Metabolic Syndrome Associated With Changes in Spine and Entheses in PsA

A prospective observational study of patients with psoriatic arthritis (PsA) showed that metabolic syndrome (MetS) is associated with degenerative and metabolic changes in the spine and entheses, but not with radiographic damage.

The investigators set out to explore the association between MetS and peripheral and axial radiographic features in PsA.

Patients with PsA were followed from 1978 to 2024. “We identified patients with MetS on longitudinal follow-up and used generalized estimating equations (GEE) analysis to define the radiographic features independently associated with MetS, adjusting for age, sex, PsA disease duration, calendar decade, and use of targeted disease modifying anti-rheumatic drugs,” the authors wrote.

From a study population consisted of 1422 patients, 400 patients (28.1%) had MetS at baseline while 836 (58.79%) ever had a record of MetS over a median follow-up duration of 10.59 years. The mean age of the cohort at baseline was 44.43, with 789 (55.5%) patients identifying as male. Patients’ mean body mass index was 28.79 kg/m2.

“In the GEE analysis, MetS was not significantly associated with axial disease or radiographic damage to peripheral joints, assessed as the presence of syndesmophytes or sacroiliitis and the radiographic damaged joint count, respectively,” the authors wrote.

However, they noted, “MetS was significantly associated with calcaneal spurs, diffuse idiopathic skeletal hyperostosis, and degenerative disc disease.”

Kharouf F, Gao S, Tunc SE, et al. The association between metabolic syndrome and radiographic changes in psoriatic arthritis: a cohort study. Arthritis Care Res. Published online March 2, 2025. https://doi.org/10.1002/acr.25513