M, Kucuksahin O, Kimyon G, Akyol L, Onat AM, Kisacik B, Erden A, Omma A, Ersozlu Bakirli D, Ozisler C, Gonullu E, Pehlevan S, Solmaz D, Cinar M, Cetin G, Tufan A, Aydin Tufan M, Kilic L, Erten S, Kasifoglu T, Kobak S, Senel S, Akar S, Ozgen M, Kasapoglu-Gunal E, Yazisiz V, Yılmaz S, Donmez S, Dogan , Kart Koseoglu H, Erbasan F, Yildiz F, Bes C, Balkarli A, Sahin A, Mercan R, Arslan F, Dogru A, Pay S, Yavuz S, Cakir N, Kabasakal Y, Aydin SZ. Disease Activity Indices and Body Mass Index: Cross-Sectional Analysis of a Large Psoriatic Arthritis Cohort [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/disease-activity-indices-and-body-mass-index-cross-sectional-analysis-of-a-large-psoriatic-arthritis-cohort/. Accessed .

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