Metabolic syndrome (MetS) affects patients with psoriatic arthritis (PsA) and rheumatoid arthritis (RA) differently, with the cardiovascular risk being stronger in PsA compared with RA, according to a study published in the Journal of Clinical Medicine.
Previous studies have revealed a higher prevalence of all CV risk factors in PsA patients, whereas only diabetes and obesity were found to be increased in RA. However, whether MetS clinical presentation and their components were comparable across both conditions remains unclear.
For this study, Dr. Fabiola Atzeni and colleagues compared MetS prevalence and impact on the CV risk in PsA to RA. Their study included 170 patients referred to a Rheumatology clinic. Of the participants, 78 had PsA, and 92 had RA. The researchers looked at their mean age at diagnosis, disease duration, presence of MetS, and other risk factors.
The researchers observed that although most variables were comparable, patients in the PsA cohort were younger and reported a shorter disease duration. Twice as many PsA patients also reported the presence of MetS than PsA (51.3% vs 27.2%), and almost three times as many patients in the PsA cohort had dyslipidemia than PsA (71.8% vs 28.3%). The history of cardiovascular events was comparable between both groups.
The study revealed hypertension and metabolic syndrome are both risk factors for cardiovascular events (CV events) in people with PsA, but dyslipidemia is a risk factor significantly associated with CV events in people with RA.
Generally, the association between traditional risk factors of MetS (older age, male gender, smoking, hypertension, dyslipidemia, and diabetes) with CV events is stronger in PsA than in RA. This is supported by the fact that the coefficient of determination (R^2) is greater in the PsA cohort than in the RA cohort (0.70 vs 0.30).
“These findings are relevant for clinical practice as a disease-specific management of cardiovascular risk may be required in distinct chronic inflammatory diseases of the joints,” the researchers concluded. “However, clinical validation in larger studies is needed. Further efforts are required to develop disease-specific strategies for managing cardiovascular risk in PsA and RA.”
Journal Source: Journal of Clinical Medicine