Resumen

ZAFFARANA, C.A. et al. Prevalence of obesity in a cohort of patients with psoriatic arthritis and associated factors. Rev. argent. reumatolg. [online]. 2017, vol.28, n.2, pp.19-25. ISSN 0327-4411.

A high prevalence of obesity has been observed in patients with Psoriatic Arthritis (PsA). Also, an association with a greater severity of cutaneous psoriasis has been described, but its relationship with the severity of PsA has been less studied. Objectives: To evaluate the prevalence of obesity in a cohort of patients with PsA and their association with sociodemographic and clinical characteristics of the disease. Material and methods: We studied consecutive patients ≥18 years of age with a diagnosis of PsA according to CASPAR criteria of the RAPSODIA cohort. Sociodemographic data, time of evolution, form of onset, evolution of PsA, comorbidities and treatment were collected. Disease activity was assessed by counting 66/68 swollen and painful joints, respectively. DAS28 composite indices, DAPSA, BASDAI questionnaire and MDA criteria. Functional capacity (HAQ-A, BASFI), quality of life (DLQI, PsAQoL), cutaneous involvement (PASI), nail (PNSS), entesis (MASES) and presence of dactylitis. An analogous visual scale (AVS) was used to grade cutaneous psoriasis severity, pain and overall assessment of disease activity according to physician (EGEm) and patient (EGEp). Physical examination was performed with measurement of height (m), weight (kg) and blood pressure (mm Hg). The Body Mass Index (BMI)=weight/height² was calculated. Patients were classified according to the WHO International Classification of Nutrition Status in: Normal (BMI 18.5-24.9), Overweight (BMI 25-29.9) and Obesity (BMI ≥30). Obesity was classified as grade I or mild (BMI 30-34.9), grade II or moderate (BMI 35-39.9) and grade III or severe (BMI ≥40). Statistical Analysis: Descriptive Statistics. T test and ANOVA. Chi² and Fisher's exact test. Multiple logistic regression model (dependent variable: obesity). Results: We included 110 patients with PsA. 56 (50.9%) were men. The median BMI was 28.38 (BER: 15.5-32.2). 21 (19.1%) had normal BMI, 48 (43.6%) were overweight, 41 (37.3%) were obese. Of the obese patients, 33 (80.5%) had mild obesity, 6 (14.6%) moderate and 2 (4.9%) severe obesity. Obese patients had worse BASFI functional capacity: 4.4±2.8 vs. 2.7±2.5, p=0.03) and greater pain (6.7±7.6 vs. 4.6±2.4, p=0.048). No patient with normal weight had type II DBT, vs. 16 patients (18%) were overweight and obese (p=0.03). Mean PASI was higher in the obese and overweight group but this difference lost statistical significance when adjusted for evolution time. In the multiple logistic regression analysis, after adjusting for different variables (age, sex, functional capacity, time of evolution and pain), steroid treatment remained associated with the presence of overweight and obesity (OR: 3.93, 95% CI: 1.29-11.9, p=0.016). Conclusions: More than 80% of our cohort patients had an abnormal BMI. The presence of obesity was associated with worse functional capacity by BASFI and greater pain, and a BMI ≥25 was associated with the presence of DBT II. Steroid treatment was the only variable independently associated with overweight and obesity.

Palabras clave : obesity; prevalence; psoriatic arthritis.

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