Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, , Toronto, Ontario, Canada.
Ann Rheum Dis. 2013 Dec;72(12):1956-61. doi: 10.1136/annrheumdis-2012-202325. Epub 2012 Dec 14.
To compare the prevalence of metabolic syndrome (MetS) and the levels of related biomarkers in patients with psoriatic arthritis (PsA) and psoriasis without arthritis (PsC).
This study compared patients with PsA and patients with PsC. The presence of MetS was determined. Serum levels of insulin, adiponectin and leptin were measured. The homeostasis model assessment for insulin resistance (HOMA-IR) was calculated. HOMA-IR, adiponectin and leptin were log-transformed. Continuous variables were compared using the t test and the χ(2) test was used for discrete variables. Multivariate regression models were used to investigate the association of MetS and adiponectin with PsA compared to PsC after adjusting for potential confounding variables.
203 PsA and 155 PsC patients were analysed. The prevalence of MetS was higher in PsA patients compared to those with PsC. However, this did not reach statistical significance (36.5% vs 27.1%, p=0.056). The levels of adipokines were significantly higher in PsA compared to PsC: adiponectin (8.8±5.2 vs 7.4±4.5 log (µg/ml), p=0.009) and leptin in women (3.1±0.8 vs 2.8±0.8, log (ng/ml), p=0.04). HOMA-IR was also higher in PsA (0.97±0.63 vs 0.68±0.81, p<0.001). No difference was observed in leptin levels in men. In multivariate regression analysis, PsA (p=0.04) and the psoriasis area and severity index score (p=0.02) were associated with MetS. Adiponectin was significantly associated with PsA (p=0.005), the use of anti-tumour necrosis factor α therapy (p=0.03) and active joint count (p=0.001).
MetS and related adipokines correlated with an increased burden of skin and joint inflammation.
比较患有银屑病关节炎（PsA）和无关节炎银屑病（PsC）患者的代谢综合征（MetS）患病率和相关生物标志物水平。
本研究比较了 PsA 患者和 PsC 患者。确定 MetS 的存在。测量血清胰岛素、脂联素和瘦素水平。计算胰岛素抵抗的稳态模型评估（HOMA-IR）。对 HOMA-IR、脂联素和瘦素进行对数转换。使用 t 检验比较连续变量，使用 χ(2)检验比较离散变量。使用多变量回归模型，在调整潜在混杂变量后，调查与 PsC 相比，MetS 和脂联素与 PsA 的关联。
分析了 203 例 PsA 和 155 例 PsC 患者。与 PsC 患者相比，PsA 患者的 MetS 患病率更高，但无统计学意义（36.5% vs 27.1%，p=0.056）。与 PsC 相比，PsA 患者的脂联素水平显著更高：脂联素（8.8±5.2 vs 7.4±4.5 log（µg/ml），p=0.009）和女性的瘦素（3.1±0.8 vs 2.8±0.8，log（ng/ml），p=0.04）。HOMA-IR 也在 PsA 中更高（0.97±0.63 vs 0.68±0.81，p<0.001）。男性的瘦素水平无差异。在多变量回归分析中，PsA（p=0.04）和银屑病面积和严重程度指数评分（p=0.02）与 MetS 相关。脂联素与 PsA 显著相关（p=0.005）、使用抗肿瘤坏死因子-α 治疗（p=0.03）和活跃关节计数（p=0.001）。
MetS 和相关脂联素与皮肤和关节炎症负担增加相关。
