AB0762 METABOLIC SYNDROME IN EGYPTIAN PSORIATIC ARTHRITIS PATIENTS.
Authors: M. Imam, M. Helal, M. Hassan, E. Hassan, S. Essam
Journal: Annals of the Rheumatic Diseases (2020)

Background: Psoriatic arthritis (PsA) is a chronic inflammatory arthritis affecting 20:30% of patients with skin Psoriasis (PsO). It is strongly associated with obesity, particularly excess visceral adiposity, which leads to insulin resistance, hyperglycemia, dyslipidemia, and hypertension (HTN). All the previous findings are grouped in Metabolic Syndrome (MetS) which increase the risk of development of Type 2 diabetes mellitus (T2DM) by five folds and cardiovascular disease (CVD) by two folds. Objectives: The aim of this work was to define those who fulfill MetS criteria in PsA patients thus of greater risk to develop CVD and T2DM. Methods: Fifty PsA patients diagnosed according to the CASPAR criteria and 50 matched healthy controls were included in this study. All patients were subjected to thorough clinical evaluation of the musculoskeletal system. The disease activity was assessed by DAPSA and BASDAI. Skin severity was assessed by the PASI. Disability assessment was done by the HAQ-DI. Laboratory investigations included: CRP, uric acid and diabetic profile (including HOMA-IR ) and lipid profile in patients and control subjects. Subjects were defined as having MetS according to International Diabetes Federation (IDF) criteria: Abdominal obesity was measured by Waist circumference (WC) for Egyptian cutoffs values (WC&gt;100.5 cm in men and &gt;96.25 cm in women).The subjects must have central obesity to identify MetS plus any two of the following four factors: 1) Raised triglycerides level (TG) ≥ 150 mg/dL or on specific treatment. 2) Reduced levels of high-density lipoprotein cholesterol (HDL &lt;40 mg/dL in males and &lt;50mg/dL in females or on specific treatment. 3) HTN: (systolic: ≥130mm H g or diastolic: ≥ 85 mm Hg) or on treatment for HTN. 4) Raised fasting glucose levels (≥ 100 mg/dL), or previously diagnosed T2DM. Results: Metabolic syndrome was significantly higher among PsA patients than control group (42% Vs 16% respectively). Regarding frequency of MetS components, obesity was the highest component among PsA patients (62%) as illustrated in Figure 1. CRP mean level was significantly higher in PsA patients compared to control group with p &lt;0.001 * . CRP serum level showed a positive significant correlation with DAPSA score and HOMA-IR (P= 0.031, 0.002 respectively) Correlations between MetS components and (disease activity, skin severity and physical function) are shown in Table 1. Conclusion: 1-There is high frequency of MetS in PsA patients compared to control group. 2- Obesity and DMT2 were the most common components of MetS. References: [1]Eder L, Harvey P, Chandran V, Rosen CF, Dutz J, Elder JT, et al. Gaps in diagnosis and treatment of cardiovascular risk factors in patients with psoriatic disease: an international multicenter study. The Journal of rheumatology. 2018:jrheum. 170379. [2]Alberti KGMM, Zimmet P, Shaw J. Metabolic syndrome—a new world-wide definition. A consensus statement from the international diabetes federation. Diabetic medicine. 2006;23(5):469-80. Psoriatic Arthritis Metabolic syndrome WC BMI TG HDL FBS HOMA-IR Systolic BP Diastolic BP DAPSA r s -0.233 0.081 0.086 -0.116 0.263 0.387 0.136 -0.170 P 0.308 0.728 0.710 0.616 0.250 0.083 0.557 0.462 BASDAI r s 0.798 * 0.152 0.060 -0.110 -0.424 -0.294 0.168 -0.027 P &lt;0.001 * 0.509 0.798 0.636 0.055 0.196 0.467 0.906 PASI r s 0.435 * 0.226 0.363 -0.521 * -0.276 -0.253 -0.054 -0.060 P 0.049 * 0.324 0.106 0.015 * 0.227 0.268 0.818 0.795 HAQ-DI r s 0.189 0.176 0.168 -0.286 -0.240 -0.184 -0.343 -0.276 P 0.413 0.445 0.466 0.209 0.295 0.424 0.128 0.225 Disclosure of Interests: None declared