Correlation Between Insulin Resistance and Psoriatic Arthritis Disease Activity: A Cross-Sectional Study

Abstract

Objectives: Most psoriatic arthritis (PsA) research and studies focus solely on the skin and joint manifestations, but there is also an increased risk of metabolic disorders, including insulin resistance (IR). This study aims to discover the relationship between IR and disease activity (DA) in PsA and its phenotype. Materials and methods: Patients with PsA classified using the CASPAR criteria with the disease activity was measured using the DAPSA score, and IR was identified as an elevated HOMA-IR of >2.5. The disease phenotype was determined with Moll and Wright’s classification of the PsA subtype. The Pearson correlation test examined the relationship between DA and IR. The descriptive analysis was conducted to determine the relationship between the DAPSA score and HOMA-IR value in each PsA phenotype. All tests were two-tailed, analysed with GraphPad Prism 9, and a P-value of less than .05 was considered statistically significant. Results: From thirty-one patients, there was a strong and positive relationship between DA and IR (r = .768, P = .000). We also observed variations in DAPSA score and HOMA-IR value across different phenotypes, with symmetrical polyarthritis exhibiting the highest DAPSA score (21.55 ± 3.50) and HOMA-IR value (2.913 ± .5392) despite asymmetrical oligoarthritis that being the most frequent phenotype. Conclusion: Our study revealed a significant association between disease activity and insulin resistance in PsA patients, with the symmetrical polyarthritis phenotype demonstrating the highest levels of DAPSA score and IR value. This finding allowed rheumatologists to behold this manifestation and could improve PsA patients' long-term outlook.