Background/Purpose:   Epidemiological studies have found a high prevalence of obesity in patients with Psoriatic Arthritis (PsA). It was described the association between obesity and severity of psoriasis, but the relationship to the severity of PsA has been less studied. Our purpose was to assess the prevalence of obesity in a cohort of patients with PsA and its association with clinical and sociodemographic characteristics

Methods:   PsA patients ≥18 years old according to CASPAR criteria, belonging to RAPSODIA (Registro de Artritis Psoriásica, IREP Argentina) cohort were included. Socio-demographic data, disease duration, type of onset and evolution of PsA, comorbidities, acute phase reactants and lipid profile were collected. Treatment data were collected through direct interview with the patient, complementing with medical history. 66 tender and 68 swollen joints count, enthesitis (MASES), presence of dactilitis, cutaneous (PASI) and nail involvement (PNSS) were evaluated. Disease activity (BASDAI), functional capacity (HAQ, BASFI), quality of life (DLQI, PsAQoL) questionnaires were completed. DAS28, DAPSA and MDA (Minimal Disease Activity) composite indexes were calculated. Visual analog scale (VAS) was used to grade severity of skin psoriasis, pain and patient and physician global assessment of disease activity. Height (cm), weight (kg) and blood pressure (mm Hg) were measured. BMI was calculated. Patients were classified according to WHO in normal (BMI 18.5-24.9), overweight (BMI 25-30) and obesity (BMI ≥30). Obesity was classified as grade I or mild (BMI 30-34.9), grade II or moderate (BMI 35-39.9) and grade III or severe (BMI ≥40). Statistical analysis: Descriptive statistics. T test and ANOVA. Chi² and Fisher exact test. Multiple logistic regression (dependent variable: obesity). Univariate general linear model.

Results:  110 patients were included, 56 (50.9%) were men, median age 55 years (IQR 44.7-63.2) and median disease duration of PsA 10 years (IQR 6-17) and median duration of psoriasis was 24 years (IQR: 15.5-33.9). 19 patients (17.3%) met MDA. The median BMI was 28.4 (IQR 15.5-32.2). 23 patients (19.1%) had normal BMI, 48 (43.6%) overweight and 41 (37.3%) obesity. Of obese patients, 33 (80.5%) had mild obesity, 6 (14.6%) moderate and 2 (4.9%) severe. Obese patients had worse functional capacity that patients with normal weight (BASFI 4.4 ±2.8 vs 2.7± 2.5, p = 0.03) and higher pain (VAS 6.7 ±7.6 vs 4.6 ±2.4, p = 0.05). PASI score was higher in obese vs patients with normal BMI (2.8 ±2.9 vs 1.6± 1.7, p= 0.02). There were no differences according to sex, age, comorbidities, laboratory variables, disease duration, or extension of joint involvement. Obese patients had received steroid treatment more frequently in the past, but at the time of study evaluation no differences in treatment were observed. Type II diabetes was significantly more frequent in obese patients 16 vs 0 (p=0.03).

Conclusion:  We observed that 81% of PsA patients are overweight or obese. The presence of obesity was associated with higher level of pain, greater skin involvement and worse functional capacity

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/prevalence-of-obesity-in-patients-with-psoriatic-arthritis-and-its-impact-on-the-severity-of-the-disease/