Metabolic syndrome more common in patients with psoriatic arthritis

[Fred]

Metabolic syndrome is significantly more common in patients with psoriatic arthritis than in those with rheumatoid arthritis, based on data from nearly 2,000 adults.

Previous studies have suggested that metabolic syndrome is associated with "a state of chronic, low-grade inflammation," said Dr. Asena Bahce-Altuntas of Albert Einstein College of Medicine in New York.

"Since psoriatic arthritis [PsA] is characterized by inflammation of both skin and joints, we may be underestimating this cardiovascular risk in PsA," she said at the annual meeting of the American College of Rheumatology.

To compare the prevalence of metabolic syndrome in patients with PsA versus rheumatoid arthritis (RA), Dr. Bahce-Altuntas and her colleagues used data from the Consortium of Rheumatology Researchers of North America (CORRONA) registry, a prospective, observational cohort including 4,014 patients with PsA and 25,976 patients with RA in academic and private practices throughout the United States. Lipid profile data were available for 1,956 patients from the CORRONA registry: 294 with PsA and 1,662 with RA.

Overall, 27% of PsA patients met criteria for metabolic syndrome, compared with 19% of RA patients. In addition, several specific components of metabolic syndrome were significantly more common in PsA patients.

In particular, significantly more PsA patients than RA patients had triglycerides greater than 150 mg/dL (38% vs. 28%).

Significantly more PsA patients than RA patients were male (54% vs. 23%, respectively), and the mean age was significantly greater in RA patients than in PsA patients (62 years vs. 56 years, respectively). However, after age, sex, and ethnicity were controlled for, the odds of metabolic syndrome remained significantly higher for PsA patients (odds ratio, 1.44).

Metabolic syndrome was defined as a body mass index greater than 30 kg/m2 and any two of the following criteria: triglycerides greater than 150 mg/dL, HDL less than 40 mg/dL for men or less than 50 mg/dL for women, a diagnosis of hypertension, or a diagnosis of diabetes.

In a subanalysis of obese patients (133 PsA patients and 654 RA patients with a BMI greater than 30), the prevalence of metabolic syndrome remained significantly higher in PsA patients (60%) than in RA patients (49%), as did the prevalence of patients with triglycerides greater than 150 mg/dL (51% vs. 39%).

The results suggest that metabolic syndrome and its components are significantly more common in PsA than in RA. "High triglycerides appear to drive the estimated increase in risk of metabolic syndrome in PsA vs. RA

[Caroline]

Now
Metabolic syndrome is the medical term for a combination of diabetes, high blood pressure (hypertension) and obesity. It puts you at greater risk of getting coronary heart disease, stroke and other conditions that affect the blood vessels.

So this means probably
1. Psoriasis / PsA patients are heavier… (at least than RA patients) but also on average
2. Have higher tryclicrides….(some kind of fat)

Now
Triglycerides are a type of fat (lipid) found in your blood.

When you eat, your body converts any calories it doesn't need to use right away into triglycerides. The triglycerides are stored in your fat cells. Later, hormones release triglycerides for energy between meals.

If you regularly eat more calories than you burn, particularly from high-carbohydrate foods, you may have high triglycerides (hypertriglyceridemia).

So in fact the last means that the patient is eating too much. 

Might this be a chicken and egg problem? Or is this reason more complex? 
Chicken and egg in the sense of what was first.. obesity and then psoriasis or psoriasis and then obesity. 

A complex reason for me would be… you have psoriasis in your younger years and this embarrasses you, and you start eating to compensate.

The definition of metabolic syndrome, does not really point to inflammation being the cause of the problems.

[Fred]

I didn't eat more in my younger days after being diagnosed, I ate more after giving up smoking.

For me psoriasis came first, I was very very fit but becoming so called "Obese" didn't come till my late 50s.

[Caroline]

I didn't eat more in my younger days after being diagnosed, I ate more after giving up smoking.

For me psoriasis came first, I was very very fit but becoming so called "Obese" didn't come till my late 50s.

Well.. I am certainly not obese myself. But I do know several people with psoriasis, who are thicker than normal.
But on the other side, I also know some very skinny people who have psoriasis…

Finally it are the numbers that count. … If you research the correct parameters.

[jiml]

I think you're right Caroline as I don't think we will ever know what came first as I think we are all so different and to do a study with 5 times as many RA patients than PsA in the study could well account for the higher percentage for PsA surely you need similar numbers of each to get an accurate comparison

[Fred]

I think you're right Caroline as I don't think we will ever know what came first as I think we are all so different and to do a study with 5 times as many RA patients than PsA in the study could well account for the higher percentage for PsA surely you need similar numbers of each to get an accurate comparison

You summed it up Jim "we are all different" we have seen for ourselves here at Psoriasis Club how different treatments work for some but not for others, we have members from all walks of life and we know just as well as the doctors and drug makers that psoriasis and psoriatic arthritis is next to impossible to keep under control for all of us.

[Caroline]

I think you're right Caroline as I don't think we will ever know what came first as I think we are all so different and to do a study with 5 times as many RA patients than PsA in the study could well account for the higher percentage for PsA surely you need similar numbers of each to get an accurate comparison

You summed it up Jim "we are all different" we have seen for ourselves here at Psoriasis Club how different treatments work for some but not for others, we have members from all walks of life and we know just as well as the doctors and drug makers that psoriasis and psoriatic arthritis is next to impossible to keep under control for all of us.

Very wise words gentlemen…