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Psoriatic arthritis linked with diabetes, other endocrine disorders
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Psoriatic arthritis was linked with diabetes, Cushing disease, hypothyroidism and osteoporosis, according to a recent analysis of Israeli patients.
Using a Clalit Health Services database, Devy Zisman, MD, at Carmel Medical Center in Israel, and colleagues identified 3,161 patients who were diagnosed with psoriatic arthritis (PsA) between 2002 and 2013. Validation of diagnosis in this cohort had a positive predictive value of 90.5%. Each patient with PsA was matched by age and gender with 10 controls from the general population who did not have rheumatic disease.
After adjustment for age, gender, smoking, obesity and steroid use, investigators found an increased risk for diabetes in patients with PsA (ratio = 1.35). After adjustment for age, gender, smoking and steroid use but not obesity, they noted an increased risk for osteoporosis (ratio = 1.56) for patients with PsA. An adjustment for only age and gender, revealed an increased risk for hypothyroidism (ratio = 1.61) among patients with PsA. In addition, only osteoporosis was linked to disease-modifying antirheumatic drug use (ratio = 1.37), which indicated a more severe stage of disease. However, investigators found no increased risk for Addison disease, acromegaly, hyperthyroidism, hypoparathyroidism, hyperparathyroidism, hyperprolactinemia, diabetes insipidus or pituitary adenoma.
“Physicians should be aware of these comorbidities and screen for [diabetes mellitus] DM, hypothyroidism and osteoporosis to provide optimal medical care to their patients with PsA,” Haddad and colleagues wrote. – by Will A. Offit
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Alan Menter, MD
Twelve comorbidities in the field of psoriasis and psoriatic arthritis have been well validated in the literature. This important statistical analysis on 3,161 psoriatic arthritis patients from Israel between 2002 and 2012 has again shown the important link between psoriatic arthritis and diabetes mellitus, as well as hypothyroidism. The new finding of a strong link of osteoporosis is important for all clinicians to understand and evaluate in the care of patients with a diagnosis of psoriatic arthritis. A recent coronary artery calcium (CAC) score study of 357 individuals with psoriasis, type 2 diabetes and normal controls showed an increase in the CAC score of the psoriasis patients was equal to that in the type 2 diabetes group, significantly higher than the normal control group.
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