Yuliasih Yuliasih, Handoyo Martino, Rahmawati Lita Diah, Wibisono Sony, Nisa Nabilatun
Rheumatology Division of Internal Medicine Department, Faculty of Medicine, Airlangga University, Surabaya, Indonesia.
Immunology, Postgraduate School, Universitas Airlangga, Surabaya, Indonesia.
J Psoriasis Psoriatic Arthritis. 2023 Oct;8(4):129-133. doi: 10.1177/24755303231180508. Epub 2023 May 31.
Most psoriatic arthritis (PsA) research and studies focus solely on the skin and joint manifestations, but there is also an increased risk of metabolic disorders, including insulin resistance (IR). This study aims to discover the relationship between IR and disease activity (DA) in PsA and its phenotype.
Patients with PsA classified using the CASPAR criteria with the disease activity was measured using the DAPSA score, and IR was identified as an elevated HOMA-IR of >2.5. The disease phenotype was determined with Moll and Wright's classification of the PsA subtype. The Pearson correlation test examined the relationship between DA and IR. The descriptive analysis was conducted to determine the relationship between the DAPSA score and HOMA-IR value in each PsA phenotype. All tests were two-tailed, analysed with GraphPad Prism 9, and a -value of less than .05 was considered statistically significant.
From thirty-one patients, there was a strong and positive relationship between DA and IR (r = .768, = .000). We also observed variations in DAPSA score and HOMA-IR value across different phenotypes, with symmetrical polyarthritis exhibiting the highest DAPSA score (21.55 ± 3.50) and HOMA-IR value (2.913 ± .5392) despite asymmetrical oligoarthritis that being the most frequent phenotype.
Our study revealed a significant association between disease activity and insulin resistance in PsA patients, with the symmetrical polyarthritis phenotype demonstrating the highest levels of DAPSA score and IR value. This finding allowed rheumatologists to behold this manifestation and could improve PsA patients' long-term outlook.
大多数银屑病关节炎(PsA)研究仅关注皮肤和关节表现,但代谢紊乱风险也会增加,包括胰岛素抵抗(IR)。本研究旨在发现PsA中IR与疾病活动度(DA)及其表型之间的关系。
使用CASPAR标准对PsA患者进行分类,采用DAPSA评分测量疾病活动度,将IR定义为空腹胰岛素抵抗稳态模型评估(HOMA-IR)>2.5。根据Moll和Wright对PsA亚型的分类确定疾病表型。采用Pearson相关检验分析DA与IR之间的关系。进行描述性分析以确定各PsA表型中DAPSA评分与HOMA-IR值之间的关系。所有检验均为双侧检验,使用GraphPad Prism 9进行分析,P值小于0.05被认为具有统计学意义。
在31例患者中,DA与IR之间存在强正相关(r = 0.768,P = 0.000)。我们还观察到不同表型的DAPSA评分和HOMA-IR值存在差异,尽管非对称性少关节炎是最常见的表型,但对称性多关节炎的DAPSA评分(21.55±3.50)和HOMA-IR值(2.913±0.5392)最高。
我们的研究揭示了PsA患者疾病活动度与胰岛素抵抗之间存在显著关联,对称性多关节炎表型的DAPSA评分和IR值最高。这一发现使风湿病学家能够关注这一表现,并可能改善PsA患者的长期预后。