LAUSR

Background Obesity is a comorbid condition in patients with psoriasis which tends to be less common in patients with psoriatic arthritis (PsA). In the general population, obesity is associated with increased inflammatory load and vascular risk, and with hypovitaminosis D. Objectives To explore the relationship between obesity and disease activity, vascular damage, serum concentrations of vitamin D (25OHD) and bone mineral density (BMD) in patients with PsA. Methods Descriptive cross-sectional study. Patients with PsA patients and peripheral joint involvement were consecutively included. Demographic (age, sex), clinical [duration of the disease, BMI (body mass index), DAS28] and analytical (25OHD, CRP, ESR) variables were collected. Patients with a BMI≥30 kg/m2; were considered obese, and we considered vitamin D deficiency when 25OHD<20 ng/ml and vitamin D insufficiency when 25OHD 20–30 ng/ml. Within a period of 3 months, atheroma plaque and intima media thickness (IMT) measurement was performed by ultrasonography of the carotid arterial tree using an Esaote MyLab70XVG with a 7–12 MHz linear transducer and an automated program measuring IMT through radiofrequency (Quality intima media Thickness in real time, QIMT). Pulse wave velocity (PWV) was obtained by analysis of brachial pulse waves with an automated and validated system (Mobil O Graph). IMT>900 µ and PWV ≥10 m/s were considered pathological. Measurement of BMD was performed using an HOLOGIC densitometer. Statistical analysis was performed with the SPSS 17.0 program. Results We included 108 patients, 60% women, with a meanage of 55,6 (SD 12,6) years and a mean duration of PsA of 19,5 (SD 28) years. The mean BMI was 27(DE 5,4) kg/m2;, 35% of the patients being obese. The mean CRP, ESR and DAS28 were 6,6 (DE 4,5) mg/l, 10,7(DE 11) mm/h and 2,32(DE 0,8), respectively. 28% of patients had 25OHD deficiency and 32% had 25OHD insufficiency. The mean values of the IMT and PWV were 715 (SD 149)µ and PWV 8 (SD 1.8)m/s, respectively. 12% of patients had osteoporosis, and up to 39% had osteopenia. Obesity was associated with a higher PsA activity measured by CRP (8.5 vs 5.7 mg/L, p=0.001) and ESR (38.6 vs 8.7 mm/h, p=0, 04), although DAS28 was not different between groups. We also observed differences between obese and non-obese regarding the mean values of IMT (770 vs 709 μ, p=0.046) and PWV (8.9 vs 8 m/s, p=0.021), the presence of atheroma plaque nearly reaching statistical significance (39% vs 30%, p=0,07). No association was observed between obesity and 25OHD levels, BMD and DAS28. Conclusions obesity is linked to an increased inflammatory load and more vascular damage in our PsA patients. A strategy of tight control of obesity and other vascular risk factors should be implemented when monitoring PsA patients. Disclosure of Interest None declared