Background Psoriatic arthritis (PsA) patients (pts) have increased cardiovascular morbidity, metabolic disorders and mortality. The reasons of accelerated atherosclerosis are still unknown. Metabolic syndrome (MetS) is a claster of cardiovascular disease (CVD) risk factors - abdominal obesity, dyslipidemia; insulin resistance and hypertension. There have been limited data evaluating association of MetS, body mass index (BMI), PsA activity and subclinical carotid atherosclerosis in different population of PsA pts.
Objectives To evaluate prevalence and relationship of MetS, subclinical carotid atherosclerosis, BMI, disease activity and duration in PsA pts.
Methods 128 (F.-79) with PsA, according to the CASPAR criteria, mean age 43 [34;49] years (yrs.), PsA duration - 7 [3;13] yrs., Psoriasis duration -15 [6; 26] yrs., mean body mass index (BMI) – 26.4 [23.5;29.4], DAS 3.86 [2.72;5.14] without any signs of CVD were included. All pts underwent standard clinical examination. MetS was defined using by IDF new criteria: central obesity defined as waist circumference (abdominal obesity) ≥94cm for Europid M. and ≥80cm for F. plus any two of the following: elevated triglycerides (TGs) ≥150mg/dl or specific treatment for this lipid abnormalities; reduced high-density lipoprotein cholesterol (HDL) as <40mg/dl in M. and <50mg/dl in F. or specific treatment for this lipid abnormalities, elevated blood pressure (BP) (systolic BP≥130 or diastolic BP≥85 mm Hg or treatment for hypertension), raised fasting plasma glucose (FPG) ≥100 mg/dl or previously diagnosed type 2 diabetes. Carotid intima-media thickness (cIMT) was measured using a high-resolution B-mode ultrasound machine. Subclinical atherosclerosis was defined as mean cIMT>0.9mm.
Results MetS was found in 49 out of the 128 pts (38.3%). Large waist circumference (abdominal obesity) was found in 72 out of the 128 pts (56.3%), low HDL - in 65 out the 128 pts (50.8%), elevated TGs - in 12 out the 128 pts (9.4%), high systolic BP - in 32 out of the 128 pts (25%), raised FPG – in 8 out of 128 pts (6.25%). PsA pts with MetS had a significantly higher PsA activity compare to those without MetS by DAS - 4,4 [3,2; 5,6]/3,6 [2,5;4,7] accordingly, p=0,02. PsA pts with MetS had a significantly higher BMI compare to those without MetS – 29.1 [27.9;33.2]/24.5 [21.6;26.6], accordingly, p<0.0001. Subclinical carotid atherosclerosis was found in 65 out of 128 pts (51%). PsA pts with MetS had a significantly higher cIMT compare to those without MetS – 0.94 [0.84;1.03]/0.84 [0.75;0.94] accordingly, p<0.0001. Significantly correlations were observed between cIMT and abdominal obesity (R=0.41, p<0,0001), BP (R=0.41, p<0.0001), TG (R=0.36, p<0.0001), BMI (R=0.40, p<0.0001) and PsA duration (R=0.18, p<0.03).
Conclusions MetS was found in nearly half of PsA pts with a tendency towards abdominal obesity, dyslipidemia and arterial hyperthension. MetS in most cases was found in PsA pts with high disease activity. The components of MetS such as abdominal obesity, hyperthension, dyslipidemia, high BMI and PsA duration are highly related to the development of subclinical carotid atherosclerosis in PsA pts.
Disclosure of Interest None declared