From the Medicine and Rheumatology Unit, Dipartimento di Patologie Ortopediche Complesse.
Clinical Trial Center, Direzione Scientifica, IRCCS Istituto Ortopedico Rizzoli, Bologna.
J Clin Rheumatol. 2022 Mar 1;28(2):e324-e329. doi: 10.1097/RHU.0000000000001706.
Psoriatic arthritis (PsA) is burdened by an increased susceptibility to cardiovascular diseases. Comorbid diabetes may represent one of the key factors contributing to this risk. The aim of our medical records review study was to investigate the prevalence of type 2 diabetes (T2D) and type 1 diabetes (T1D) in an Italian PsA cohort.
The clinical records of all patients consecutively seen at our clinic with a diagnosis of PsA during a 12-month period were reviewed to identify comorbid T2D or T1D. For comparison, a 1:1 age- and sex-matched group of individuals with noninflammatory diseases was recruited.
The final study cohort comprised 408 patients. The prevalence of T2D was 7.8% (95% confidence interval, 5.6-10.8) in PsA and 4.4% in controls (95% confidence interval, 2.8-6.9; p = 0.04). Two cases (0.49%) of T1D were identified in the PsA cohort, whereas no cases were observed in controls. In a multivariate logistic regression model including age, disease duration, and body mass index (BMI) as covariates, increasing age (odds ratio [OR], 1.079; p = 0.006) and BMI (OR, 1.188; p = 0.011) but not PsA duration predicted being classified as having T2D. In a similar model accounting for age and BMI, average disease activity score including 28 joints and C-reactive protein showed a trend toward significance (OR, 1.639; p = 0.066).
In conclusion, our data provide further support to the emerging evidence of an increased risk of T2D in PsA patients. Cardiometabolic comorbidity represents a significant aspect of integrated arthritis management to improve long-term cardiovascular outcomes and to provide a comprehensive treatment.
银屑病关节炎（PsA）易患心血管疾病。合并糖尿病可能是导致这种风险的关键因素之一。我们的病历回顾研究旨在调查意大利 PsA 队列中 2 型糖尿病（T2D）和 1 型糖尿病（T1D）的患病率。
回顾性分析了我们诊所 12 个月内连续诊断为 PsA 的所有患者的临床记录，以确定合并 T2D 或 T1D。为了比较，招募了一组年龄和性别相匹配的非炎症性疾病患者。
最终研究队列包括 408 例患者。PsA 患者 T2D 的患病率为 7.8%（95%置信区间，5.6-10.8），对照组为 4.4%（95%置信区间，2.8-6.9；p=0.04）。在 PsA 队列中发现了 2 例（0.49%）T1D，而对照组中没有发现。在包括年龄、疾病持续时间和体重指数（BMI）作为协变量的多变量逻辑回归模型中，年龄增加（比值比[OR]，1.079；p=0.006）和 BMI（OR，1.188；p=0.011），而不是 PsA 持续时间，可预测被归类为患有 T2D。在一个考虑年龄和 BMI 的类似模型中，包括 28 个关节和 C 反应蛋白的平均疾病活动评分显示出显著趋势（OR，1.639；p=0.066）。
总之，我们的数据为 PsA 患者 T2D 风险增加的新证据提供了进一步支持。心血管代谢合并症是关节炎综合管理的重要方面，可改善长期心血管结局并提供全面治疗。
