Aljohani Roaa
Department of Medicine, College of Medicine, Taibah University, Madinah, Saudi Arabia.
Open Access Rheumatol. 2022 Feb 17;14:7-16. doi: 10.2147/OARRR.S347797. eCollection 2022.
Psoriatic arthritis (PsA) is a well-known inflammatory disorder with a wide variety of phenotypes that extend beyond the joints. It has been defined as an immune-mediated disorder in which Th-1 and Th-17 cells play a key role. It has been associated with an elevated risk of metabolic syndrome (MetS), which is characterized by abdominal obesity, hypertension, hyperglycemia, and hyperlipidemia. While the exact pathophysiology of the link between PsA and MetS has yet to be precisely determined, persistence of inflammatory abnormalities, with overexpression of pro-inflammatory cytokines, might be the cause. Studies have consistently emphasized the strong association between elevated risk of developing cardiovascular disease and MetS in individuals with underlying PsA. The literature has also shown an association between the increased PsA severity and the increased frequency of MetS components. This association has important clinical consequences when treating patients with PsA. Therefore, screening programs should be implemented for PsA patients to evaluate whether they have MetS, and appropriate treatment should be given to manage cardiometabolic risk factors. Patients should also be closely monitored for potential adverse treatment effects on co-morbidities. This article summarizes the evidence of associations between several components of MetS and PsA and analyzes the impact of treatment on these factors.
银屑病关节炎（PsA）是一种众所周知的炎症性疾病，具有多种超出关节范围的表型。它被定义为一种免疫介导的疾病，其中Th-1和Th-17细胞起关键作用。它与代谢综合征（MetS）风险升高有关，代谢综合征的特征是腹部肥胖、高血压、高血糖和高脂血症。虽然PsA与MetS之间联系的确切病理生理学尚未精确确定，但炎症异常的持续存在以及促炎细胞因子的过度表达可能是原因。研究一直强调，患有潜在PsA的个体发生心血管疾病的风险升高与MetS之间存在密切关联。文献还表明，PsA严重程度增加与MetS各组分的频率增加之间存在关联。这种关联在治疗PsA患者时具有重要的临床意义。因此，应该为PsA患者实施筛查计划，以评估他们是否患有MetS，并应给予适当治疗以管理心脏代谢危险因素。还应密切监测患者治疗对合并症的潜在不良影响。本文总结了MetS的几个组分与PsA之间关联的证据，并分析了治疗对这些因素的影响。
