Obesity in Early Adulthood as a Risk Factor for Psoriatic Arthritis | Cancer Biomarkers | JAMA Dermatology | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 18.206.177.17. Please contact the publisher to request reinstatement.
1.
Henseler  TChristophers  E Disease concomitance in psoriasis.  J Am Acad Dermatol 1995;32 (6) 982- 986PubMedGoogle ScholarCrossref
2.
Naldi  LChatenoud  LLinder  D  et al.  Cigarette smoking, body mass index, and stressful life events as risk factors for psoriasis: results from an Italian case-control study.  J Invest Dermatol 2005;125 (1) 61- 67PubMedGoogle ScholarCrossref
3.
Cohen  ADGilutz  HHenkin  Y  et al.  Psoriasis and the metabolic syndrome.  Acta Derm Venereol 2007;87 (6) 506- 509PubMedGoogle ScholarCrossref
4.
Cohen  ADSherf  MVidavsky  LVardy  DShapiro  JMeyerovitch  J Association between psoriasis and the metabolic syndrome: a cross-sectional study.  Dermatology 2008;216 (2) 152- 155PubMedGoogle ScholarCrossref
5.
Huerta  CRivero  ERodríguez  L Incidence and risk factors for psoriasis in the general population.  Arch Dermatol 2007;143 (12) 1559- 1565PubMedGoogle ScholarCrossref
6.
Sterry  WStrober  BMenter  AInternational Psoriasis Council, Obesity in psoriasis: the metabolic, clinical and therapeutic implications: report of an interdisciplinary conference and review.  Br J Dermatol 2007;157 (4) 649- 655PubMedGoogle ScholarCrossref
7.
Marino  MGCarboni  IDe Felice  CMaurici  MMaccari  FFranco  E Risk factors for psoriasis: a retrospective study on 501 outpatients clinical records.  Ann Ig 2004;16 (6) 753- 758PubMedGoogle Scholar
8.
Murray  MLBergstresser  PAdams-Huet  BCohen  J Relationship of psoriasis severity to obesity using same-gender siblings as controls for obesity.  Clin Exp Dermatol 2009;34 (2) 140- 144PubMedGoogle ScholarCrossref
9.
Sakai  RMatsui  SFukushima  MYasuda  HMiyauchi  HMiyachi  Y Prognostic factor analysis for plaque psoriasis.  Dermatology 2005;211 (2) 103- 106PubMedGoogle ScholarCrossref
10.
Gelfand  JMGladman  DMease  P  et al.  Epidemiology of psoriatic arthritis in the population of the United States.  J Am Acad Dermatol 2005;53 (4) 573PubMedGoogle ScholarCrossref
11.
Krueger  GG Clinical features of psoriatic arthritis.  Am J Manag Care 2002;8 (6) ((suppl)) S160- S170PubMedGoogle Scholar
12.
Elkayam  OOphir  JYaron  MCaspi  D Psoriatic arthritis: interrelationships between skin and joint manifestations related to onset, course and distribution.  Clin Rheumatol 2000;19 (4) 301- 305PubMedGoogle ScholarCrossref
13.
Pitzalis  C Skin and joint disease in psoriatic arthritis: what is the link?  Br J Rheumatol 1998;37 (5) 480- 483PubMedGoogle ScholarCrossref
14.
Cohen  MRReda  DClegg  DDepartment of Veterans Affairs Cooperative Study Group on Seronegative Spondyloarthropathies, Baseline relationships between psoriasis and psoriatic arthritis: analysis of 221 patients with active psoriatic arthritis: Department of Veterans Affairs Cooperative Study Group on Seronegative Spondyloarthropathies.  J Rheumatol 1999;26 (8) 1752- 1756PubMedGoogle Scholar
15.
Gladman  DDAntoni  CMease  PClegg  DNash  P Psoriatic arthritis: epidemiology, clinical features, course, and outcome.  Ann Rheum Dis 2005;64 ((suppl 2)) ii14- ii17PubMedGoogle Scholar
16.
Libby  P Role of inflammation in atherosclerosis associated with rheumatoid arthritis.  Am J Med 2008;121 (10) ((suppl 1)) S21- S31PubMedGoogle ScholarCrossref
17.
Han  CRobinson  DJ  JrHackett  MParamore  LFraeman  KBala  M Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis.  J Rheumatol 2006;33 (11) 2167- 2172PubMedGoogle Scholar
18.
Escalante  AHaas  Rdel Rincón  I Paradoxical effect of body mass index on survival in rheumatoid arthritis: role of comorbidity and systemic inflammation.  Arch Intern Med 2005;165 (14) 1624- 1629PubMedGoogle ScholarCrossref
19.
Herron  MDHinckley  MHoffman  M  et al.  Impact of obesity and smoking on psoriasis presentation and management.  Arch Dermatol 2005;141 (12) 1527- 1534PubMedGoogle ScholarCrossref
20.
National Heart, Lung, and Blood Institute, Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdfAccessed October 1, 2009
21.
Ciocon  DHKimball  A Psoriasis and psoriatic arthritis: separate or one and the same?  Br J Dermatol 2007;157 (5) 850- 860PubMedGoogle ScholarCrossref
22.
McGonagle  DBenjamin  MTan  A The pathogenesis of psoriatic arthritis and associated nail disease: not autoimmune after all?  Curr Opin Rheumatol 2009;21 (4) 340- 347PubMedGoogle ScholarCrossref
23.
Tam  LSTomlinson  BChu  T  et al.  Cardiovascular risk profile of patients with psoriatic arthritis compared to controls: the role of inflammation.  Rheumatology (Oxford) 2008;47 (5) 718- 723PubMedGoogle ScholarCrossref
24.
Setty  ARCurhan  GChoi  HK Obesity, waist circumference, weight change, and the risk of psoriasis in women: Nurses' Health Study II.  Arch Intern Med 2007;167 (15) 1670- 1675PubMedGoogle ScholarCrossref
25.
Hamminga  EAvan der Lely  ANeumann  HThio  H Chronic inflammation in psoriasis and obesity: implications for therapy.  Med Hypotheses 2006;67 (4) 768- 773PubMedGoogle ScholarCrossref
26.
Tilg  HMoschen  A Adipocytokines: mediators linking adipose tissue, inflammation and immunity.  Nat Rev Immunol 2006;6 (10) 772- 783PubMedGoogle ScholarCrossref
27.
Lord  GMMatarese  GHoward  JBaker  RBloom  SLechler  R Leptin modulates the T-cell immune response and reverses starvation-induced immunosuppression.  Nature 1998;394 (6696) 897- 901PubMedGoogle ScholarCrossref
28.
De Rosa  VProcaccini  CCalì  G  et al.  A key role of leptin in the control of regulatory T cell proliferation.  Immunity 2007;26 (2) 241- 255PubMedGoogle ScholarCrossref
29.
Cerman  AABozkurt  SSav  ATulunay  AElbaşi  MErgun  T Serum leptin levels, skin leptin and leptin receptor expression in psoriasis.  Br J Dermatol 2008;159 (4) 820- 826PubMedGoogle ScholarCrossref
30.
Wang  YChen  JZhao  YGeng  LSong  FChen  H Psoriasis is associated with increased levels of serum leptin.  Br J Dermatol 2008;158 (5) 1134- 1135PubMedGoogle ScholarCrossref
31.
Takahashi  HTsuji  HTakahashi  IHashimoto  YIshida-Yamamoto  AIizuka  H Plasma adiponectin and leptin levels in Japanese patients with psoriasis.  Br J Dermatol 2008;159 (5) 1207- 1208PubMedGoogle Scholar
32.
Johnston  AArnadottir  SGudjonsson  J  et al.  Obesity in psoriasis: leptin and resistin as mediators of cutaneous inflammation.  Br J Dermatol 2008;159 (2) 342- 350PubMedGoogle ScholarCrossref
33.
Aviña-Zubieta  JAChoi  HSadatsafavi  MEtminan  MEsdaile  JLacaille  D Risk of cardiovascular mortality in patients with rheumatoid arthritis: a meta-analysis of observational studies.  Arthritis Rheum 2008;59 (12) 1690- 1697PubMedGoogle ScholarCrossref
34.
Gladman  DDAng  MSu  LTom  BSchentag  CFarewell  V Cardiovascular morbidity in psoriatic arthritis.  Ann Rheum Dis 2009;68 (7) 1131- 1135PubMedGoogle ScholarCrossref
35.
Kara  NAydin  FSenturk  N  et al.  Lack of association between the G-2548A polymorphism of the leptin gene and psoriasis in a Turkish population.  Int J Dermatol 2007;46 (12) 1271- 1274PubMedGoogle ScholarCrossref
Study
July 2010

