Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.


Increased Prevalence of Metabolic Syndrome and Higher Serum Leptin Levels in Patients with Psoriatic Arthritis.

Zisman1,  Devy, Nissan1,  S., Eder1,  Lihi, Feld1,  J., Rahat1,  M.A, Elias1,  Muna, Rimar1,  D.

Carmel Medical Center, Haifa, Israel
Carmel Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine Technion, Haifa, Israel

Background/Purpose:

To evaluate the prevalence of metabolic syndrome (MeS) in patients with psoriatic arthritis (PsA) compared to the general population and to determine its association with clinical biomarkers of inflammation and serum levels of pro- and anti-atherogenic adipokines.

Methods:

Patients with PsA from a rheumatology clinic who met the CASPAR criteria were compared to control subjects without psoriasis and inflammatory rheumatic diseases, all of who were followed in a community clinic. All patients were interviewed regarding demographic data, concomitant diseases, medical treatment, smoking, physical activity and alcohol consumption. Blood pressure, body mass index (BMI), waist circumference and disease activity parameters were measured. Laboratory evaluation included fasting blood glucose level and lipid profile. The presence of MeS was determined according to the definition of the International Diabetes Federation criteria. Serum adiponectin and leptin levels were analyzed in 32 individuals in each group by ELISA. Continuous variables were compared by t-test, and a Chi square test was used for comparing discrete variables. Multivariate regression models compared the association of MeS, leptin and adiponectin with PsA in comparison to controls, after adjusting for potential confounders.

Results:

74 patients with PsA (average age of 57.6 years) were compared to 82 controls. The groups were comparable with regard to age, gender, smoking status, alcohol consumption, and physical activity, as well as personal and family history of atherosclerotic heart disease, hypertension, diabetes mellitus and hyperlipidemia. BMI was higher in PsA patients compared to the control group (29.6 vs. 27.8, p=0.04).

The prevalence of MeS was higher in PsA patients compared to the control group (54.8% vs. 36.6%, p=0.02). The difference remained statistically significant after adjustment for age, gender, ethnicity and smoking status (Odds Ratio=2.33, 95% confidence interval 1.16–4.69). No association was found between the occurrence of MeS and parameters of articular disease activity, severity of skin manifestation or treatment (anti TNFa agents, classical Disease Modifying Anti Rheumatic Drugs, steroids and non-steroidal anti inflammatory agents).

Leptin levels and leptin/adiponectin ratio were higher in PsA patients compared to controls (83.4 ng/ml vs. 51.7 ng/ml, p=0.001 and 6.3×10-3 vs. 4.1×10-3, p=0.015, respectively). These differences remained statistically significant after adjustment for age and gender.

Conclusion:

A higher prevalence of MeS was found in patients with PsA compared to the general population, accompanied by an increase in plasma concentration of leptin, the pro-atherogenic factor and the leptin/adiponectin ratio, thus pointing to an increased risk of vascular morbidity in PsA patients.

To cite this abstract, please use the following information:
Zisman, Devy, Nissan, S., Eder, Lihi, Feld, J., Rahat, M.A, Elias, Muna, et al; Increased Prevalence of Metabolic Syndrome and Higher Serum Leptin Levels in Patients with Psoriatic Arthritis. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1868
DOI:

Abstract Supplement

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