title: Age at disease onset may help to further characterize the disease phenotype in psoriatic arthritis.
abstract: OBJECTIVE
  To evaluate whether the age of disease presentation helps to better characterize the disease phenotype in PsA.
  
  
  METHODS
  Retrospective cohort study that included 205 consecutive patients fulfilling the CASPAR criteria for PsA. Study outcomes were assessed using univariate and multivariate analyses according to the age of onset of both skin and joint disease (cut off at 40years).
  
  
  RESULTS
  Early onset psoriasis (EOP) showed more extensive skin involvement (OR 2.3, P=0.011), axial pattern as disease onset (OR 4.6, P=0.009) and mixed pattern during evolution (OR 2.4, P=0.019), family history of both psoriasis (OR 3.1, P=0.003) and PsA (OR 4.0, P=0.021), higher prevalence of HLA-C*06 (OR 2.03, P=0.03) and HLA-B*27 (OR 2.7, P=0.02). Early onset arthritis (EOA) had more family history of PsA (OR 2.9, P=0.007), and HLA-B*27 positivity (OR 5.9, P<0.0001). Patients with late onset arthritis (LOA) were more likely to have DM (OR 4.0, P=0.009), hypertension (OR 2.5, P=0.004), dyslipidemia (OR 2.3, P=0.011), and obesity (OR 1.7, P=0.012). Late onset psoriasis (LOP) tended to have more obesity (OR 1.9, P=0.035), DM (OR 9.4, P<0.0001), hypertension (OR 4.1, P<0.0001), and ischemic heart disease during follow-up (OR 5.9, P=0.021). In multivariate analysis, LOP predicted DM development (OR 12.1, P=0.006). LOA was shown to be an independent risk factor for hypertension (OR 5.2, P=0.039).
  
  
  CONCLUSIONS
  Age at disease onset exerts a strong influence on several domains of disease phenotype in PsA. Therefore, this descriptor should be considered a good stratification option for epidemiological and genetic studies in PsA.
authors.affiliation: Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), Avenida de Roma, C/Celestino Villamil s/n, 33011 Oviedo, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Alonso
authors.affiliation: Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), Avenida de Roma, C/Celestino Villamil s/n, 33011 Oviedo, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Tejón
authors.affiliation: Clinical Epidemiology Unit, Complejo Hospitalario Donostia, 20080 Donostia, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Sarasqueta
authors.affiliation: Dermatology Division, Hospital Universitario Central de Asturias (HUCA), Avenida de Roma, C/Celestino Villamil s/n, 33011 Oviedo, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Coto
authors.affiliation: Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), Avenida de Roma, C/Celestino Villamil s/n, 33011 Oviedo, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Alperi
authors.affiliation: Rheumatology Division, Hospital Universitario Central de Asturias (HUCA), Avenida de Roma, C/Celestino Villamil s/n, 33011 Oviedo, Spain. Electronic address: rubenque7@yahoo.es.
authors.forename: Rubén
authors.initials: R
authors.lastname: Queiro
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D015535:Arthritis, Psoriatic / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
keywords: Age at disease onset; Cardiovascular risk factors; Psoriasis; Psoriatic arthritis