Obesity in Early Adulthood as a Risk Factor for Psoriatic Arthritis

Author Affiliations

Author Affiliations: Department of Dermatology (Drs Soltani-Arabshahi, Feng, Goldgar, Callis Duffin, and Krueger) and College of Nursing (Dr Wong), University of Utah School of Medicine, Salt Lake City.

Arch Dermatol. 2010;146(7):721-726. doi:10.1001/archdermatol.2010.141
Abstract

Objective  To study whether obesity increases the risk of psoriatic arthritis (PsA), given that obesity is a risk factor for psoriasis and is associated with more severe disease.

Design  Case series. We used Cox regression analysis to study the relationship between obesity and PsA while controlling for age at psoriasis onset, current body mass index (BMI), sex, family history of psoriasis, worst-ever body surface area (BSA) involvement, Koebner phenomenon, and nail involvement.

Setting  Dermatology clinics at the University of Utah School of Medicine.

Patients  Volunteer sample of patients with dermatologist-diagnosed psoriasis enrolled in the Utah Psoriasis Initiative from November 2002 to October 2008 (943 subjects; 50.2% women, 49.8% men).

Main Outcome Measures  Physician diagnosis of PsA from self-report questionnaire.

Results  In our subjects, we found that BMI at age 18 years was predictive of PsA (odds ratio [OR], 1.06) (P < .01) over and above control variables. Other variables that were predictors of PsA included younger age at psoriasis onset (odds ratio [OR], 0.98) (P < .01), female sex (OR, 1.45) (P = .01), higher worst-ever BSA involvement with psoriasis (OR, 1.01) (P = .04), Koebner phenomenon (OR, 1.59) (P < .01), and nail involvement (OR, 1.76) (P < .01). Current BMI and family history of psoriasis were not significant predictors of PsA.

Conclusions  This study suggests that obesity at age 18 years increases the risk of developing PsA. Adiposity is associated with higher levels of inflammatory cytokines known to be associated with psoriasis. This inflammatory milieu could increase the risk of PsA in predisposed subjects. Prevention and early treatment of obesity may decrease the risk of PsA.

×