Metabolic Syndrome in Psoriatic Arthritis Linked to Degenerative Spine and heel issues: Study

A new study published in the journal of Arthritis Care and Research revelaed that metabolic syndrome is associated with calcaneal spurs, diffuse idiopathic skeletal hyperostosis, and degenerative disc disease, but not with radiographic axial or peripheral joint damage. 

In 24% of cases, psoriatic arthritis (PsA), a complicated inflammatory illness with diverse clinical characteristics, exacerbates psoriasis. Peripheral arthritis, enthesitis, dactylitis, spondylitis, and sacroiliitis are musculoskeletal symptoms of PsA. The co-occurrence of recognized cardiovascular risk factors, such as insulin resistance, obesity, atherogenic dyslipidemia, and hypertension, is commonly referred to as metabolic syndrome, despite the fact that it has several definitions. These have a lot in common, including pathophysiologic processes, routes, and mediators.

Given that inflammation mediates joint deterioration in PsA, it is reasonable to assume that individuals with MetS experience more radiographic progression. Only a small number of research, with conflicting findings, have looked into this link. Thus, this study investigated the relationship between MetS and axial and peripheral radiographic characteristics in PsA.

Patients with PsA who were monitored at this prospective observational cohort from 1978 to 2024 were included. After controlling for age, sex, the duration of PsA disease, calendar decade, and the use of specific disease-modifying antirheumatic medications, researchers used generalized estimating equations (GEE) analysis to identify the radiographic features independently associated with MetS in patients with MetS on longitudinal follow-up.

A total of 1,422 patients made up the study population where 400 (28.1%) of them had MetS at baseline (clinic entrance), and 836 (58.79%) had a record of MetS during a median follow-up period of 10.59 (interquartile range 4.52–18.28) years. The group at baseline had a mean (SD) age of 44.43 (12.98) years, and 789 patients (55.5%) identified as male. 28.79 (6.36) kg/m2 was the mean (SD) body mass index.

MetS did not substantially correlate with either axial disease or radiographic damage to peripheral joints, as measured by the radiographic damaged joint count or the presence of syndesmophytes or sacroiliitis, respectively, in the GEE study. Conversely, degenerative disc disease, widespread idiopathic skeletal hyperostosis, and calcaneal spurs were all substantially linked to MetS.

Overall, MetS is not linked to radiographic damage in PsA, but it is linked to metabolic and degenerative alterations in the spine and entheses.

Source:

Kharouf, F., Gao, S., Tunc, S. E., Ye, J. Y., Pereira, D., Gladman, D. D., & Chandran, V. (2025). Association between metabolic syndrome and radiographic changes in psoriatic arthritis: A cohort study. Arthritis Care & Research. https://doi.org/10.1002/acr.25513