Psoriatic Arthritis Patients Face Higher Burden of Metabolic Syndrome, Meta-Analysis Shows
Sweden: A new meta-analysis published in Clinical Rheumatology highlights that individuals with psoriatic arthritis (PsA) face a significantly greater burden of metabolic syndrome (MetS) compared with the general population and patients with other inflammatory arthropathies such as rheumatoid arthritis (RA) and ankylosing spondylitis (AS).
The study, conducted by Sara Andreasson and Anna Södergren from the Department of Public Health and Clinical Medicine, Umeå University, Sweden, highlights the need for proactive screening and preventive strategies in PsA care.
The researchers systematically reviewed evidence from major databases, including Ovid Medline, Web of Science, and Scopus, up to February 2024. Out of 1,526 screened publications, 20 relevant studies were included in the final analysis. A random-effects model was used to assess prevalence, and funnel plots were used to evaluate potential bias.
The study revealed the following findings:
- PsA patients had higher odds of developing metabolic syndrome compared to the general population (LogOR 0.93).
- The risk of metabolic syndrome was greater in PsA patients than in those with rheumatoid arthritis (LogOR 0.63).
- PsA patients also had a higher prevalence of metabolic syndrome than ankylosing spondylitis patients (LogOR 1.04).
- The prevalence of metabolic syndrome in PsA was similar to that seen in cutaneous psoriasis (LogOR 0.15).
- PsA patients showed increased risks of central obesity, hypertriglyceridemia, impaired glucose tolerance, and diabetes mellitus compared with rheumatoid arthritis patients.
The study emphasizes that MetS—a cluster of conditions including abdominal obesity, dyslipidemia, hypertension, and glucose intolerance—significantly contributes to cardiovascular morbidity. The overlap between psoriatic disease pathways, obesity, and endothelial dysfunction may partly explain why PsA patients are particularly vulnerable.
While the findings strongly support intensified monitoring of metabolic health in PsA patients, the authors acknowledged several limitations. Few studies matched participants for age and sex, sample sizes varied widely, and outcome measures were inconsistent. High heterogeneity was observed in some analyses, and a potential publication bias was suggested, particularly in comparisons between PsA and PsO. Moreover, limited data prevented detailed evaluation of MetS components in PsA versus PsO, AS, and general population groups.
Despite these challenges, the meta-analysis reinforces the importance of incorporating cardiovascular risk assessment into routine PsA management. According to the authors, understanding how disease activity, systemic inflammation, and antirheumatic treatments influence MetS development remains an area requiring further research.
“PsA was consistently associated with a higher prevalence of metabolic syndrome compared to the general population, RA, and AS. This highlights the need for systematic screening and early intervention to reduce long-term cardiovascular risks in these patients,” the study noted.
"The results add to growing evidence that comprehensive PsA care should extend beyond joint and skin manifestations to address broader metabolic and cardiovascular health. Proactive measures, including lifestyle modification, treatment of metabolic risk factors, and achieving minimal disease activity, could play a key role in reducing complications for this vulnerable patient population," the authors concluded.
Reference:
Andreasson, S., Södergren, A. Prevalence of metabolic syndrome and its components in psoriatic arthritis compared with general population, cutaneous psoriasis, and other inflammatory arthropathies: a meta-analysis. Clin Rheumatol (2025). https://doi.org/10.1007/s10067-025-07637-z
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