Possible potential interactions between obesity, quality of life, psychological status and clinical parameters in psoriatic arthritis

Abstract

Background: Psoriatic arthritis (PsA), a chronic rheumatic disease associated with reduced quality of life. Obesity is an important clinical problem which may interfere with loss of functioning and quality of life. Obesity is usually an overlooked entity in patients with PsA. Several studies were invastigated prevalence and the impact of obesity on disease activity in patients with PsA, however relationship between psychological status and quality of life have not been evaluated comparatively. Objectives: To assess the impact of obesity on quality of life, psychological status and clinical parameters in patients with PsA. Methods: Patients with PsA were recruited who met CASPAR classification criteria enrolled by Turkish League Against Rheumatism-NETWORK (TLAR-NETWORK) derived from 24 different centers of our country. Patients with BMI 30 kg/m2 were considered obese. Differences among patients with or without obesity were assessed.VAS fatigue, psychological status and health related quality of life measures [SF-36; HAQ; Psoriatic arthritis quality of life (PsAQoL); Hospital Anxiety and Depresson Scale], FACIT-Fatigue, DAS28, BASDAI, BASFI, BASMI, Maastrich Ankylosing Spondylitis Enthesitis Score (MASES) and Psoriasis area severity index (PASI) scores were compered between this groups. Results: A total 1130 patients with PsA (36.0% male, 64.0% female) included in this study. In this cohort 37.6% obese and 62.4% non-obese. The presence of peripheral arthritis, enthesitis, dactylitis, uveitis and spine involvement, PASI scores as well as MASES scores were quite similar between patients with and without obesity. Obese patients had significantly higher scores in VAS fatigue and disease activity, poorer QoL and physical functions compared to non-obese patients (p<0.05). Obese patients had high risk for anxiety and depression (p <0.05). Conclusion: Obesity associated with the risk of depression and anxiety, fatigue, poorer QoL and higher disease activity.These findings suggest that obesity should be considered while assessing patients with PsA.