Gonzalez-Gay Miguel A, Ferraz-Amaro Ivan, Castañeda Santos, Pinto Tasende Jose A, Uriarte-Ecenarro Miren, Plaza Zulema, Sánchez-Alonso Fernando, García Gómez Carmen, González-Juanatey Carlos, Llorca Javier
Instituto de Investigación Sanitaria (IIS)-Fundación Jiménez Díaz, Madrid, Spain
Division of Rheumatology, Fundación Jiménez Díaz, Madrid, Spain.
RMD Open. 2025 Mar 7;11(1):e005352. doi: 10.1136/rmdopen-2024-005352.
To evaluate the predictive value of the metabolic score for insulin resistance (METS-IR) in identifying patients with psoriatic arthritis (PsA) at high risk of cardiovascular (CV) events.
Assessment of patients with PsA enrolled in the Spanish prospective CARdiovascular in ReuMAtology (CARMA) project. Baseline data from 500 PsA patients without a history of CV events, chronic kidney disease, diabetes mellitus or statin use at the baseline visit were analysed. Patients were prospectively followed for 10 years in rheumatology outpatient clinics at tertiary centres. The performance of the METS-IR in predicting CV events was evaluated. METS-IR was categorised into three groups: <2.25, 2.25-2.48 and >2.48.
Over 4788 patient-years of follow-up, 27 individuals experienced at least one CV event. The annualised incidence rate was 5.6 events per 1000 patient-years (95% CI: 3.7 to 8.2). PsA patients with CV events had significantly higher METS-IR scores than those without CV events (2.37±0.24 vs 2.26±0.19; p=0.01). In this regard, patients who had CV events were more commonly included in the METS-IR 2.25-2.48 and >2.48 categories than those without CV events (p=0.008). Adjusted regression models indicated that PsA patients with a METS-IR >2.48 at baseline had an increased risk of experiencing a CV event during the follow-up period.
In PsA patients under close observation in rheumatology units included in the prospective CARMA project, METS-IR serves as a reliable prognostic predictor of CV.
评估胰岛素抵抗代谢评分（METS-IR）在识别银屑病关节炎（PsA）患者发生心血管（CV）事件高风险方面的预测价值。
对纳入西班牙前瞻性风湿病心血管疾病（CARMA）项目的PsA患者进行评估。分析了500例在基线访视时无CV事件、慢性肾病、糖尿病或他汀类药物使用史的PsA患者的基线数据。患者在三级中心的风湿病门诊接受了为期10年的前瞻性随访。评估了METS-IR在预测CV事件方面的表现。METS-IR分为三组：<2.25、2.25 - 2.48和>2.48。
在超过4788患者年的随访中，27例患者经历了至少一次CV事件。年化发病率为每1000患者年5.6次事件（95%CI：3.7至8.2）。发生CV事件的PsA患者的METS-IR评分显著高于未发生CV事件的患者（2.37±0.24对2.26±0.19；p = 0.01）。在这方面，发生CV事件的患者比未发生CV事件的患者更常被纳入METS-IR 2.25 - 2.48和>2.48类别（p = 0.008）。校正回归模型表明，基线时METS-IR>2.48的PsA患者在随访期间发生CV事件的风险增加。
在前瞻性CARMA项目纳入的风湿病科密切观察的PsA患者中，METS-IR可作为CV的可靠预后预测指标。
