Physical inactivity and other cardiovascular risk factors in patients with psoriatic arthritis: Do we really "kill two birds with one stone" by managing inflammation?

INTRODUCTION

To evaluate physical activity (PA) levels in patients with psoriatic arthritis (PsA) and their associations with cardiovascular (CV) risk factors, psychosocial parameters, and functional status, and to identify distinct patient subgroups using latent class analysis.

MATERIAL AND

METHODS

In this cross-sectional study, 62 adults with PsA fulfilling Classification Criteria for Psoriatic Arthritis (CASPAR) were consecutively recruited from the Institute of Rheumatology. Physical activity was assessed using the International Physical Activity Questionnaire Short Form (IPAQ-SF) and categorized as low, moderate, or high. Cardiovascular risk factors, fatigue (Functional Assessment of Chronic Illness Therapy Fatigue Scale - FACIT-F), functional status (Health Assessment Questionnaire Disability Index - HAQ-DI), depression (Patient Health Questionnaire-9 - PHQ-9), anxiety (Beck Anxiety Inventory - BAI), kinesiophobia (Tampa Scale for Kinesiophobia - TSK), and sarcopenia risk (SARC-F) were evaluated. Disease activity was measured using the clinical Disease Activity Index for Psoriatic Arthritis (cDAPsA). Latent class analysis was applied to identify patient subgroups based on PA, comorbidities, and psychosocial variables.

RESULTS

Mean age was 44.5 ±10.3 years; 52% were female. Physical activity was low in 19.4%, moderate in 67.7%, and high in 12.9%. Lower PA was associated with older age (p = 0.04), higher fatigue (FACIT-F 29 ±7 vs. 43 ±6.4, p = 0.01), and greater disability (HAQ-DI 0.9 vs. 0.1, p = 0.03). The prevalence of obesity was 51.6% (n = 32), hypertension (HT) 23% (n = 16), dyslipidemia 30% (n = 19), and diabetes mellitus type 2 12.9% (n = 8). Latent class analysis identified two classes: class I - younger, predominantly female (56%), higher education (82%), moderate PA (75%), lower cardiometabolic burden (obesity 46%, HT 14%, dyslipidemia 10%), and lower psychosocial impact; class II - broader age range, male predominance (54%), lower PA (30% low, 60% moderate), higher cardiometabolic burden (HT 86%, obesity 56%, dyslipidemia 35%), greater kinesiophobia (74%), and sarcopenia risk (19%).

CONCLUSIONS

In PsA, low PA is associated with higher fatigue, functional impairment, and cardiometabolic and psychosocial burden. Latent class analysis revealed distinct subgroups, suggesting the need for personalized, multidisciplinary interventions targeting physical and psychological barriers. Integrating tailored PA promotion alongside pharmacological control may improve both joint and CV outcomes.