Central Obesity Linked to Higher Disease Severity in Psoriatic Arthritis: Study
Researchers have found in a new study that central obesity is a sole predictor of disease severity and disability among persons with psoriatic arthritis (PsA). The research concluded that higher waist circumference patients not only have enhanced inflammatory activity but also poorer physical and psychosocial results, such as fatigue, depression, and disability. The study was published in the journal Frontiers in Medicine by Salvatore C. and colleagues.
Psoriatic arthritis is a chronic inflammatory condition of joints and entheses, frequently associated with psoriasis. The main aim was to evaluate the correlation between central obesity and a range of disease-related, functional, and patient-reported outcomes (PROMs) across a real-world PsA population. It sought to establish whether central obesity had an independent effect on disease activity, inflammation, and disease burden overall after accounting for demographic and treatment variables.
This was a cross-sectional observational study done in a tertiary rheumatology outpatient clinic. Adult PsA patients were diagnosed using the CASPAR (Classification Criteria for Psoriatic Arthritis) criteria and were evaluated in detail by a multidisciplinary team of rheumatologists, dermatologists, and physiotherapists.
Data gathered included:
Clinical and pharmacologic history
Anthropometric measurements like waist circumference and BMI
Disease activity indices: DAPSA (Disease Activity in Psoriatic Arthritis) and CRP (C-reactive protein)
Patient-reported outcome measures (PROMs): FACIT-F (fatigue), PHQ-9 (depression), HAQ (disability), and PsAID (disease impact)
Central obesity was operationally defined based on waist circumference cutoffs of ≥88 cm in women and ≥102 cm in men. Multivariable regression models were employed to examine associations between central obesity and disease outcomes after adjustment for age, sex, disease duration, and antirheumatic treatments.
Key Findings
Total patients: 158 (54.4% female; median age 55.4 years)
Prevalence of central obesity: 70.2%
Inflammatory activity: Increased CRP levels in centrally obese patients
Disease activity: Increased DAPSA scores in obese patients
Patient-reported outcomes:
Increased fatigue (FACIT-F)
Increased depression scores (PHQ-9)
Increased disability (HAQ)
Worse disease impact (PsAID)
Adjusted analysis: Independent of demographics and treatment, central obesity predicted increased disease activity and poorer PROMs.
This research proved that central obesity is an important and independent predictor of increased disease activity, inflammation, and patient-reported disability in psoriatic arthritis. The results highlight the value of the routine assessment of waist circumference in PsA management and propose that addressing visceral adiposity will enhance inflammatory and quality-of-life outcomes in those affected.
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