Obese Adults Face Higher Risk of Psoriatic Arthritis
Adults who suffer from psoriasis and are obese may face a higher risk of developing psoriatic arthritis (PsA) as they grow older. Psoriatic arthritis shares some clinical features with rheumatoid arthritis, both leading to joint destruction and significant morbidity.
Razieh Soltani-Arabshahi MD of the University of Utah School of Medicine evaluated 943 study participants enrolled in the Utah Psoriasis Initiative between November 2002 and October 2008, all of whom had psoriasis confirmed by a dermatologist. Slightly over 50% of the participants were women (50.2%). BMI was based on the participants’ self-reported height and weight at age 18 and at the time of enrollment in the study.
Each unit increase in BMI at age 18 was associated with a 5.3% increased risk of developing psoriatic arthritis. Patients who were obese at that age were three times more likely to develop arthritis than those of normal weight.
The researchers also found that 20% of the overweight or obese participants developed psoriatic arthritis by age 35, compared with those with a normal BMI who did not develop PsA until age 48. Being younger when psoriasis first occurred, being female and having larger body surfaces affected with psoriasis was also predictive of who would develop psoriatic arthritis at a younger age.
Psoriatic arthritis affects between 6 and 42% of patients with psoriasis. It may be mild and involve only a few joints, but in some it is severe, even affecting the bones in the spine. In an accompanying editorial to the study, Alexis Ogdie MD and Joel M. Gelfand MD, both of the University of Pennsylvania Hospital, note that PsA symptoms often do not surface until years after the development of psoriasis.
The authors conclude that their findings, "support a growing concept that patients more prone to psoriatic arthritis might benefit from more frequent and meticulous screening measures for early detection and treatment of psoriatic arthritis, i.e., before the development of irreversible joint destruction." PsA patients are also at increased risk for cardiovascular disease.
Soltani-Arabshahi R, et al "Obesity in early adulthood as a risk factor for psoriatic arthritis"Arch Dermatol 2010; 146: 721-726.
Ogdie A, Gelfand J "Identification of risk factors for psoriatic arthritis: scientific opportunity meets clinical need" Arch Dermatol 2010; 146: 785-788.