Obesity and psoriatic arthritis: from pathogenesis to clinical outcome and management
Open Access
- 18 September 2012
- journal article
- review article
- Published by Oxford University Press (OUP) in Rheumatology
- Vol. 52 (1), 62-67
- https://doi.org/10.1093/rheumatology/kes242
Abstract
PsA is an axial and/or peripheral inflammatory arthritis associated with psoriasis, included in the group of spondylarthritides. It has been suggested that PsA could be a systemic disease, involving even coronary arteries and the heart. An increased prevalence of vascular risk factors has been found in PsA subjects as compared with the general population and psoriatic subjects. Moreover, PsA patients exhibit an increased prevalence of liver steatosis, a marker of metabolic syndrome, and of obesity. Interestingly, many reports demonstrate that adipose tissue is metabolically active, representing a source of inflammatory mediators, known as adipokines. The latter include TNF-α, macrophage chemoattractant protein-1, plasminogen activator inhibitor-1 (PAI-1), IL-6, leptin and adiponectin, leading to a pro-inflammatory status in obese subjects. This evidence supports the idea of obesity as a low-grade inflammatory disease. Accordingly, obesity might be associated with some rheumatic diseases. In particular, it seems to affect several features of PsA, such as its development, cardiovascular risk and clinical outcome. Recent data suggest that increased BMI in early adulthood increases the risk of PsA development in psoriatic patients, supporting a link between fat-mediated inflammation and joint involvement. Obesity may represent an additive cardio-metabolic risk factor in PsA subjects. Abdominal obesity may also determine an increased risk of not achieving minimal disease activity in PsA patients, highlighting the role of abdominal fat accumulation as a negative predictor of good clinical response to biologic agents. This review assesses the relationship between obesity and PsA according to the available literature.Keywords
This publication has 47 references indexed in Scilit:
- Platelet Reactivity and Disease Activity in Subjects with Psoriatic ArthritisThe Journal of Rheumatology, 2011
- Obesity, Visceral Fat, and NAFLD: Querying the Role of Adipokines in the Progression of Nonalcoholic Fatty Liver DiseaseISRN Gastroenterology, 2011
- Obesity is associated with fatal coronary heart disease independently of traditional risk factors and deprivationHeart, 2011
- The c-Abl tyrosine kinase controls protein kinase Cδ-induced Fli-1 phosphorylation in human dermal fibroblastsArthritis & Rheumatism, 2011
- Prevalence of atherosclerotic risk factors and the metabolic syndrome in patients with chronic inflammatory arthritisArthritis Care & Research, 2011
- Adiponectin in Cardiovascular Inflammation and ObesityInternational Journal of Inflammation, 2011
- Adipocytokines are associated with radiographic joint damage in rheumatoid arthritisArthritis & Rheumatism, 2009
- Incidence and clinical predictors of psoriatic arthritis in patients with psoriasis: A population‐based studyArthritis Care & Research, 2009
- LeptinAnnual Review of Physiology, 2000
- TrueInternational Journal of Obesity, 1998