Sex-specific associations between nutritional status, disease activity, and fatigue in psoriatic arthritis: a cross-sectional analysis.

OBJECTIVE

The purpose of this study was to evaluate the relationship between nutritional status-assessed by the Controlling Nutritional Status (CONUT) score-and disease activity, fatigue, and sleep quality in patients with psoriatic arthritis (PsA), with attention to sex-specific differences.

METHODS

113 adults with PsA were included in this cross-sectional study. Nutritional status was classified as normal (CONUT 0-1) or malnutrition (CONUT ≥ 2). Disease activity was assessed using the Disease Activity in Psoriatic Arthritis (DAPSA) score, fatigue using the Fatigue Severity Scale (FSS), and sleep quality using the Jenkins Sleep Scale (JSS). Correlation and ROC analyses were performed.

RESULTS

Malnutrition was identified in 18.6% of patients. Compared to those with normal nutritional status, malnourished patients had higher CRP (12.8 vs. 6.4 mg/L, p = 0.012) and lower albumin and lymphocyte levels (p < 0.001). High disease activity (DAPSA > 28) was more common in the malnutrition group (38.1% vs. 15.2%, p = 0.029). The CONUT score correlated with DAPSA (Rho = 0.327, p < 0.001), CRP (Rho = 0.422, p < 0.001), and fatigue severity (Rho = 0.186, p = 0.048). No association was observed with sleep quality. ROC analysis showed that CONUT ≥ 2 predicted high disease activity (AUC 0.70). In sex-stratified analyses, correlations with DAPSA and fatigue were present only in females.

CONCLUSION

Higher CONUT scores were associated with greater disease activity and fatigue among patients with psoriatic arthritis. These results underscore the potential value of incorporating routine nutritional evaluation into the comprehensive management of PsA.