Currado Damiano, Berardicurti Onorina, Saracino Francesca, Trunfio Francesca, Kun Lyubomyra, Marino Annalisa, Corberi Erika, Lamberti Ludovica, Ruscitti Piero, Liakouli Vasiliki, Vadacca Marta, Rigon Amelia, Arcarese Luisa, Pietramale Manuela, De Vincenzo Francesco, Vomero Marta, Ciccia Francesco, Giacomelli Roberto, Navarini Luca
Unit of Allergology, Clinical Immunology and Rheumatology, Department of Medicine, University Campus Bio-Medico di Roma, via Alvaro del Portillo 21, 00128, Rome, Italy.
Clinical and Research Section of Rheumatology and Clinical Immunology, Fondazione Policlinico Campus Biomedico, Rome, Italy.
Rheumatol Ther. 2025 Jun;12(3):581-592. doi: 10.1007/s40744-025-00758-6. Epub 2025 Mar 26.
Psoriatic arthritis (PsA) is a complex inflammatory disease often associated with metabolic syndrome (MetS). It has been demonstrated that pain catastrophizing (PC), characterized by an exaggerated negative cognitive and emotional response to actual or anticipated pain, impacts the achievement of remission and therapy discontinuation in patients with PsA. In this study, we evaluate the potential role of MetS, the most prevalent comorbidity in PsA, in influencing PC in patients with PsA.
We conducted a cross-sectional, observational study on 170 patients with PsA who met the Classification Criteria for PsA and MetS criteria. Data on disease activity, PC, and comorbidities were collected and analyzed using univariable and multivariable regressions.
Our results indicate a significant association between MetS and elevated PC levels in patients with PsA. Univariable analysis identified female gender, fibromyalgia, and higher Disease Activity for Psoriatic Arthritis (DAPSA) scores as factors associated with increased PC. Multivariable analysis, adjusted for age, sex, fibromyalgia, and DAPSA, confirmed that MetS independently correlates with higher PC levels (b = 8.84, 95% CI 4.66-13.02, p < 0.0001) and its domains (helplessness, rumination, magnification).
These findings suggest that MetS significantly impacts PC in PsA, underscoring the need for a multidisciplinary approach to patient management. This study highlights the importance of addressing MetS to reduce pain catastrophizing and enhance disease management in PsA.
银屑病关节炎（PsA）是一种复杂的炎症性疾病，常与代谢综合征（MetS）相关。研究表明，疼痛灾难化（PC），即以对实际或预期疼痛的过度负面认知和情绪反应为特征，会影响PsA患者的缓解和治疗中断。在本研究中，我们评估了PsA中最常见的合并症MetS在影响PsA患者PC方面的潜在作用。
我们对170例符合PsA分类标准和MetS标准的PsA患者进行了一项横断面观察性研究。收集疾病活动、PC和合并症的数据，并使用单变量和多变量回归进行分析。
我们的结果表明，MetS与PsA患者PC水平升高之间存在显著关联。单变量分析确定女性性别、纤维肌痛和较高的银屑病关节炎疾病活动（DAPSA）评分是与PC增加相关的因素。在对年龄、性别、纤维肌痛和DAPSA进行调整的多变量分析中，证实MetS与较高的PC水平（b = 8.84，95% CI 4.66 - 13.02，p < 0.0001）及其领域（无助感、沉思、放大）独立相关。
这些发现表明，MetS对PsA患者的PC有显著影响，强调了患者管理采用多学科方法的必要性。本研究强调了处理MetS以减少疼痛灾难化和加强PsA疾病管理的重要性。
