[Association of diabetes mellitus with high activity and radiographic progression of psoriatic arthritis].

BACKGROUND

Psoriatic arthritis (PsA) exhibits the greatest predisposition to the development of metabolic disorders compared to other inflammatory joint diseases, including those with a high risk of type 2 diabetes mellitus (T2DM).

AIM: To study the clinical and imaging characteristics of patients with PsA depending on the presence of DM.

MATERIALS AND

METHODS

This retrospective study included 309 patients (219 men and 90 women) with PsA. Patients were divided into subgroups based on the presence or absence of T2DM. A comparative analysis of quantitative and qualitative indicators, as well as a correction analysis, was conducted.

RESULTS

The proportion of patients with diabetes in the study sample was 13.9%. Patients with concomitant T2DM were characterized by a less frequent presence of advanced stages of sacroiliitis, but more often had a higher BASDAI index (Bath Ankylosing Spondylitis Disease Activity Index) (6.4±1.9 vs 5.4±1.5; p< 0.001), as well as a greater number of painful joints (13.0 [7.3; 20.0] vs 7.0 [3.0; 15.0]; p=0.01) and erythrocyte sedimentation rate level (25.0 [16.0; 40.0] vs 16.0 [6.0; 34.0]; p=0.02), more often had nail psoriasis, and were characterized by more advanced stages of functional impairment. Patients with T2DM were more likely to be currently receiving methotrexate, sulfasalazine, leflunomide, and nonsteroidal anti-inflammatory drugs, and were also more likely to have a history of intra-articular glucocorticoid administration with a comparable history of anti-cytokine therapy. Furthermore, patients with T2DM were more likely to be obese (25.0% vs 8.24%; p< 0.001) and have cardiovascular disease (72.09% vs 27.82%; p< 0.001).

CONCLUSION

The presence of diabetes was associated with higher PsA activity and radiographic progression.